CA AB595

Health care service plans must obtain prior approval from the Department of Managed Health Care director before merging, consolidating, or being purchased, acquired, or controlled by any entity, including another health care service plan or licensed insurer.

Health care service plans must submit complete transaction descriptions, modified exhibits, federal or state agency approvals, and other documentation required by the director for approval determination.

The director may conditionally approve transactions with conditions benefiting subscribers and enrollees, and may disapprove transactions that would substantially lessen competition or create a monopoly in health care service plan products.

The department must hold a public meeting for major transactions (those affecting significant enrollees, involving material assets, or adversely affecting subscribers or the health care delivery system) and may hold meetings for other transactions before approving, conditionally approving, or disapproving.

Health care service plans must pay the same filing fees as other material modifications plus reimburse the director for independent analysis, competitive opinions, public meeting costs, and statement preparation expenses, regardless of the director's final approval decision.