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CA AB2028
Bill
Status
2/1/2024
Primary Sponsor
Liz Ortega
Click for details
AI Summary
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Requires health care service plans and health insurers that issue specialized dental health care contracts or policies to maintain a minimum medical loss ratio (MLR) of 85%
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Mandates annual rebates to enrollees or insureds on a pro rata basis if the MLR falls below 85%, calculated as the difference between 85% and the actual MLR multiplied by total premium revenue
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Applies MLR requirements to dental-specific coverage while exempting Medi-Cal, Medi-Cal Access Program, and California Major Risk Medical Insurance Program policies
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Exempts disability insurance for dental-only coverage that pays fixed benefits on a cash payment only basis from the MLR requirements
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Declares no state reimbursement is required under Article XIII B of the California Constitution because violations constitute crimes under existing health care service plan regulations
Legislative Description
Medical loss ratios.
Last Action
In committee: Set, first hearing. Hearing canceled at the request of author.
4/18/2024