ARTICLE 3.16. Nongrandfathered Small Employer Plans
Article 3.16 added by Stats. 2012, Ch. 852, Sec. 3.
§§ 1357.500–1357.516 · 17 sections
- § 1357.500 As used in this article, the following definitions shall apply: (a) “Child” means a child described in Section 22775 of the Government Code and subdivisions…
- § 1357.501 This article shall apply only to nongrandfathered small employer health care service plan contracts and only with respect to plan years beginning on or after…
- § 1357.502 (a) A health care service plan providing or arranging for the provision of essential health benefits, as defined by the state pursuant to Section 1302 of…
- § 1357.502.5 Nothing in this article shall be construed to preclude the application of this chapter to either of the following: (a) An association, trust, or other…
- § 1357.503 (a) (1) Each plan shall fairly and affirmatively offer, market, and sell all of the plan’s small employer health care service plan contracts to all small…
- § 1357.503.035 (a) For plan contracts subject to this article, an association that meets the definition of a guaranteed association, as set forth in Section 1357.500, except…
- § 1357.504 (a) With respect to small employer health care service plan contracts offered outside the Exchange, after a small employer submits a completed application form…
- § 1357.505 (a) Notwithstanding paragraph (2) of subdivision (a) of Section 1357.503, an association of employers may offer a large group health care service plan contract…
- § 1357.506 A small employer health care service plan contract shall not impose a preexisting condition provision or a waiting or affiliation period upon any individual.
- § 1357.507 Nothing in this article shall be construed as prohibiting a health care service plan from restricting enrollment of late enrollees to open enrollment periods…
- § 1357.508 A small employer health care service plan contract shall provide to subscribers and enrollees at least all of the essential health benefits as defined by the…
- § 1357.509 (a) To the extent permitted by PPACA, a plan shall not be required to offer a health care service plan contract or accept applications for the contract…
- § 1357.510 The director may require a plan to discontinue the offering of contracts or acceptance of applications from any small employer or group upon a determination by…
- § 1357.512 (a) The premium rate for a small employer health care service plan contract issued, amended, or renewed on or after January 1, 2014, shall vary with respect to…
- § 1357.514 In connection with the offering for sale of a small employer health care service plan contract subject to this article, each plan shall make a reasonable…
- § 1357.515 (a) At least 20 business days prior to renewing or amending a plan contract subject to this article which will be in force on the operative date of this…
- § 1357.516 (a) Health care service plans may enter into contractual agreements with qualified associations, as defined in subdivision (b), under which these qualified…