While all the major insurers in California now have electronic personal health records in place, only about 5 percent of health plan members are taking advantage of them and the industry is struggling with issues of records portability. The average profit margin for multi-line HMOs in California in 2007 was 5.6 percent, according to data compiled by HealthLeaders-InterStudy, with the highest margin belonging to Blue Shield of California at 8.9 percent. Average premium rates for members of CalPERS will increase by an overall 4.3 percent for 2009 – the lowest increase in more than a decade. The CalPERS board praised Blue Shield of California for sharing with members its savings achieved from lower medical cost trends, but it chastised Kaiser Foundation Health Plan for refusing to budge from its 8.1-percent rate hike. By January 2009, HMOs will have to comply with regulations mandating interpretation services in any language in which the member of a commercial plan requests it. A California-based Medicare plan, SCAN Health plan, is looking to expand into new markets beyond California and Arizona. Finally, while the legalization of gay marriage in California will have little effect on insurers that have already insured domestic partners through group plans, the law could have more far-reaching impact on health benefits in other states.