President Obama Favors Repealing Antitrust Exemption

Last year the House passed legislation which would repeal the limited exemption the insurance industry received when Congress passed the McCarran-Ferguson Act of 1945. The law shields insurance companies from federal antitrust laws as long as they are subject to state regulations. Among those opposed to a repeal of the exemption is Nebraska Senator Ben …

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California to Announce New Rules for HMO Members

On Wednesday, the California Department of Managed Health Care (“CDMH”) is scheduled to roll out new regulations that limit HMO members’ wait times for an appointment with a physician or specialist, the Los Angeles Times reports. The rules stem from a 2002 state law that called for HMOs to provide faster access to medical care. …

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California’s 2009 Insurance Legislation: It Was an Important Year

2009 was an important year for insurance legislation in California.  An excellent review of this legislation was posted on December 4, 2009 by the Barger & Wolen LLP legal blog (quoted verbatim from the blog) as follows: “LIFE, HEALTH AND DISABILITY INSURANCE” 1. AB 23: Cal-COBRA Premium Assistance Establishes notice requirements that must be provided …

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California Health Insurance Premiums Double in 7 Years

The National Underwriter reports that between 2002 and 2009, health care premiums in California rose almost 118%, a new study by the California HealthCare Foundation finds.  In the same period, California’s overall inflation rate increased 23%.  Single coverage premiums in California cost $5,133 annually in 2009, while premiums for family coverage were $13,525. The survey …

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California Insurance Commissioner Unveils Proposed Rescission Regulations

California Insurance Commissioner Steve Poizner unveiled his proposed regulations to, according to an LA Times article dated June 3, 2009, “combat the health insurance industry practice of dropping members with costly illnesses.” According to the article, Poizner’s draft regulations would require insurers to write applications for coverage in “plain English and allow applicants a ‘not sure’ answer to …

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Court of Appeal Complicates the Analysis of Mental and Nervous Disability Claims

Bosetti v. The United States Life Ins. Co., 175 Cal. App. 4th 1208 (2009) is an important California Court of Appeal decision that addressed whether a two-year benefits limitation on disabilities due to “mental, nervous or emotional disorder[s]” could serve to limit benefits payable to an insured disabled from depression and anxiety who also complained …

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Will Healthcare Reform Affect the Rate of Claim Denials?

On Monday October 19, 2009, Lisa Girion of the Los Angeles Times reported on the healthcare reform bills being debated in Congress and their potential impact on claim denials by insurers. Girion states that, “Despite growing frustration with the way health insurers deny medical treatments, major healthcare bills pending in Congress would give patients little …

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House Committee Votes to Strip Health Insurance Industry of Exemption from Federal Antitrust Laws

As reported by the Associated Press, a House committee has voted to strip the health insurance industry of its exemption from federal antitrust laws as senators announced plans to take the same step.  The House Judiciary Committee voted 20 to 9 to repeal a law that exempted the health insurance industry from federal controls over certain …

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No More Gender Rating in California

The practice of paying different rates based on gender for the same insurance is called gender rating.  Effective January 1, 2010, health insurance companies and HMO’s writing insurance in California will not be able to charge men and women different rates for the same type of insurance policy.  It has been reported that currently, California women …

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Phone: 800-682-4137

We also have offices in Los Angeles, San Diego and San Francisco.

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