Health care coverage: investments: disclosure., the official text

An act to add Section 100524 to the Government Code, relating to health care coverage.

LEGISLATIVE COUNSEL'S DIGEST

Existing federal law, the Patient Protection and Affordable Care Act (PPACA), requires each state to establish an American Health Benefit Exchange to facilitate the purchase of qualified health benefit plans by qualified individuals and qualified small employers. Existing state law creates the California Health Benefit Exchange, also known as Covered California, to facilitate the enrollment of qualified individuals and qualified small employers in qualified health plans offered by participating carriers as required under PPACA.
This bill would require a carrier participating in the Exchange to annually disclose its material investment holdings to the Exchange on or before July 1 of each year, unless otherwise specified by regulation, beginning on July 1, 2027. The bill would require the Exchange to prominently display, and make accessible to the public, those disclosures on its internet website. If a carrier fails to comply with the disclosure requirements, the bill would require the Exchange to assess an administrative penalty against the carrier, as specified. The bill would require the Exchange to prominently post the carrier’s noncompliance status on its internet website until compliance is achieved.

The people of the State of California do enact as follows:

SECTION 1.
The Legislature finds and declares all of the following:
(a) Many health care service plans and health insurers in California receive significant public benefits through tax credits, regulatory privileges, and participation in publicly supported programs such as Covered California.
(b) Californians pay billions of dollars annually in health insurance premiums to health care service plans and health insurers with the expectation that those funds will be used primarily to support patient care and the delivery of health services.
(c) Consumers, policymakers, and the public currently have limited visibility into how health care service plans and health insurers invest their financial reserves and surplus funds.
(d) Greater transparency regarding investment holdings will help ensure accountability, inform public policy discussions, and strengthen public trust in California’s health care system.
(e) Providing public access to investment disclosures will allow consumers and policymakers to better understand how health care entities manage significant financial assets derived from patient premiums.

SEC. 2.
Section 100524 is added to the Government Code, immediately following Section 100523, to read:
100524.
(a) A carrier participating in the Exchange shall annually disclose its material investment holdings to the Exchange. The disclosure shall include both of the following:
(1) The 25 largest investment holdings of the carrier, regardless of whether or not those holdings are reported through a Form 5500 filed with the United States Department of Labor, other regulatory filing, subsidiary, affiliate, pooled investment vehicle, or other investment structure.
(2) A copy of the carrier’s Form 5500 filed with the United States Department of Labor.
(b) (1) The initial disclosure required by subdivision (a) shall include material investment holdings covering the five calendar years before January 1, 2027.
(2) Following the initial disclosure, a carrier shall update its disclosure annually to include material investment holdings for the immediately preceding calendar year.
(3) Annual disclosures shall be submitted to the Exchange on or before July 1 of each year, unless otherwise specified by regulation, beginning on July 1, 2027.
(c) The Exchange shall prominently display, and make accessible to the public, the disclosures required by this section and the carrier’s Form 5500 on the Exchange’s internet website.
(d) (1) If a carrier fails to comply with the disclosure requirements of this section within 30 days of the reporting deadline, the Exchange shall assess an administrative penalty against the carrier.
(2) The administrative penalty shall be one thousand dollars ($1,000) per day for each day the carrier remains out of compliance following the 30-day grace period.
(3) A carrier that fails to comply with the disclosure requirements of this section shall prominently post a notice on its public internet website stating that the carrier is not in compliance with California law requiring disclosure of investment holdings.
(4) The Exchange shall prominently post the carrier’s noncompliance status on its internet website until compliance is achieved.
(e) For purposes of this section, “material investment holdings” means investments the carrier has made in a calendar year that are a direct or indirect ownership interest, financial stake, or beneficial interest in an entity, fund, asset, or investment vehicle.