Insurance omnibus: developmental services.

Existing law divides insurance into various classes, including long-term care insurance, which includes an insurance policy, certificate, or rider advertised, marketed, offered, solicited, or designed to provide coverage for diagnostic, preventive, therapeutic, rehabilitative, maintenance, or personal care services that are provided in a setting other than an acute care unit of a hospital. Existing law, for the purposes of long-term care insurance, defines "alternate plan of care" as a plan of care developed by a licensed health care practitioner that includes a specification of long-term care services required by an insured that are not specifically defined as a covered service under the policy, and specifies that an insurer is not required to include a provision in a long-term care insurance policy that authorizes an alternate plan of care. This bill, among other things, would clarify that an insurer and an insured may agree to use an alternate plan of care even if there is no provision in the long-term care insurance policy that specifically authorizes one, that neither an insurer nor an insured is obligated to negotiate an alternate plan of care, and that if an insurer does not accept an extra-contractual request for an alternate plan of care, the rejection is not a denial of a claim. Existing law requires the Insurance Commissioner to conduct an examination of the business and affairs of insurers admitted in this state at least once every 5 years. This bill would require an admitted insurer to maintain all records necessary to determine the financial condition of the insurer for the current year plus the 5 previous years. Existing law provides the means by which an insurer may redomesticate its principal place of business to this state or redomesticate to any other state in which it is admitted to transact the business of insurance. Existing law defines "redomestication" as the transfer of an insurer's place of incorporation from another state to this state or from this state to another state. Existing law requires the Secretary of State to file the certificate of redomestication of an insurer for which articles of incorporation have previously been filed if the commissioner has approved the redomestication. This bill would delete the above-described requirement that the Secretary of State file the certificate of redomestication, would require an insurer redomesticating to this state to file articles of incorporation with the Secretary of State, as prescribed, and would require an insurer redomesticating to another state to file a statement of redomestication with the Secretary of State, as prescribed. Existing law requires a property broker-agent and a casualty broker-agent to, prior to acting in the capacity of an insurance broker, file and continuously maintain in force the required bond. This bill would also require a personal lines broker-agent to comply with these requirements and would require that the bond be filed with the commissioner. Existing law prohibits a person who has failed any Department of Insurance license qualification examination 10 times within the previous 12-month period from enrolling in any further license qualification examinations for a period of 12 months. This bill would delete the above-described prohibition and would instead prohibit a person from being admitted to more than 10 license qualification examinations of the same type in any 12-month period, as specified. The bill would also specify the types of license qualification examinations covered by these provisions. Existing law provides requirements for specified licensees to include certain information on business cards, written price quotations, and print advertisements distributed in this state for insurance products. This bill, commencing January 1, 2019, would exempt, among others, insurance adjusters from these requirements, would add personal lines licensees and limited lines automobile insurance agents to the list of licensees to whom these requirements apply, and would modify the required information, as specified. Existing law provides that the information obtained in the administration of the Unemployment Insurance Law is for the exclusive use and information of the Director of Employment Development in the discharge of his or her duties and is not open to the public. However, existing law requires the director to permit the use of specified information for specified purposes, and allows the director to require reimbursement for direct costs incurred. Existing law provides that a person who knowingly accesses, uses, or discloses this confidential information without authorization is guilty of a misdemeanor. Existing law establishes the Employment First Policy, which is the policy that opportunities for integrated, competitive employment be given the highest priority for working-age individuals with developmental disabilities, regardless of the severity of their disabilities. This bill would require the Director of Employment Development to provide any peace officer with the Enforcement Branch of the Department of Insurance with specified information that relates to specific insurance fraud investigations, as provided. The bill would also require the Director of Employment Development to disclose specified information to the State Department of Developmental Services to assist the State Department of Developmental Services in the implementation of the Employment First Policy. By providing this information to the Department of Insurance and the State Department of Developmental Services, this bill would expand the crime related to the unauthorized disclosure of this information, and would impose a state-mandated local program. Existing law provides that all information and records obtained by the State Department of Developmental Services in the course of providing intake, assessment, and services to persons with developmental disabilities are confidential and may only be disclosed under specified circumstances. This bill would authorize the disclosure to authorized employees of the Employment Development Department of information and records obtained in the course of providing intake, assessment, and services to persons with developmental disabilities as necessary to enable the Employment Development Department to provide specific information to the State Department of Developmental Services for purposes of the Employment First Policy. This bill would also make technical, nonsubstantive changes, delete obsolete provisions, and correct cross-references. This bill would incorporate additional changes to Section 1095 of the Unemployment Insurance Code proposed by AB 1275 to be operative only if this bill and AB 1275 are enacted and this bill is enacted last. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.