ARTICLE 6.2. Review of Rate Increases
Article 6.2 added by Stats. 2010, Ch. 661, Sec. 4.
§§ 1385.01–1385.14 · 18 sections
- § 1385.01 For purposes of this article, the following definitions shall apply: (a) (1) “Blended” means a rating method that combines community rating and experience…
- § 1385.02 This article shall apply to a health care service plan contract offered in the individual or group market in California, including a health care service plan…
- § 1385.026 The Legislature finds and declares that Sections 19 and 29 of this act, which add Sections 1385.0011 and 1385.0021, respectively, to the Health and Safety…
- § 1385.03 (a) (1) A health care service plan shall file with the department all required rate information for grandfathered individual and grandfathered and…
- § 1385.035 (a) It is the intent of the Legislature in enacting this section to ensure that enrollees and subscribers benefit from reductions in the rate of growth in…
- § 1385.04 (a) For large group health care service plan contracts, all health plans shall file with the department at least 60 days prior to implementing any rate change…
- § 1385.043 (a) A health care service plan, not including a specialized health care service plan, shall annually report to the department the information described in…
- § 1385.045 (a) For large group health care service plan contracts, a health care service plan shall file with the department the weighted average rate increase for all…
- § 1385.046 (a) Upon receiving notice of a rate change, a large group contractholder that has coverage that is experience rated in whole or blended and that meets the…
- § 1385.05 Notwithstanding any provision in a contract between a health care service plan and a provider, the department may request from a health care service plan any…
- § 1385.06 (a) A filing submitted under this article shall be actuarially sound. (b) (1) The plan shall contract with an independent actuary or actuaries consistent with…
- § 1385.07 (a) Notwithstanding Division 10 (commencing with Section 7920.000) of Title 1 of the Government Code, all information submitted under this article shall be…
- § 1385.08 (a) On or before July 1, 2012, the director may issue guidance to health care service plans regarding compliance with this article. This guidance shall not be…
- § 1385.09 A health care service plan contract subject to Section 1385.03 or 1385.04 shall file a separate schedule documenting the cost savings associated with Section…
- § 1385.10 (a) (1) A health care service plan shall annually provide claims data at no charge to a large group purchaser if the large group purchaser requests the…
- § 1385.11 (a) Whenever it appears to the department that any person has engaged, or is about to engage, in any act or practice constituting a violation of this article,…
- § 1385.13 The department shall do all of the following in a manner consistent with applicable federal laws, rules, and regulations: (a) Provide data to the United States…
- § 1385.14 (a) This section shall apply only to a health care service plan covering dental services and a specialized health care service plan covering dental services,…