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Anthem Blue Cross CA Security Breach Update Pt IV

Further updates regarding the security breach of Anthem's online application tracker program.

As of today, 470,000 individual subscribers have been notified of a potential compromise. 230,000 are in California, the rest across the various Anthem states.

There are some disturbing bits of information surfacing.

Apparently the breach went on for quite some time and was only discovered in March when an attorney who breached the system filed a class action lawsuit regarding the breach. I have at least two clients who were breached as far back as November, 2009.

Perhaps the most troubling is that, according to the Atlanta Journal-Constitution, a company investigation has yet to identify 10 computer addresses (IPs) that accessed information. This is of concern as this would indicate that these 10 breaches were not conducted by the attorney(s) and are IP addresses of unknown hackers.

I will update when I receive additional information. Questions for California subscribers should be addressed to Anthem individual membership at 800-333-0912.

Some current press articles on the Wellpoint/Anthem breach:

Reuters

Associated Press

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CA Temporary Federal Risk Pool Approved

Yesterday, two legislative bills were passed in Sacramento which will allow for California to run a temporary risk pool using federal funds (under PPACA). The risk pool will provide coverage on a temporary basis until January, 2014.

The two bills, SB 227 (Alquist) and AB 1887 (Beall) will provide both parity for mental health and substance abuse (AB 1887) as well as the temporary risk pool for uninsurable California residents (SB 227). Passage of SB 227 was predicated on prior passage of AB 1887.

California will receive $761,000,000 of federal funds for the risk pool. State sources indicate that the risk pool will not use any California state funds.

Details including qualification requirements, insurance plans (will be PPO style) and rates should be forthcoming from the MRMIB. MRMIP will run the program alongside the state major risk program.

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7 Cancer Symptoms Men Tend to Ignore

One should also listen to people close to you, such as your close friends or wife. Sometimes others notice things about us that we're unaware of or don't want to admit.

Below are some symptoms that are commonly overlooked and could be signs of cancer

1. Inexplicable Weight Loss
If you observe sharp decline in your body weight, even when there are no major changes to your diet or exercise regime, it's essential to find out why. Most of the times, unexplained weight loss
could be an early sign of colon and other digestive cancers.

2. Shortness of Breath
Often, lung cancer patients, when they look back remember noticing their inability to catch their breath. They couldn’t even walk short distances without wheezing. Chest pain shortness of breath, spitting blood can be signs of testicular cancer that spreads to the lungs.

3. Chronic Stomach Problems
Unexplained stomach aches, or feeling completely full even after a small serving of food are common early symptom of stomach cancer. Liver cancer patients have been known to frequently visit their doctors complaining of upset stomachs or stomach pains. Get an ultrasound done after consulting your doctor if you have a stomach ache that doesn’t go away.

4. Difficulty in Swallowing
Men identified with esophageal cancer, looking back remember a feeling of pressure and soreness when swallowing that just didn't go away. This is a sign of tightening of the esophagus which could mean the existence of a tumor. Sometimes it is one of the first signs of lung cancer too.

5. Frequent Infections
Catching infections easily or having fever often with body aches can indicate leukemia, a cancer of the blood cells. Here, the bone marrow produces abnormal white blood cells which drain the body's infection-fighting capabilities. See your doctor if you show these symptoms for over an extended period of time.

6. Swelling of Facial Features
Some patients later diagnosed with lung cancer reported noticing swelling, puffiness, or redness in the face. The explanation behind this is that lung tumors obstruct the blood vessels in the chest, thus checking blood from running freely from the head and face. Don’t ignore any puffiness on your face if it doesn’t go away.

7. Persistent heartburn
If you have frequent incidents of heartburn or a constant feeling of pain in the chest after eating anything, see your doctor and get screened for esophageal cancer. When the stomach acid ascends into the esophagus, it causes heartburn and a sour taste in the throat. It can set off a condition called Barrett's esophagus, which can lead to esophageal cancer.

Going through this brief guide on cancer in men will help you to learn about the diseases at early stages.

For assessing your risk factors for certain kinds of cancer, it is very important to study your family records of cancer properly.

