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<ns0:Description>
<ns0:Id>20250SB__124499INT</ns0:Id>
<ns0:VersionNum>99</ns0:VersionNum>
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<ns0:Action>
<ns0:ActionText>INTRODUCED</ns0:ActionText>
<ns0:ActionDate>2026-02-19</ns0:ActionDate>
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<ns0:SessionYear>2025</ns0:SessionYear>
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<ns0:MeasureNum>1244</ns0:MeasureNum>
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<ns0:AuthorText authorType="LEAD_AUTHOR">Introduced by Senator Allen</ns0:AuthorText>
<ns0:Authors>
<ns0:Legislator>
<ns0:Contribution>LEAD_AUTHOR</ns0:Contribution>
<ns0:House>SENATE</ns0:House>
<ns0:Name>Allen</ns0:Name>
</ns0:Legislator>
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<ns0:Title> An act to add the heading of Article 1 (commencing with Section 10600) to Chapter 7 of Part 2 of Division 2 of, and to add Article 2 (commencing with Section 10610) to Chapter 7 of Part 2 of Division 2 of, the Insurance Code, relating to health care coverage. </ns0:Title>
<ns0:RelatingClause>health care coverage</ns0:RelatingClause>
<ns0:GeneralSubject>
<ns0:Subject>Public Agency Benefits Intermediary Compensation Disclosure Act. </ns0:Subject>
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<ns0:DigestText>
<html:p>Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law requires various disclosures to be made regarding health insurance benefits and coverages. Existing law generally regulates the conduct of business between insurers and broker-agents, including requirements regarding contracts in which the broker-agent represents the insurer.</html:p>
<html:p>This bill, the Public Agency Benefits Intermediary Compensation Disclosure Act, would require a covered service provider, defined to mean a broker, agent, consultant, or advisor that meets specified criteria, to disclose to a public agency or its group health plan the direct and indirect compensation it expects to receive for providing brokerage or consulting services, among other information, before it enters into, extends, renews, or materially amends a contract or
arrangement for brokerage services or consulting services with the public agency or its plan. The bill would also require a covered service provider to disclose compensation and material financial interests related to a covered health care benefits arrangement that the covered service provider recommends, places, renews, services, or materially influences for the public agency or its group health plan. Disclosure would be required under these provisions if the covered service provider reasonably expects it would receive $1,000 or more in compensation during the term of the contract or arrangement. The bill would require these disclosures at specified times.</html:p>
<html:p>This bill would prohibit a covered service provider from requesting, accepting, or receiving direct or indirect compensation in connection with brokerage services or consulting services provided to a public agency or its plan unless the compensation is disclosed, and would prohibit evasion of disclosure
requirements. The bill would authorize the Insurance Commissioner to investigate alleged violations of these provisions and would set forth specified administrative penalties for violations.</html:p>
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<ns0:VoteRequired>MAJORITY</ns0:VoteRequired>
<ns0:Appropriation>NO</ns0:Appropriation>
<ns0:FiscalCommittee>YES</ns0:FiscalCommittee>
<ns0:LocalProgram>NO</ns0:LocalProgram>
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<ns0:TaxLevy>NO</ns0:TaxLevy>
<ns0:Election>NO</ns0:Election>
<ns0:UsualCurrentExpenses>NO</ns0:UsualCurrentExpenses>
<ns0:BudgetBill>NO</ns0:BudgetBill>
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<ns0:Bill id="bill">
<ns0:Preamble>The people of the State of California do enact as follows:</ns0:Preamble>
<ns0:BillSection id="id_746A842E-F64A-4870-8AC0-584EF92045A9">
<ns0:Num>SECTION 1.</ns0:Num>
<ns0:Content>
<html:p>This act shall be known, and may be cited, as the Public Agency Benefits Intermediary Compensation Disclosure Act.</html:p>
</ns0:Content>
</ns0:BillSection>
<ns0:BillSection id="id_1EAE61F0-B5B7-4B55-B713-33CF0B78D00D">
<ns0:Num>SEC. 2.</ns0:Num>
<ns0:Content>
<html:p>The Legislature finds and declares all of the following:</html:p>
<html:p>
(a)
<html:span class="EnSpace"/>
Public agencies expend significant public funds on employee health care benefits and health care benefits-related services and must make procurement decisions transparently and in the public interest.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
Public agencies frequently rely on brokers, agents, consultants, and advisors to recommend, procure, renew, and service health care employee benefits arrangements and benefits-related vendors.
</html:p>
<html:p>
(c)
<html:span class="EnSpace"/>
Compensation arrangements, including indirect, contingent, or noncash compensation paid by carriers and vendors, including compensation not solely
attributable to a particular public agency contract, can create conflicts of interest that may not be visible to public purchasers and their governing bodies.
</html:p>
<html:p>
(d)
<html:span class="EnSpace"/>
Brokers, agents, consultants, and advisors currently receive compensation from multiple sources connected to their recommendations, including overrides, contingent or volume-based bonuses, retention bonuses, market-derived income, revenue sharing, referral fees, marketing allowances, administrative allowances, rebates, technology subsidies, and noncash benefits, which may create incentives misaligned with the interests of public agencies and their plan members.
</html:p>
<html:p>
(e)
<html:span class="EnSpace"/>
Under current federal law, the Employee Retirement Income Security Act (ERISA), group health plans are entitled to comprehensive broker and consultant compensation disclosure under Section 202 of the Consolidated Appropriations Act, 2021 (Public Law 116-260).
