CHAPTER 8.01. Nongrandfathered Small Employer Health Insurance [10753. - 10753.18.7.]

Chapter 8.01 added by Stats. 2012, Ch. 852, Sec. 14.

§§ 10753–10753.18.7 · 22 sections

1. ARTICLE 1. Definitions §§ 10753–10753.01 · 2 sections

   • § 10753 (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…
   • § 10753.01 (a) For purposes of this chapter, “health benefit plan” does not include policies or certificates of specified disease or hospital confinement indemnity…
2. ARTICLE 2. Small Employer Carrier Requirements §§ 10753.02–10753.18.7 · 20 sections

   • § 10753.02 (a) This chapter shall apply only to nongrandfathered health benefit plans and only with respect to plan years commencing on or after January 1, 2014. (b) All…
   • § 10753.02.1 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…
   • § 10753.03 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…
   • § 10753.04 The commissioner may issue regulations that are necessary to carry out the purposes of this chapter.
   • § 10753.05 (a) A group or individual policy or contract or certificate of group insurance or statement of group coverage providing benefits to employees of small…
   • § 10753.05.2 (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…
   • § 10753.06 Every carrier shall file with the commissioner the reasonable participation requirements and employer contribution requirements that are to be included in its…
   • § 10753.06.5 (a) With respect to small employer health benefit plans offered outside the Exchange, after a small employer submits a completed application, the carrier…
   • § 10753.08 A health benefit plan shall not impose a preexisting condition provision or a waiting or affiliation period upon any individual.
   • § 10753.09 Nothing in this chapter shall be construed as prohibiting a carrier from restricting enrollment of late enrollees to open enrollment periods provided under…
   • § 10753.11 (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…
   • § 10753.12 (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…
   • § 10753.13 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,…
   • § 10753.14 (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…
   • § 10753.16 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,…
   • § 10753.17 (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…
   • § 10753.18 (a) In addition to any other remedy permitted by law, the commissioner shall have the administrative authority to assess penalties against carriers, insurance…
   • § 10753.18.5 (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…
   • § 10753.18.55 (a) Carriers may enter into contractual agreements with qualified associations, as defined in subdivision (b), under which these qualified associations may…
   • § 10753.18.7 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…