Let your doctor know and together you can keep these cancers at bay.

source:http://www.themedguru.com/20100421/feature/7-cancer-symptoms-men-tend-ignore-86134338.html

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Anthem Security Breach Update

Article from the Orange County Register indicating that more than 200,000 affected so far by the security breach of the Anthem Blue Cross Online Application Tracker.

Orange County Register Article

According to the article, the attorneys who breached the system have returned all of the improperly obtained private information to a custodian of the court system. I expect that means that everyone who was affected by the breach can be assured that their private information is now safeguarded.

For clarification to the majority of my clients, this security breach does not impact HIPAA applications (nor small group). The application tracker program allows applicants (and apparently others) for individual & family plans to view a PDF of the electronic application. This PDF file contains the full application information including PHI and financial information.

HIPAA applications, like other "paper" applications, are not rendered to PDF for viewing and list on agent services as "application not submitted online -- not available for viewing". They are also not eligible for the application tracker program even though an e-mail is generated indicating it's availability.

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MRMIB Moving Forward on Fed Risk Pool

MRMIB (California's Major Risk Medical Board) is putting together the federal major risk pool program for California. According to the most recent document, MRMIB is targeting PPO model coverage plans allowing for provisions to match the new federal PPACA guideline (no annual or lifetime caps, lower deductibles (under $1500) and so on).

According the the MRMIB, target date for the risk pool to be operating is September, 2010.

According to information provide by Pricewaterhouse Coopers (PwC) to the MRMIB, enrollment in the new risk pool could be approximately 25,000 California residents.

For comparison, MRMIP (California's Major Risk Insurance Plan) enrolls a total enrollment of about 7,100.

The risk pool funding will be a combination of premium from subscribers and federal dollars. No state monies will be used to fund the California federal risk pool.

More information as soon as I get it. Remember, the two primary conditions a person must meet to participate in the federal risk pool are:

1. Uninsured for six months or longer and unable to obtain private, group or public health insurance

2. Must have a health condition determined by the pool as a qualifying condition (these have not been published yet)

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Anthem Security Breach Update

I have a couple of updates regarding the security breach of the Anthem Blue Cross "Application Tracker" system.

1. Anyone who submitted an application for a minor child/children only that was breached and has received ID theft protection for the minor(s) will, if there was information breach for the parent/guardian, also receive the protection. Anthem is currently sorting applications on minors-only to determine if any breach of the parent/guardian information also occurred. This may take a bit of time as the original determinations were made based on the applicants. Anthem will have to research applications in full to determine who else may have had PHI or private information compromised in regard to that application. You can contact member services at 800-333-0912 at Anthem Blue Cross for assistance.

2. It is important to bear in mind that, while Anthem Blue Cross has ultimate responsibility with regard to this hacker manipulation, the responsible party(s) is/are mainly attorneys who are looking to file a law suit against Anthem. Yes, the carrier is ultimately responsible for 100% security of your information, as are we agents.

3. I have never really understood the need for an "application tracker" program in the first place. Anthem has provided this "link" to track you own application online and, unfortunately, this is an unintended result. The application generates e-mail updates (which are secure) at any change of application status for any applicant who provides a valid e-mail address. Since you have to provide a valid e-mail address and select opt-in on e-mail notification to even receive the application tracker link, you will automatically receive the e-mail updates anyway. Unless you have a burning desire to view the PDF of your application, anything else will automatically be communicated by secure e-mail, thus rendering the application tracker program redundant.

This hack was not of an agent's database or agent log in access to the insurance company web site. This hack was on a program designed to let anyone who applies for individual coverage online with Anthem to track their own application. It is not necessary unless you have applied direct with the carrier since your independent agent will be monitoring progress and advising you (or should be!).

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Cartoon characters attract kids to junk food



Shrek, Dora the Explorer, and other lively TV and movie stars beloved by children have been moonlighting as junk-food pitchmen in recent years. And they're good at it.

Fifty percent of children say that food from a package bedecked with a cartoon celebrity such as Shrek tastes better than the same exact food from a plain package, according to a new study.