Public agencies sponsoring nonfederal governmental plans are not covered by ERISA and do not receive equivalent transparency protections, regardless of whether or not those responsible for procuring health care benefits owe fiduciary duties to plan members.
</html:p>
<html:p>
(f)
<html:span class="EnSpace"/>
Existing California law requires health care service plans and insurers to disclose broker compensation to public agency governing boards, but this plan-side disclosure does not capture the full scope of compensation that intermediaries receive from third-party sources, including vendors, pharmacy benefit managers, joint powers authorities, and other entities that may pay referral fees, revenue sharing, or other indirect compensation.
</html:p>
<html:p>
(g)
<html:span class="EnSpace"/>
It is in the public interest to require transparent, proactive disclosure of direct and indirect compensation and material financial interests so that public agencies and their governing
bodies can appropriately evaluate recommendations before acting on them. Unlike federal law, which requires disclosure only upon request by the plan, public agencies should receive disclosure automatically and in advance of any recommendations.
</html:p>
<html:p>
(h)
<html:span class="EnSpace"/>
Intermediaries should not be permitted to avoid disclosure obligations by restructuring compensation arrangements, relabeling services, or routing payments through affiliated or unaffiliated entities.
</html:p>
<html:p>
(i)
<html:span class="EnSpace"/>
It is the intent of the Legislature to bring parity in compensation transparency protections to California public agencies comparable to those applicable to ERISA plans under federal law, without imposing ERISA-style fiduciary duties, burdensome monitoring responsibilities, or reporting obligations on public agencies that may inadvertently raise health care costs for plan members.
</html:p>
<html:p>
(j)
<html:span class="EnSpace"/>
Transparency improves public purchasing outcomes and deters compensation structures that undermine competitive procurement for the benefit of public agencies, their plan members, and California taxpayers.
</html:p>
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<ns0:Num>SEC. 3.</ns0:Num>
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The heading of Article 1 (commencing with Section 10600) is added to Chapter 7 of Part 2 of Division 2 of the
<ns0:DocName>Insurance Code</ns0:DocName>
, to read:
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<ns0:LawHeading id="id_501C527B-A7C2-4DE6-A803-C9A70016663C" type="ARTICLE">
<ns0:Num>1.</ns0:Num>
<ns0:LawHeadingVersion id="id_F0C2277A-DAC0-4E76-814B-D04FD4205131">
<ns0:LawHeadingText>Health Insurance Disclosure Act of 1974</ns0:LawHeadingText>
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<ns0:BillSection id="id_5254C1A8-CFC9-466F-BD08-9322297B7E5B">
<ns0:Num>SEC. 4.</ns0:Num>
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Article 2 (commencing with Section 10610) is added to Chapter 7 of Part 2 of Division 2 of the
<ns0:DocName>Insurance Code</ns0:DocName>
, to read:
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<ns0:LawHeading id="id_A136F494-6E27-491A-9DCA-8689F54F3DCA" type="ARTICLE">
<ns0:Num>2.</ns0:Num>
<ns0:LawHeadingVersion id="id_710CED2C-3091-4181-AB33-5EBE764E806E">
<ns0:LawHeadingText>Public Agency Benefits Intermediary Compensation Disclosure</ns0:LawHeadingText>
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<ns0:LawSection id="id_22C43D61-9B7D-43B0-B91F-D204E6AEB28A">
<ns0:Num>10610.</ns0:Num>
<ns0:LawSectionVersion id="id_2FFB109D-3AA4-4852-9F46-002B350D6E6A">
<ns0:Content>
<html:p>For purposes of this article:</html:p>
<html:p>
(a)
<html:span class="EnSpace"/>
“Affiliate” means an entity that directly or indirectly, through one or more intermediaries, controls, is controlled by, or is under common control with another entity, or is an officer, director, or employee of, or partner in, that entity. Unless otherwise specified, “affiliate” refers to an affiliate of the covered service provider. “Affiliate” includes a person or entity created, recruited, or designated with the intent to avoid the disclosure requirements of this article.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
“Brokerage services” includes soliciting, recommending, placing, arranging, enrolling, renewing, extending, or otherwise materially influencing the selection of a covered health care benefits
arrangement or vendor for a covered plan or public agency, and related assistance with procurement, marketing, negotiation, or implementation of those arrangements.
</html:p>
<html:p>
(c)
<html:span class="EnSpace"/>
“Compensation” means anything of monetary value paid in cash or noncash form, including money, fees, commissions, consulting payments, retainers, overrides, contingent or volume-based compensation, bonuses including retention bonuses, referral fees, revenue sharing, marketing allowances, administrative allowances, rebates, technology subsidies, gifts, awards, trips, profit sharing, data access or data monetization payments, and any other remuneration or economic benefit received in connection with services provided to a public agency or covered plan, including credits, allowances, expense reimbursements, and expense offset.
</html:p>
<html:p>
(d)
<html:span class="EnSpace"/>
“Consulting services” includes advising a covered plan or public agency on plan design,
vendor selection, procurement strategy, benefits administration, evaluation of proposals, compliance support, or any other advisory service related to covered health care benefits arrangements.
