Current through Register 2024 Notice Reg. No. 38, September 20, 2024
(a) By April
1, 2009, every health insurer shall have established and implemented a Language
Assistance Program (LAP) that complies with the requirements of Insurance Code
sections
10133.8 and
10133.9 and this
regulation. The Commissioner shall allow health insurers a reasonable degree of
flexibility in the methods by which they achieve compliance.
(b) The LAP shall be documented in a plan with
comprehensive written policies and procedures that describe, at a minimum, the
following elements: assessment of insureds; provision of language assistance
services; staff training; and compliance monitoring. In addition, the policies and
procedures shall include the following:
(1) How
insureds will be informed of the availability of language assistance services at no
charge to insureds and how to access those services;
(2) How contracting providers will be notified of
the health insurer's LAP requirements for provision of language assistance services
including the notice of the availability of language assistance services;
(3) How a survey of the language preferences and
assessment of the linguistic needs of the insured population will be conducted
including an explanation of the methodology for collection of relevant
data;
(4) How vital documents will be
translated into the indicated/threshold languages including standards to ensure the
quality and accuracy of the written translation;
(5) How the insurer will provide individual access
to interpretation services including an explanation of the standards to ensure the
quality and timeliness of oral interpretation services;
(6) A training plan for the provision of adequate
and ongoing training regarding the LAP for all health insurer staff who have contact
with LEP persons. The training shall include instruction on, among other things, the
health insurer's policies and procedures for accessing language assistance, working
effectively with LEP persons, working effectively with in-person and telephonic
interpreters, and, cultural differences among and diversity of the health insurer's
insured population; and,
(7) How the
insurer will evaluate the LAP including an analysis of complaints and satisfactions
surveys.
(c) Every health
insurer shall develop a written notice that discloses the availability of language
assistance services to insureds and explains how to access those services.
(1) A copy of this notice shall be included with
all vital documents and all new and renewing insured welcome packets or similar
correspondence from the health insurer confirming a new or renewed enrollment. The
notice of availability of translated vital documents shall be translated into the
threshold languages; however, nothing in this section shall prohibit an insurer from
translating the notice into additional languages. A written notice shall also advise
LEP insureds of the availability of interpreter services in his/her preferred spoken
language at all points of contact.
(2)
The Commissioner may develop the notice advising LEP insureds of the availability of
language assistance services. Insurer specific information regarding how to access
those services shall be provided by the health insurer. If the notice is developed
by the Commissioner, it shall reflect that access to oral interpretation services
requires informing insureds of the availability of interpreter services in his/her
preferred spoken language and that availability of translated vital documents
requires informing insured in the threshold languages that vital documents are
available in specifically identified threshold languages. Health insurers shall
provide the Commissioner's notice to their insureds as specified in these
regulations.
(d) Health
insurers shall require compliance with their language assistance program developed
pursuant to these regulations by every contractor, health care provider, and any
network that is contracted to provide health care to insureds. Health insurers who
directly contract with health care providers or who lease networks of health care
providers shall use these contracts to implement the specific provisions of the
health insurer's LAP, seeking amendments to such contracts as needed within a
reasonable time of the effective date of these regulations. Health insurers shall
retain financial responsibility for the implementation of the LAP except to the
extent that delegated financial responsibility has been negotiated separately and
incorporated by reference into its contract.
(e) By December 1, 2008, every health insurer
shall file their LAPplan with the Commissioner, in accordance with sections
10133.8 and
10133.9 of the
Insurance Code.
(1) The plan shall include but is
not limited to the written LAP policies and procedures, together with information
and documents sufficient to demonstrate compliance with the requirements and
standards of Insurance Code sections
10133.8 and
10133.9 and
these regulations. The filing shall include the section
10133.8(b)(3)(B)(v)
notice to insureds regarding the availability of language assistance services and
how to access those services. All material filed with the Commissioner that contains
documents in non-English languages shall include the English version of each
non-English document as well as an attestation by the translator stating the
qualifications of the translator and affirming that the non-English translation is
an accurate translation of the English version.
(2) The Commissioner shall evaluate the totality
of the health insurer's LAP to determine whether the program as a whole provides
meaningful access for LEP insureds. This evaluation shall include a review of the
information obtained from health insurer's biennial reporting to the Commissioner as
required by these regulations and may consider relevant operational and demographic
factors, including but not limited to:
(A) The
nature of insureds points of contact;
(B) The frequency with which particular languages
are encountered including specific challenges encountered in providing meaningful
access and the process by which insurers address these challenges;
(C) The type of provider network or networks and
methods of health care service delivery;
(D) The variations and character of a health
insurer's service area;
(E) The
availability of translation and interpretation services and professionals;
(F) The health insurer's implementation of best
practices and utilization of existing and emerging technologies to increase access
to language assistance services, such as video interpreting programs, language
translation software, collaboration with other health insurers to share a pool of
interpreters, and other methods and technologies.
(3) The Commissioner shall periodically review
health insurer compliance with the standards and requirements of section 10133.8 and
10133.9 of the
Insurance Code and these regulations by methods that may include, but are not
limited to, market conduct exams, reviews of consumer grievances and complaints and
health provider complaints to the Department of Insurance. The Commissioner may also
periodically request that health insurers submit information and data regarding
insureds language needs and demographic profile.
1. New section
filed 9-19-2007; operative 10-19-2007 (Register 2007, No.
38).
Note: Authority cited: Sections
10133.8 and
10133.9,
Insurance Code. Reference: Sections
10133.8 and
10133.9,
Insurance Code.