And when given a choice, the vast mass of kids pick the food from the cartoon-adorned package as a snack, the study found.

The use of TV and movie characters on food packaging is "premeditated to access certain feelings, memories, and associations," says Dr. Thomas Robinson, M.D., a professor of child health at the Stanford University School of Medicine, who was not involved in the study. "If you associate certain products with things that are otherwise considered fun, it's going to make those products seem more desirable."

Cartoon characters tend to appear on junk food, which makes health experts even more concerned about the magnetic effect they have on kids. Although characters such as Dora and SpongeBob SquarePants have been used to market fruits and vegetables, they are most often used on chips, candy, and other unhealthy snacks. SpongeBob has even hawked Kentucky Fried Chicken.


"Parents may not set out to buy unhealthy products," says the lead author of the study, Christina Roberto, M.S., a doctoral student at Yale University's Rudd Center for Food Policy and Obesity, in New Haven, Connecticut. "But kids can be really, really persuasive. They see them and they want them, and it gets difficult to have that battle in the grocery store."

In the study, which is in print this week in the journal Pediatrics, Roberto and her colleagues presented 40 children ages 4 to 6 with paired samples of graham crackers, gummy fruit snacks, and baby carrots. Each pair of sample foods was identical down to the clear packaging, except that one of the packages had a sticker of Shrek, Dora the Explorer, or Scooby Doo on it.

Between 50 percent and 55 percent of the children said that the food with the sticker on it tasted better than the same food in the plain package. (The percentage varied with each food.) And between 73 percent and 85 percent selected the food in the character packaging as the one they'd prefer to eat as a snack.


"Marketers know that cartoon characters sell food products; that's why they use them," says Marion Nestle, Ph.D., a professor of nutrition, food studies, and public health at New York University. "This study really nails it down. Now we have evidence for asking--no, requiring--food marketers to stop using cartoons to market junk foods to kids."

The American Psychological Association and other organizations have likewise called for the abolition of all marketing of food products to children, a stance that Robinson says is reasonable.

"Young children, particularly under the age of 7 or 8, really don't understand the persuasive intent of marketing," he says. "That seems inherently unfair, and something we should protect children from, just like we protect them from other things we think are beyond their cognitive ability, like pornography."

new ways to deal with picky eaters

Using the power of cartoon characters for good--to market healthy foods--may be less effective than restrictions on junk-food marketing, Roberto says. The cartoon characters had the least influence on children's preferences when they were on the package of baby carrots, she notes.

"It might be that they're not used to seeing [the characters] on vegetables," Roberto says. Or it might be that kids already know that "a carrot is a carrot is a carrot," she adds, whereas they're not sure how a specific brand of graham cracker or gummy snack will taste.

Is it Baby Fat or Obesity?

Food and beverage companies in the U.S. spend more than $1.6 billion each year to attract children's attention, and 13 percent of that is spent on character licensing and similar cross-promotion efforts, according to Federal Trade Commission data cited in the study.

But the calls for reform have had some impact. The use of licensed characters on food products declined between 2006 and 2008, according to research conducted by the Rudd Center.

"It's good to see the voluntary work on this," says Roberto. "But we'd like to see more."

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Blue Shield CA To Hold Current Rates For July 2010

Blue Shield of California announced today that the company would make no rate or benefit changes to individual & family health plans in California at this time.

Blue Shield's "product cycle" normally allows adjustments of rates and plan benefit changes two times per year, in January and July.

Communication to agents indicates that everything will remain as current in terms of price and benefits until the next product cycle, which will be announced at a later date.

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Anthem Blue Cross Security Breach (Individual Health)

Anyone who has recently applied for individual health insurance with Anthem Blue Cross and been assigned an online application tracker link needs to be aware of the following unauthorized security breach. Affected applicants will receive notification with details and one year of free identity protection services. No agent has been or likely will be notified of specific applicants (if any) who were affected.

PHI Breach by Individual Applicant, Attorneys

Anthem Blue Cross recently learned of a situation in which a small number of individuals manipulated the web address within the website we use to allow people to track the status of their Individual insurance applications. Through this manipulation, some of these individuals gained unauthorized access to certain private information.