</html:p>
<html:p>
(e)
<html:span class="EnSpace"/>
“Contract or arrangement” means an agreement, whether written, oral, or implied, pursuant to which a covered service provider provides or agrees to provide brokerage services or consulting services, and includes a broker of record letter, agent of record designation, or any similar authorization. The effective date of a broker of record letter or similar designation shall be treated as the date of entering into a contract or arrangement for purposes of the timing requirements in Section 10614.
</html:p>
<html:p>
(f)
<html:span class="EnSpace"/>
“Covered health care benefits arrangement” means a contract, policy, program, or arrangement for health care employee benefits or health care benefits-related services that is recommended,
placed, renewed, extended, or materially influenced by a covered service provider for a covered plan or public agency, including all of the following:
</html:p>
<html:p>
(1)
<html:span class="EnSpace"/>
Medical coverage, whether insured, self-funded, or both.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
Stop-loss, captive, or reinsurance arrangements.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
Dental coverage.
</html:p>
<html:p>
(4)
<html:span class="EnSpace"/>
Vision coverage.
</html:p>
<html:p>
(5)
<html:span class="EnSpace"/>
Voluntary or worksite benefits, including life insurance, disability insurance, accident insurance, critical illness insurance, and hospital indemnity insurance.
</html:p>
<html:p>
(6)
<html:span class="EnSpace"/>
Third-party administration services, including trust or joint powers authority administration, health reimbursement arrangements, health savings accounts,
flexible spending accounts, continuation coverage, and leave administration.
</html:p>
<html:p>
(7)
<html:span class="EnSpace"/>
Network administration services.
</html:p>
<html:p>
(8)
<html:span class="EnSpace"/>
Network access vendors and rental network arrangements.
</html:p>
<html:p>
(9)
<html:span class="EnSpace"/>
Provider aggregators, including centers of excellence and direct contract aggregators.
</html:p>
<html:p>
(10)
<html:span class="EnSpace"/>
Pharmacy benefit management services and related rebate programs.
</html:p>
<html:p>
(11)
<html:span class="EnSpace"/>
Pharmacy benefit cost containment programs.
</html:p>
<html:p>
(12)
<html:span class="EnSpace"/>
Recordkeeping services.
</html:p>
<html:p>
(13)
<html:span class="EnSpace"/>
Medical management and utilization review vendors.
</html:p>
<html:p>
(14)
<html:span class="EnSpace"/>
Wellness services and
programs.
</html:p>
<html:p>
(15)
<html:span class="EnSpace"/>
Transparency tools and data analytics vendors.
</html:p>
<html:p>
(16)
<html:span class="EnSpace"/>
Group purchasing organization preferred vendor panels.
</html:p>
<html:p>
(17)
<html:span class="EnSpace"/>
Disease management vendors and products.
</html:p>
<html:p>
(18)
<html:span class="EnSpace"/>
Care navigation and care management services.
</html:p>
<html:p>
(19)
<html:span class="EnSpace"/>
Telehealth services and platforms.
</html:p>
<html:p>
(20)
<html:span class="EnSpace"/>
Compliance services.
</html:p>
<html:p>
(21)
<html:span class="EnSpace"/>
Employee assistance programs.
</html:p>
<html:p>
(22)
<html:span class="EnSpace"/>
Human resource information systems.
</html:p>
<html:p>
(23)
<html:span class="EnSpace"/>
Benefits or coverages purchased through a multiemployer purchasing
arrangement, such as a joint powers authority, trust fund, or cooperative.
</html:p>
<html:p>
(24)
<html:span class="EnSpace"/>
Benefits or coverage for retirees, including Medicare supplement plans, Medicare Advantage plans, retiree health exchanges, and other retiree coverage programs.
</html:p>
<html:p>
(25)
<html:span class="EnSpace"/>
Actuarial services, including actuarial valuations, ratesetting analysis, reserve certifications, and other actuarial consulting related to covered health care benefits arrangements.
</html:p>
<html:p>
(26)
<html:span class="EnSpace"/>
Enrollment services and benefit enrollment platforms.
</html:p>
<html:p>
(27)
<html:span class="EnSpace"/>
Digital health and specialty condition management programs, including mental health, musculoskeletal, fertility and family-building, diabetes management, weight management, and substance use disorder programs.
</html:p>
<html:p>
(28)
<html:span class="EnSpace"/>
Reference-based pricing and direct contracting programs.
</html:p>
<html:p>
(29)
<html:span class="EnSpace"/>
Onsite, near-site, or shared-site clinic services.
</html:p>
<html:p>
(30)
<html:span class="EnSpace"/>
Claims auditing, claims repricing, and subrogation services.
</html:p>
<html:p>
(31)
<html:span class="EnSpace"/>
Dependent eligibility verification and audit services.
</html:p>
<html:p>
(32)
<html:span class="EnSpace"/>
Patient advocacy, health care concierge, and medical bill negotiation services.
</html:p>
<html:p>
(33)
<html:span class="EnSpace"/>
Benefits communication and employee education services.
</html:p>
<html:p>
(34)
<html:span class="EnSpace"/>
Banking and custodial services for health-related accounts, including health reimbursement arrangement, health savings account, and flexible spending account custodians.
</html:p>
<html:p>
(35)
<html:span class="EnSpace"/>
Captive insurance management and captive feasibility consulting services.
