0 chapters · 3,633 sections in this title.
Ins. Code § 10753 Section 10753
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(a) “Agent or broker” means a person or entity licensed under Chapter 5 (commencing with Section 1621) of Part 2 of Division 1. (b) “Benefit plan design” means a specific health coverage product issued by a carrier to small employers, to trustees of associations that include smal…
Ins. Code § 10753.01 Section 10753.01
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(a) For purposes of this chapter, “health benefit plan” does not include policies or certificates of specified disease or hospital confinement indemnity provided that the carrier offering those policies or certificates complies with the following: (1) The carrier files, on or bef…
Ins. Code § 10753.02 Section 10753.02
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Any person or entity subject to the requirements of this chapter shall comply with the standards set forth in Chapter 7 (commencing with Section 3750) of Part 1 of Division 9 of the Family Code and Section 14124.94 of the Welfare and Institutions Code.
Ins. Code § 10753.03 Section 10753.03
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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.
Ins. Code § 10753.04 Section 10753.04
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The commissioner may issue regulations that are necessary to carry out the purposes of this chapter.
Ins. Code § 10753.05 Section 10753.05
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(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 …
Ins. Code § 10753.06 Section 10753.06
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(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…
Ins. Code § 10753.08 Section 10753.08
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A health benefit plan shall not impose a preexisting condition provision or a waiting or affiliation period upon any individual.
Ins. Code § 10753.09 Section 10753.09
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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.
Ins. Code § 10753.11 Section 10753.11
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(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…
Ins. Code § 10753.12 Section 10753.12
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(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 …
Ins. Code § 10753.13 Section 10753.13
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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…
Ins. Code § 10753.14 Section 10753.14
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(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 …
Ins. Code § 10753.16 Section 10753.16
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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…
Ins. Code § 10753.17 Section 10753.17
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(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…
Ins. Code § 10753.18 Section 10753.18
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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.