The vast majority of the manipulation and the resulting unauthorized access occurred at the hands of certain attorneys, who were representing an applicant. We believe that this manipulation was conducted to support a class action lawsuit against Anthem Blue Cross or its parent company - over the very breach they were committing.

The ability to manipulate the web address (URL) was available for a relatively short period of time following an upgrade to the system. After the upgrade was completed, a third party vendor validated that all security measures were in place, when in fact they were not. As soon as the situation was discovered, we made the necessary security changes to prevent it from happening again.

Anthem has worked since discovery of this matter to analyze the data in an effort to identify all individuals whose information may have been impacted and prepared to communicate directly to affected members and applicants as soon as possible.

We have received no indication that any information has been used in a way that is detrimental to the applicant; however, out of an abundance of caution, all appropriate applicants will receive a detailed notification from Anthem explaining what happened, and will be offered identity protection services for one year at no cost.

Note: This does not impact Group, Senior or State-Sponsored Business.

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Schoolgirl, 12, with body of 96-year-old refuses to be beaten by aging disease by living life to the full



When Hayley Okines arrives home after a serious day at school she would have more reason to complain than most. The 12-year-old suffers from the quick aging disease progeria, an extremely rare condition that affects one in eight million people.

But despite suffering from arthritis, having little hunger and intriguing a cocktail of pills morning and night, the youth refuses to be beaten.

Her mother Kerry, told the Mail Online: 'I'm so proud of Hayley. No matter what life throws at her she just gets on with it. She doesn't let her arthritis stop her and runs around with her friends and she is very good at taking her medication.'

Hayley's life story is the subject of a documentary to be broadcast on Five tonight. When she last featured in the channel's 'Extraordinary People' series in 2007 she was about to take part in a pioneering medical trial in America.

Her parents from Bexhill, East Sussex, were hideously aware that the average lifespan for a child with progeria is only 13 years old and Hayley was devastated when she lost her best friend to the disease in 2006.



Hayley was well enough to attend her local secondary school and astonished her family by how well she adapted to her new surroundings.

Kerry said: 'We were worried because of the sheer size of the school and of rough and tumble because Hayley is quite fragile. But she settled in quickly and has made a couple of new friends as well. She is particularly good at science and maths.

'She also had her first sleepovers this year and the girls enjoyed chatting and playing on the Nintendo Wii and doing all the usual girly things.'

Kerry who has two other children - Louis, 8 and Ruby, 5 - is now hoping to organise a UK reunion for children with progeria, after the annual U.S event was cancelled due to a lack of funding.

Although they have managed to raise £4,000 to host the event they are still £14,000 short of their target.

'We're desperate not to cancel the event and have even looked at getting a bank loan,' Kerry said.


'We've already had families of 18 children with progeria say they would like to attend and we're hoping that a sponsor might come forward to help.

'It means so much to the children to meet others with the same condition.'

Kerry and her husband Mark will be taking Hayley back to Boston in July for another check-up and are confident Hayley will continue to deal with whatever life throws at her.

'Hayley just gets on with her life,' Kerry said.

'She is a fighter and has achieved a great deal in a short time.'

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California MRMIP Enrollment Waiting List

Recently I posted that MRMIP (California's State Major Risk Program) had eliminated the waiting list for enrollments. Apparently they have filled all of the open enrollment slots and now have a 1-month waiting list to enroll.

For information on MRMIP including plans, benefits and rates, visit my California Health Plans page.

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Bay Area sees increase in whooping cough cases

The Bay Area is in the middle of a whooping cough outbreak, with six times as many cases so far this year as last year, and public health officials are encouraging new parents to get vaccinated and avoid large crowds to protect their infants.

The entire state is seeing large increases in whooping cough, which is the familiar name for pertussis. So far five infants - all of them under 4 months old - have died in California, and all of them caught the disease from their mother or another caregiver.

None of the deaths have been in Northern California, but the Bay Area had 173 cases of whooping cough between January and the end of May, compared with 29 cases in the same period last year, according to the state public health department. Kaiser Permanente, the largest health care provider in the Bay Area, has seen 17 times more cases of pertussis in Northern California so far this year than last year.