</html:p>
<html:p>
(36)
<html:span class="EnSpace"/>
Any other product, service, or vendor recommended if compensation is paid, directly or indirectly, because of the covered service provider’s recommendation, placement, renewal, or material influence. For purposes of this paragraph, “materially influence” includes providing advice, analysis, recommendations, or other input that was relied upon or adopted by the public agency in making a procurement, renewal, or vendor selection decision.
</html:p>
<html:p>
(g)
<html:span class="EnSpace"/>
“Covered plan” means a group health plan sponsored by a public agency in this state, including a nonfederal governmental plan, without regard to if the plan is self-funded, fully insured, or a combination of funding arrangements. “Covered plan” includes coverage purchased through a joint powers authority.
</html:p>
<html:p>
(h)
<html:span class="EnSpace"/>
“Covered service provider” means a broker, agent, consultant, or advisor that enters into a contract or arrangement with a covered plan or public agency and reasonably expects, knew, or should have known it would receive, compensation, direct or indirect, to be received in connection with providing brokerage services or consulting services described in this article, regardless of if those services will be performed, or the compensation received, by the covered service provider, an affiliate, a subcontractor, or a related party.
</html:p>
<html:p>
(i)
<html:span class="EnSpace"/>
“Direct compensation” means compensation received directly from the covered plan or from the public agency plan sponsor.
</html:p>
<html:p>
(j)
<html:span class="EnSpace"/>
“Indirect compensation” means compensation received from any source other than the covered plan, the public agency plan sponsor, the covered service provider, or an
affiliate. Compensation received from a subcontractor is indirect compensation unless it is received in connection with services performed under the subcontractor’s contract or arrangement.
</html:p>
<html:p>
(k)
<html:span class="EnSpace"/>
“Material change” means a change to any information required to be disclosed under this article, including a new source of compensation, a new category of compensation, a change in payer or recipient, a change in formula or methodology, or a change in assumptions used to estimate compensation, that a reasonable person would consider important in evaluating potential conflicts of interest.
</html:p>
<html:p>
(
<html:i>l</html:i>
)
<html:span class="EnSpace"/>
“Noncash compensation” means compensation that is not paid in cash, including travel, lodging, meals, entertainment, gifts, conference sponsorships, lead lists, technology, preferred access, or other items of value.
</html:p>
<html:p>
(m)
<html:span class="EnSpace"/>
“Public
agency” means the state, a county, a city, a city and county, a school district, a community college district, a special district, a joint powers authority, a public authority, a public entity, or any other governmental entity in this state that is authorized to sponsor, purchase, or administer employee health care benefits.
</html:p>
<html:p>
(n)
<html:span class="EnSpace"/>
“Related party” means a covered service provider’s affiliate, subcontractor, or any other person or entity through which compensation is paid or received in connection with services provided to a covered plan or public agency, including entities in which the covered service provider has an ownership or financial interest.
</html:p>
<html:p>
(o)
<html:span class="EnSpace"/>
“Responsible public agency official” means the public agency officer, employee, or governing body with authority to cause the public agency or covered plan to enter into, extend, renew, or materially amend a contract or arrangement
for services or a covered health care benefits arrangement.
</html:p>
<html:p>
(p)
<html:span class="EnSpace"/>
“Subcontractor” means any person or entity, or an affiliate of a person or entity, that is not an affiliate of the covered service provider and that, pursuant to a contract or arrangement with the covered service provider or an affiliate, reasonably expects compensation for performing one or more services in connection with a covered health care benefits arrangement.
</html:p>
<html:p>
(q)
<html:span class="EnSpace"/>
“Technology-related compensation” means fees, payments, credits, subsidies, or other consideration paid by carriers, vendors, or other third parties for use of, access to, licensing of, or integration with technology platforms, enrollment systems, benefits administration systems, eligibility management systems, data systems, or other proprietary tools owned, licensed, or operated by the covered service provider or a related party. Technology-related
compensation is indirect compensation for purposes of this article, regardless of how it is characterized by the parties.
</html:p>
</ns0:Content>
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</ns0:LawSection>
<ns0:LawSection id="id_7C33C962-7A1F-4F1E-BFF5-30E858561908">
<ns0:Num>10611.</ns0:Num>
<ns0:LawSectionVersion id="id_407E91A6-A06D-42A5-B7ED-7A7C9BA74608">
<ns0:Content>
<html:p>
(a)
<html:span class="EnSpace"/>
This article establishes disclosure requirements for brokers, agents, consultants, advisors, and other service providers that provide brokerage services or consulting services to California public agencies in connection with health care employee benefits, regardless of whether the covered service provider is domiciled, headquartered, or maintains a principal place of business within or outside of this state.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
The purpose of this article is to ensure that public agencies receive transparent disclosure of compensation and potential conflicts of interest on a reasonable timeframe to inform procurement and renewal decisions regarding health care benefits and benefits-related services.
</html:p>
<html:p>
(c)
<html:span class="EnSpace"/>
(1)
<html:span class="EnSpace"/>
This article imposes disclosure obligations on covered service providers.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
This article does not impose a fiduciary duty, validation duty, monitoring duty, reporting duty, disclosure request duty, or any civil liability on a public agency, a covered plan, or a responsible public agency official arising from any of the receipt or acknowledgment of a disclosure under this article.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
This article does not alter, expand, or diminish a fiduciary duty that may exist under other provisions of state, local, or municipal law.
