Title INS, California Ins. Code

The commissioner shall have the authority to determine whether a health benefit plan is covered by this chapter, and to determine whether an employer is a small employer within the meaning of Section 10753. (Added by Stats. 2012, Ch. 852, Sec. 14. (AB 1083) Effective January 1, 2…

The commissioner may issue regulations that are necessary to carry out the purposes of this chapter. (Added by Stats. 2012, Ch. 852, Sec. 14. (AB 1083) Effective January 1, 2013.)

(a) A group or individual policy or contract or certificate of group insurance or statement of group coverage providing benefits to employees of small employers as defined in this chapter shall not be issued or delivered by a carrier subject to the jurisdiction of the commissione…

(a) For contracts expiring after July 1, 1994, 60 days prior to July 1, 1994, an association that meets the definition of guaranteed association, as set forth in Section 10753, except for the requirement that 1,000 persons be covered, shall be entitled to purchase small employer …

Every carrier shall file with the commissioner the reasonable participation requirements and employer contribution requirements that are to be included in its health benefit plans. Participation requirements shall be applied uniformly among all small employer groups, except that …

(a) With respect to small employer health benefit plans offered outside the Exchange, after a small employer submits a completed application, the carrier shall, within 30 days, notify the employer of the employer’s actual rates in accordance with Section 10753.14. The employer ha…

A health benefit plan shall not impose a preexisting condition provision or a waiting or affiliation period upon any individual. (Repealed and added by Stats. 2014, Ch. 195, Sec. 13. (SB 1034) Effective January 1, 2015.)

Nothing in this chapter shall be construed as prohibiting a carrier from restricting enrollment of late enrollees to open enrollment periods provided under Section 10753.05 as authorized under Section 2702 of the federal Public Health Service Act. (Added by Stats. 2012, Ch. 852, …

(a) To the extent permitted by PPACA, a carrier shall not be required by the provisions of this chapter to do any of the following: (1) Offer coverage to, or accept applications from, a small employer where the small employer is seeking coverage for eligible employees and depende…

(a) A carrier shall not be required to offer coverage or accept applications for benefit plan designs pursuant to this chapter where the carrier demonstrates to the satisfaction of the commissioner both of the following: (1) The acceptance of an application or applications would …

All health benefit plans subject to this chapter shall be renewable with respect to all eligible employees or dependents at the option of the policyholder, contractholder, or small employer except as follows: (a) (1) For nonpayment of the required premiums by the policyholder, co…

(a) The premium rate for a small employer health benefit plan issued, amended, or renewed on or after January 1, 2014, shall vary with respect to the particular coverage involved only by the following: (1) Age, pursuant to the age bands established by the United States Secretary …

In connection with the offering for sale of a health benefit plan subject to this chapter to small employers: Each carrier shall make a reasonable disclosure, as part of its solicitation and sales materials, of the following: (a) The provisions concerning the carrier’s ability to…

(a) No carrier shall provide or renew coverage subject to this chapter until a statement has been filed with the commissioner listing all of the carrier’s health benefit plans currently in force that are offered or proposed to be offered for sale in this state, identified by form…

(a) In addition to any other remedy permitted by law, the commissioner shall have the administrative authority to assess penalties against carriers, insurance producers, and other entities engaged in the business of insurance or other persons or entities for violations of this ch…

(a) (1) In addition to any other remedy permitted by law, whenever the commissioner shall have reason to believe that any carrier, production agent, or other person or entity engaged in the business of insurance has violated this chapter, and that a proceeding by the commissioner…

(a) Carriers may enter into contractual agreements with qualified associations, as defined in subdivision (b), under which these qualified associations may assume responsibility for performing specific administrative services, as defined in this section, for qualified association…

Notwithstanding any other provision of law, no provision of this chapter shall be construed to limit the applicability of any other provision of the Insurance Code unless such provision is in conflict with the requirements of this chapter. (Added by Stats. 2012, Ch. 852, Sec. 14.…