"We would like to see everybody get immunized against pertussis - adolescents, adults, everyone. It's especially important for those around newborn infants," said Dr. John Talarico, chief of the immunization branch for the state public health department.



Whooping cough, which gets its name from the noise children make when they gasp for breath between violent coughs, is a respiratory infection that can be deadly in babies. It is usually just an annoying illness in older children and adults, although it can turn into bronchitis or other lung infections.

Natural cycle


The recent rise in whooping cough is probably due to the cyclical nature of an infectious disease: A large group of people gets sick and experiences a short period of immunity, and five or so years later, enough people have lost their immunity that the disease is able to spread freely again.

Pertussis was once thought to be on its way toward disappearing, like many once-widespread diseases that are now prevented with vaccines. But the whooping cough vaccine doesn't provide lifelong protection.

Babies start getting vaccinated at age 2 months and are considered fully protected by the time they enter kindergarten, but children probably lose their immunization by high school. Almost all adults are susceptible to the disease - and in fact, unprotected adults are "the reservoir" of infection that can spread to vulnerable babies, said Dr. Stephen Parodi, chief of infectious disease for Kaiser Permanente Northern California.

"We traditionally thought of pertussis as a children's disease, and that's who's been vaccinated in the past," Parodi said. "By the time we're young adults, we basically don't have immunity. That puts our young children at risk for getting exposed to it."

A vaccine for adults and older children became available in 2005 - it's known as the Tdap, and combines a pertussis vaccine with the tetanus booster shot adults should get every 10 years.

California public health officials are pushing programs to vaccinate all parents who have a baby. Vaccinations typically cost $67 in San Francisco. However, a coupon offering a discounted pertussis vaccination is given to anyone who picks up a birth certificate for a new baby.

Avoid crowds

Parents with newborns also might want to avoid large crowds for at least the first few months during the whooping cough outbreak, said Kathy Harriman, an epidemiologist with the state's public health immunization branch.

"It's probably not the greatest idea to take a new infant out amongst crowds, where you can't control who's around your infant, and people like to come up and take a look," Harriman said.

Doctors also stressed that parents of newborns check in with a pediatrician if a baby shows even mild symptoms of whooping cough, which resemble cold symptoms. The disease is easily treated with antibiotics, but by the time babies develop the obvious "whooping" noise in their cough, they are often very ill already.

"Infants who are infected initially don't look really sick," Harriman said. "They don't have a fever, they might have a runny nose, their cough might not be that noticeable. With a really young infant, I would err on the side of caution."


Symptoms of whooping cough

-- Initially, symptoms are similar to the common cold, and include runny nose, sneezing, red and watery eyes, and a dry cough.

-- After a week or two, severe coughing attacks may occur. Some individuals may develop a persistent hacking cough. For others, the coughing may be serious enough that patients bring up thick phlegm, vomit, turn red or blue in the face and become extremely fatigued. This is when the high-pitched "whoop" sound that defines the disease may become apparent.

-- Parents with infants should consult their pediatrician if their baby develops even mild cold symptoms in the middle of a whooping cough outbreak.

Whooping cough outbreak

California, and the Bay Area in particular, has seen a dramatic increase in whooping cough cases this year. Here are the statistics through May 31 compared with the same period in 2009:

California: 190 cases, no deaths in 2009; 584 cases, five deaths in 2010

Bay Area: 29 cases in 2009; 173 cases in 2010 (no deaths)

San Francisco had 20 confirmed or suspected cases of pertussis in all of 2009; it had 15 cases by May 27 this year. Alameda County had 33 cases in all of 2009 and 26 cases through May of this year.

source: http://topnews.co.uk/26001-number-patients-infected-whooping-cough-comparatively-more-year, http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2010/06/04/BALJ1DPMRJ.DTL

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Do you think Physical Therapy Is Like An Antibiotic ?