</html:p>
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</ns0:LawSection>
<ns0:LawSection id="id_04C21C5E-0F17-4687-8BB2-86ACADB37D32">
<ns0:Num>10612.</ns0:Num>
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<ns0:Content>
<html:p>
(a)
<html:span class="EnSpace"/>
A covered service provider shall disclose to the responsible public agency official, and to the governing body of the public agency or the clerk or other designee identified by the governing body, in writing, the information described in Section 10613 before the covered service provider enters into, extends, renews, or materially amends a contract or arrangement for brokerage services or consulting services with the public agency or covered plan.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
A covered service provider shall disclose compensation and material financial interests related to a covered health care benefits arrangement that the covered service provider recommends, places, renews, services, or materially influences for a public agency or covered plan, including
compensation paid by carriers, vendors, third-party administrators, pharmacy benefit managers, enrollment firms, joint powers authorities, captives, and other sources, whether or not the compensation is solely attributable to the public agency’s specific contract or policy. This includes compensation received for recommending, facilitating, or influencing a public agency’s decision to join, remain with, or purchase coverage through a joint powers authority, regardless of whether the compensation is paid by the joint powers authority, a vendor contracting with the joint powers authority, or any other source.
</html:p>
<html:p>
(c)
<html:span class="EnSpace"/>
Disclosure is required pursuant to subdivisions (a) and (b) if a covered service provider reasonably expects it would receive, during the term of the contract or arrangement, one thousand dollars ($1,000) or more in compensation, direct or indirect, including compensation received by a related party. Noncash compensation shall be
included in this calculation and shall be disclosed if it exceeds two hundred fifty dollars ($250) in the aggregate during the term of the contract or arrangement, or if a reasonable person would consider it material.
</html:p>
<html:p>
(d)
<html:span class="EnSpace"/>
A description of compensation or cost may be expressed as a monetary amount, formula, percentage, or a per capita charge for each participant, beneficiary, enrollee, or insured. If the compensation or cost cannot reasonably be expressed in such terms, it may be described by any other reasonable method. The description may include a reasonable and good faith estimate if the covered service provider cannot otherwise readily describe compensation or cost, if the covered service provider explains the methodology and assumptions used to prepare the estimate. The description shall contain sufficient information to permit the public agency to understand the nature and potential magnitude of the compensation or cost and identify
potential conflicts of interest.
</html:p>
</ns0:Content>
</ns0:LawSectionVersion>
</ns0:LawSection>
<ns0:LawSection id="id_94FEB28D-8653-4081-A2D9-5B5826C8AC1D">
<ns0:Num>10613.</ns0:Num>
<ns0:LawSectionVersion id="id_73CB40A8-7DD9-401B-B096-F264A3B61AB8">
<ns0:Content>
<html:p>
(a)
<html:span class="EnSpace"/>
The written disclosure required pursuant to Section 10612 shall include, at a minimum, all of the following information, to the extent applicable:
</html:p>
<html:p>
(1)
<html:span class="EnSpace"/>
A description of the brokerage services or consulting services to be provided.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
If applicable, a statement that the covered service provider, an affiliate, or a subcontractor will provide, or reasonably expects to provide, services pursuant to the contract or arrangement directly to the public agency or covered plan as a fiduciary under applicable law. This paragraph does not create or expand fiduciary status under state law.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
A description of all direct
compensation, either in the aggregate or by service, that the covered service provider, an affiliate, a subcontractor, or a related party reasonably expects to receive in connection with the services described in paragraph (1).
</html:p>
<html:p>
(4)
<html:span class="EnSpace"/>
A description of all indirect compensation that the covered service provider, an affiliate, a subcontractor, or a related party reasonably expects to receive in connection with the services described in paragraph (1), including all of the following:
</html:p>
<html:p>
(A)
<html:span class="EnSpace"/>
A description of the arrangement pursuant to which the indirect compensation is paid.
</html:p>
<html:p>
(B)
<html:span class="EnSpace"/>
Identification of the services for which the indirect compensation will be received, if applicable.
</html:p>
<html:p>
(C)
<html:span class="EnSpace"/>
Identification of the payer of the indirect compensation.
</html:p>
<html:p>
(D)
<html:span class="EnSpace"/>
Indirect compensation includes compensation from a carrier, vendor, or third party based on a structure of incentives not solely related to the public agency’s contract or policy, including book-of-business incentives, volume bonuses, retention bonuses, and other market-derived income.
</html:p>
<html:p>
(E)
<html:span class="EnSpace"/>
A disclosure that identifies categories, types, or sources of compensation without providing corresponding amounts, good-faith estimates, or formulas for calculating amounts for each identified category, type, or source does not satisfy the requirements of this article. General descriptions of compensation arrangements that may exist or that the covered service provider may from time to time receive are insufficient. The disclosure shall state if the covered service provider reasonably expects to receive the compensation in connection with the specific public agency or covered plan during the
applicable contract period.
</html:p>
<html:p>
(5)
<html:span class="EnSpace"/>
A description of any compensation that will be paid among the covered service provider, an affiliate, subcontractor, or related party in connection with the services described in paragraph (1) if the compensation is set on a transaction basis, such as commissions, finder’s fees, placement fees, or other similar incentive compensation based on business placed or retained, including identification of the services for which the compensation will be paid and identification of the payers and recipients of such compensation.
</html:p>
<html:p>
(6)
<html:span class="EnSpace"/>
A description of any compensation that the covered service provider, an affiliate, related party, or a subcontractor reasonably expects to receive in connection with termination of the contract or arrangement, and how any prepaid amounts will be calculated and refunded upon termination.
</html:p>
<html:p>
(7)
<html:span class="EnSpace"/>
A description of the manner in which the compensation described in this section will be received.
</html:p>
<html:p>
(8)
<html:span class="EnSpace"/>
A description of noncash compensation, including the nature of the noncash compensation and a reasonable good faith estimate of fair market value.
</html:p>
<html:p>
(9)
<html:span class="EnSpace"/>
Identification of an ownership interest, equity stake, or other financial interest, including a pending or proposed interest under negotiation or under consideration, that the covered service provider or any related party holds in a carrier, vendor, or other entity that is a party to, or is recommended in connection with, a covered health care benefits arrangement.
</html:p>
<html:p>
(10)
<html:span class="EnSpace"/>
If any compensation cannot reasonably be expressed as a monetary amount at the time of disclosure, a reasonable and good faith estimate and
an explanation of the methodology and assumptions used to prepare the estimate, including any reasonable allocation methodology for compensation that is pooled across multiple clients.
</html:p>
<html:p>
(11)
<html:span class="EnSpace"/>
For all compensation disclosed pursuant to paragraphs (3), (4), (5), and (8), a breakdown showing all of the following separately:
</html:p>
<html:p>
(A)
<html:span class="EnSpace"/>
Compensation to the individual broker, agent, consultant, or advisor.
</html:p>
<html:p>
(B)
<html:span class="EnSpace"/>
Compensation to the firm or company by which the individual is employed or contracted.
</html:p>
<html:p>
(C)
<html:span class="EnSpace"/>
Compensation to an affiliate, subcontractor, or related party, regardless of whether the compensation is paid directly or routed through a third party or other entity.
</html:p>
<html:p>
(12)
<html:span class="EnSpace"/>
For covered service providers that
recommend, place, or service benefits arrangements for retirees, including Medicare supplement plans, Medicare Advantage plans, retiree health exchanges, or other retiree coverage, a separate statement disclosing all of the following:
</html:p>
<html:p>
(A)
<html:span class="EnSpace"/>
All compensation related to retiree benefits arrangements, broken out separately from compensation related to active employee arrangements.
</html:p>
<html:p>
(B)
<html:span class="EnSpace"/>
Whether compensation for retiree-related services is considered by the covered service provider in determining or offsetting fees for active employee services.
</html:p>
<html:p>
(C)
<html:span class="EnSpace"/>
Any arrangement pursuant to which retiree-related compensation subsidizes, offsets, or is otherwise connected to the pricing of services for active employee benefits.
</html:p>
<html:p>
(13)
<html:span class="EnSpace"/>
(A)
<html:span class="EnSpace"/>
Identification of
a material business relationship between the covered service provider, or any related party, and a carrier, vendor, or other entity that is a party to, or is recommended in connection with, a covered health care benefits arrangement, including all of the following:
</html:p>
<html:p>
(i)
<html:span class="EnSpace"/>
Consulting, advisory, or professional services agreements pursuant to which the covered service provider or related party provides services to the carrier or vendor.
</html:p>
<html:p>
(ii)
<html:span class="EnSpace"/>
Data sharing, data licensing, or data analytics agreements.
</html:p>
<html:p>
(iii)
<html:span class="EnSpace"/>
Product development, actuarial, underwriting support, or distribution agreements.
</html:p>
<html:p>
(iv)
<html:span class="EnSpace"/>
Joint ventures, strategic partnerships, or preferred partnership arrangements.
</html:p>
<html:p>
(v)
<html:span class="EnSpace"/>
Any other arrangement
pursuant to which the covered service provider or related party receives compensation from, or provides services to, a carrier or vendor that the covered service provider recommends, places, or services for the public agency.
</html:p>
<html:p>
(B)
<html:span class="EnSpace"/>
For purposes of this paragraph, a business relationship is “material” if the covered service provider or related party received or expects to receive compensation exceeding ten thousand dollars ($10,000) in the aggregate from the carrier or vendor during the twelve months preceding the disclosure or the twelve months following the disclosure.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
The disclosure shall include sufficient detail to permit the responsible public agency official and the governing body to understand the nature and potential magnitude of compensation and to identify potential conflicts of interest.
</html:p>
<html:p>
(c)
<html:span class="EnSpace"/>
The
disclosure shall be signed by an authorized representative of the covered service provider and shall include a certification that the disclosure is true, correct, and complete to the best of the signer’s knowledge and that the covered service provider will comply with the update and true-up requirements of this article.
</html:p>
<html:p>
(d)
<html:span class="EnSpace"/>
A covered service provider may satisfy this section through a standardized disclosure form adopted by the commissioner and may provide the disclosure electronically.