It seems to me that sometimes, in physical therapy, people decide to stop scheduling their appointments before I'm quite ready for that to happen. I'm sure this happens to practitioners like chiropractors as well. For us, here in Spokane, physical therapy needs are based on many factors. Only one of those is the patient's pain level. There are other reasons why people need physical therapy after a rotator cuff repair, ACL repair or car accident. When you first meet with your therapist you will probably remember that he tested lots of things about your injury, not just asked you about your pain. Why is this important you ask?

Physical therapy is like an antibiotic. Do you remember your doctor always telling you to take the whole course of the antibiotic even if your symptoms go away before you are done? The reason you need to do that is that the infection is not totally gone from your system until the antibiotic course is over. If you leave 5 or 6 pills in the bottle the infection will most likely make reappearance.



The same is true for physical therapy. When you therapist does your evaluation he finds lots of issues with your injury and only one of those is your pain. You may also have issues with range of motion, strength, endurance and function. At the end of your course of physical therapy, hopefully all of those issues will have been resolved. If you stop coming to your appointments because your pain is gone it is likely that all of your other issues have not yet been resolved. You didn't finish your "course of antibiotics". Most likely what that means is that with in a few weeks or if you're lucky a few months your original pain will return. The good news is that your therapist knows not only how to decrease your pain but how to treat all of those other issues so that your pain doesn't come back. If you commit to continuing your course of therapy until all your issues are resolved, not just your pain going away, it is much more likely your therapy will be successful for the long term. If your Spokane physical therapist completes your course of PT you will even be provided with strategies to deal with your issues in the future to help prevent their return. So when in doubt, talk to your therapist and if you still have issues with stability, strength or range of motion, continue your treatment until those are resolved and you will be much more successful.

After your physical therapy course has finished, and your physical therapist has discharged you from treatment, you will likely be given a home exercise program. Your PT should be able to give you some sort of timeline of how long you should perform your home exercise program. For some people this may mean for the rest of your life, but more commonly it will be for the next couple of months. Remember, pain is one of the worst indicators of biomechanical dysfunction. To read more visit: http://ezinearticles.com/?Physical-Therapy-Is-Like-An-Antibiotic&id=4966227

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CA SB 890 (Alquist)

There is a current California Senate Bill (SB 890) which I find intriguing.

SB 890 is currently under consideration and, if implemented ahead of full reform, would drastically change the landscape of individual health insurance in California.

Essentially, the bill would require all health insurance companies to offer a "standardized" portfolio of plans which would be limited to 5 PPO plans and 5 HMO plans. Any deviation from these 5 plan designs would be illegal to sell after July 2011. These plan designs generally mirror the design concept of the plans which will be available in the exchanges by 2014.

The plans would be designated as "Gold, Silver, Bronze, Platinum and Catastrophic". They would have a proscribed benefit level and include maternity coverage. By the way, there is another bill out there right now which would require all individual health plans to include maternity benefits again. No more non-maternity plans.

The ten standardized plans (5 PPO 5 HMO) would also function similarly to Medicare Supplements in terms of both standardization and the ability to move from one plan to another. Under SB 890, a subscriber may, at each policy anniversary, move to a plan of equal or lesser coverage on a guaranteed-issue basis. This is very similar to the California "birthday rule" for Medicare Supplement plans.

Another interesting note included in the text of SB 890 is the medical loss ratio information for California's health insurance carriers. Remember, on Jan 1 2011 carriers must comply with the new healthcare reform MLR requirements of 80% for individual and small group and 85% for large group.

You can read the text of SB 890 here

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California Moving Forward With Reform

According to a Mercury News article today, the California Legislature is moving forward with several reform bills in the coming weeks.

The legislation, which may include as many as 20 bills, would, amongst other things, create state health insurance exchanges, do away with denials for pre-existing health conditions, extend coverage to children and uncap benefit limits on health plans.

Governor Schwarzenegger has indicated that he wants many reforms in place in California before January, 2011, including health insurance exchanges.

The two most major bills are SB 900 (Alquist) and AB 1602 (Perez). Both bills would create a California insurance exchange which would operate similar to the Massachusetts Connector program.

It appears that California intends to at least try to get systems and programs in place well ahead of the final dates set by federal reform laws.

Current Version of SB 900

Current Version of AB 1602

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