</html:p>
</ns0:Content>
</ns0:LawSectionVersion>
</ns0:LawSection>
<ns0:LawSection id="id_F735FAE4-8FEB-4F5B-86F3-D73B3F020CDF">
<ns0:Num>10614.</ns0:Num>
<ns0:LawSectionVersion id="id_3543CB2B-8B06-411F-9251-CD9C1475F130">
<ns0:Content>
<html:p>
(a)
<html:span class="EnSpace"/>
A covered service provider shall disclose the information required by Section 10613 in accordance with both of the following:
</html:p>
<html:p>
(1)
<html:span class="EnSpace"/>
For a prospective contract or arrangement, the covered service provider shall provide the required disclosure with the first written communication to the responsible public agency representative or governing board that contains a formal offer, proposal, or solicitation to provide brokerage, agent, advisory, or consulting services, and shall update the disclosure before execution if there is any material change to the expected compensation.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
For an extension, renewal, or material amendment of an existing contract or arrangement, the covered
service provider shall provide the required disclosure not later than 60 days before the effective date of the extension, renewal, or material amendment.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
If the covered service provider provides ongoing services, the covered service provider shall provide an updated disclosure annually, not later than 60 days before the renewal date of each covered health care benefits arrangement for which the covered service provider provides brokerage services or consulting services.
</html:p>
<html:p>
(c)
<html:span class="EnSpace"/>
A covered service provider is in compliance with subdivision (b) if the covered service provider provides a comprehensive disclosure covering all covered health care benefits arrangements not later than 60 days before the annual renewal date of the covered service provider’s contract or arrangement with the responsible public agency official or governing board.
</html:p>
<html:p>
(d)
<html:span class="EnSpace"/>
A covered service provider shall disclose a material change to information required under this article as soon as practicable, but not later than 30 days after the date on which the covered service provider is informed of the material change, unless the disclosure is precluded due to extraordinary circumstances beyond the covered service provider’s control, in which case the information shall be disclosed as soon as practicable.
</html:p>
<html:p>
(e)
<html:span class="EnSpace"/>
For any compensation disclosed as an estimate, the covered service provider shall provide an annual true-up that includes revised disclosure not later than 90 days after the end of the contract year or plan year, as applicable. For purposes of this subdivision, the “contract year” or “plan year” means the 12-month period used for coverage under the covered health care benefits arrangement, or, if that period is not specified, the 12-month period
following the effective date or renewal date of the contract.
</html:p>
<html:p>
(f)
<html:span class="EnSpace"/>
A covered service provider that discovers an error or omission in a disclosure shall provide corrected information as soon as practicable, but not later than 30 days after the date the covered service provider knows of the error or omission.
</html:p>
</ns0:Content>
</ns0:LawSectionVersion>
</ns0:LawSection>
<ns0:LawSection id="id_26D11C52-4A04-4B16-BE00-498B092CF68C">
<ns0:Num>10615.</ns0:Num>
<ns0:LawSectionVersion id="id_64F67824-AF83-4E2C-A32A-27A00C957CBE">
<ns0:Content>
<html:p>
(a)
<html:span class="EnSpace"/>
If a covered service provider provides brokerage services, consulting services, or administrative services to a joint powers authority, the covered service provider shall do both of the following:
</html:p>
<html:p>
(1)
<html:span class="EnSpace"/>
Provide the disclosures required by this article to the responsible official of the joint powers authority and governing body.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
Make the disclosures available, either directly or through the joint powers authority, to the governing body or responsible official of each public agency that participates in the pooled arrangement, upon request and at least annually.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
A joint powers authority that receives
disclosures under this section may do both of the following:
</html:p>
<html:p>
(1)
<html:span class="EnSpace"/>
Maintain the disclosures and make them available to its member public agencies upon request.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
Include in its annual reporting to member agencies a summary of compensation disclosed by covered service providers or provide a copy of the full disclosure.
</html:p>
<html:p>
(c)
<html:span class="EnSpace"/>
A covered service provider’s obligation to disclose under this article is not satisfied by disclosure solely to the joint powers authority if the covered service provider has a direct contractual relationship with a participating public agency for services related to covered health care benefits arrangements.
</html:p>
<html:p>
(d)
<html:span class="EnSpace"/>
For compensation that is pooled across multiple public agencies or that cannot be attributed solely to a single public
agency, the covered service provider shall use a reasonable allocation methodology and shall disclose the methodology used.
</html:p>
<html:p>
(e)
<html:span class="EnSpace"/>
A covered service provider that recommends, facilitates, or materially influences a public agency’s decision to join, remain with, or purchase coverage through a joint powers authority shall disclose to that public agency all compensation received or reasonably expected to be received, directly or indirectly, in connection with that recommendation, including all of the following:
</html:p>
<html:p>
(1)
<html:span class="EnSpace"/>
Referral fees, finder’s fees, or placement fees paid by the pooling arrangement or an entity affiliated with the pooling arrangement.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
Commissions, overrides, or other compensation paid by a carrier, vendor, or third party contracting with or through the pooling arrangement.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
Administrative fees, marketing allowances, or other payments received for maintaining or increasing membership in the pooling arrangement.
</html:p>
<html:p>
(4)
<html:span class="EnSpace"/>
An ownership interest, board position, governance role, or profit-sharing arrangement the covered service provider or a related party holds with respect to the pooling arrangement.
</html:p>
</ns0:Content>
</ns0:LawSectionVersion>
</ns0:LawSection>
<ns0:LawSection id="id_D915BCD1-312B-4863-A0EE-B15610F042A1">
<ns0:Num>10616.</ns0:Num>
<ns0:LawSectionVersion id="id_EF7CD122-BB7D-4ED1-B46B-5648FE757A3B">
<ns0:Content>
<html:p>
(a)
<html:span class="EnSpace"/>
A covered service provider shall not do any of the following:
</html:p>
<html:p>
(1)
<html:span class="EnSpace"/>
Request, accept, or receive direct or indirect compensation in connection with brokerage services or consulting services provided to a public agency or covered plan unless the compensation is disclosed pursuant to this article.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
Structure, route, recharacterize, allocate, or otherwise arrange compensation, including through an affiliate, subcontractor, or other related party, for the purpose of evading the disclosure requirements of this article.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
Relabel, rename, or recharacterize compensation as fees, consulting payments, administrative
charges, service fees, or any other designation for the purpose of circumventing the disclosure requirements of this article. The substance and economic reality of compensation arrangements shall govern their treatment under this article, regardless of the terminology used by the parties.
</html:p>
<html:p>
(4)
<html:span class="EnSpace"/>
Avoid disclosure obligations under this article by entering into a separate consulting agreement or advisory agreement for substantially similar services that would otherwise require disclosure.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
A covered service provider’s assertion, representation, or disclaimer that compensation does not impact, influence, or affect the covered service provider’s recommendations, the pricing of coverage or services, or the terms obtained for the public agency does not satisfy, reduce, or substitute for a disclosure requirement under this article and shall not be included in a disclosure as a basis for
omitting information otherwise required to be disclosed.
</html:p>
</ns0:Content>
</ns0:LawSectionVersion>
</ns0:LawSection>
<ns0:LawSection id="id_AD16F3FC-6AB1-4822-B52E-D230714956BB">
<ns0:Num>10617.</ns0:Num>
<ns0:LawSectionVersion id="id_C68AD810-B6F0-470C-9067-3711F7540EF0">
<ns0:Content>
<html:p>
(a)
<html:span class="EnSpace"/>
A covered service provider shall retain records sufficient to support the disclosures required by this article for not less than three years following the later of the following:
</html:p>
<html:p>
(1)
<html:span class="EnSpace"/>
The date the disclosure is provided.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
The termination of the contract or arrangement.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
Upon request by the commissioner, the Attorney General, a county counsel, a city attorney, or an authorized local prosecutor, a covered service provider shall make records described in subdivision (a) available for inspection.
</html:p>
</ns0:Content>
</ns0:LawSectionVersion>
</ns0:LawSection>
<ns0:LawSection id="id_24804174-B415-4A92-8BF0-92EFED226341">
<ns0:Num>10618.</ns0:Num>
<ns0:LawSectionVersion id="id_28E86C79-97A2-4D2E-97E3-F27451DBE42F">
<ns0:Content>
<html:p>
(a)
<html:span class="EnSpace"/>
The commissioner may investigate alleged violations of this article by a covered service provider that provides brokerage services or consulting services.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
(1)
<html:span class="EnSpace"/>
A covered service provider that violates this article is liable for an administrative penalty of not less than two thousand five hundred dollars ($2,500) for the first violation.
</html:p>
<html:p>
(2)
<html:span class="EnSpace"/>
A covered service provider that violates this article a second or subsequent time, or that commits a knowing violation of this article, is liable for an administrative penalty of not less than five thousand dollars ($5,000) and not more than fifty thousand dollars ($50,000) for each violation.
</html:p>
<html:p>
(3)
<html:span class="EnSpace"/>
For purposes of this subdivision, each public agency to which a covered service provider failed to provide required disclosure, or to which a covered service provider provided a disclosure that failed to comply with this article, shall constitute a separate violation.
</html:p>
<html:p>
(4)
<html:span class="EnSpace"/>
Administrative penalties collected pursuant to this subdivision shall be deposited in the General Fund.
</html:p>
<html:p>
(c)
<html:span class="EnSpace"/>
After a hearing conducted in accordance with Chapter 4.5 (commencing with Section 11400) and Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code, the commissioner may suspend or revoke the license of a covered service provider licensed under this code.
</html:p>
<html:p>
(d)
<html:span class="EnSpace"/>
The commissioner may adopt regulations to implement this article, including
standardized disclosure forms and guidance materials.
</html:p>
<html:p>
(e)
<html:span class="EnSpace"/>
The commissioner may refer violations to the Attorney General, a county counsel, or a city attorney, if appropriate.
</html:p>
<html:p>
(f)
<html:span class="EnSpace"/>
This section does not affect any other authority provided by law to the commissioner or the Attorney General.
</html:p>
</ns0:Content>
</ns0:LawSectionVersion>
</ns0:LawSection>
<ns0:LawSection id="id_95B45FD9-1728-465B-A92F-29BF13CAD183">
<ns0:Num>10619.</ns0:Num>
<ns0:LawSectionVersion id="id_7AA7318E-6E20-49F8-A24E-893B872E7C7B">
<ns0:Content>
<html:p>
(a)
<html:span class="EnSpace"/>
This article applies to contracts or arrangements entered into, extended, or renewed on or after January 1, 2028.
</html:p>
<html:p>
(b)
<html:span class="EnSpace"/>
The commissioner may adopt regulations necessary to implement this article.
</html:p>
<html:p>
(c)
<html:span class="EnSpace"/>
The commissioner shall develop and make available standardized disclosure forms and guidance materials not later than July 1, 2027.
</html:p>
<html:p>
(d)
<html:span class="EnSpace"/>
Public agencies and covered service providers are encouraged to voluntarily comply with this article before January 1, 2028.
</html:p>
</ns0:Content>
</ns0:LawSectionVersion>
</ns0:LawSection>
</ns0:LawHeading>
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