ARTICLE 1. General Provisions [10110. - 10127.20.]

Article 1 enacted by Stats. 1935, Ch. 145.

§§ 10110–10127.20 · 214 sections

§ 10110 Every person has an insurable interest in the life and health of: (a) Himself. (b) Any person on whom he depends wholly or in part for education or support.…
§ 10110.1 (a) An insurable interest, with reference to life and disability insurance, is an interest based upon a reasonable expectation of pecuniary advantage through…
§ 10110.2 An insurer shall be entitled to rely upon all statements, declarations, and representations made by an applicant for insurance relative to the insurable…
§ 10110.3 (a) An insurer may not issue an individual life insurance policy to an applicant that insures the life of the applicant’s spouse unless the applicant’s spouse…
§ 10110.4 (a) Except as allowed in subdivision (c), an insurer may not issue or deliver a corporate-owned life insurance policy. (b) “Corporate-owned life insurance…
§ 10110.5 (a) A policy or endorsement issued by an admitted life and disability insurer may contain a provision for a waiver of premium payments in the event of…
§ 10110.6 (a) If a policy, contract, certificate, or agreement offered, issued, delivered, or renewed, whether or not in California, that provides or funds life…
§ 10110.7 (a) This section, except for subdivision (i), applies to a disability insurance policy that provides coverage for hospital, medical, or surgical benefits,…
§ 10110.75 (a) This section applies to a disability insurance policy that provides coverage for hospital, medical, surgical, or prescription drug benefits, excluding a…
§ 10110.8 (a) A life or disability insurance policy other than health insurance, as defined in Section 106, issued, amended, renewed, or delivered on or after January 1,…
§ 10110.9 (a) Notwithstanding any other law, except as provided in Section 10144.56, on and after January 1, 2028, a health insurer or its delegate shall subscribe to…
§ 10111 In life or disability insurance, the only measure of liability and damage is the sum or sums payable in the manner and at the times as provided in the policy…
§ 10111.2 (a) Under a policy of disability insurance other than health insurance, as defined in Section 106, including a policy of disability income insurance, as…
§ 10111.5 An insurer shall not be liable for payments claimed under an individual or group policy of life insurance if the duty to make those payments depends upon a…
§ 10111.7 (a) An insurer shall not deny or refuse to accept an application for life insurance, or refuse to insure, refuse to renew, cancel, restrict, or otherwise…
§ 10112 Subject to Section 2459 of the Probate Code, in respect to life or disability insurance, or annuity contracts (except as provided in Sections 2500 to 2507,…
§ 10112.1 (a) An individual or group health insurance policy shall not establish either of the following: (1) Lifetime limits on the dollar value of any covered benefits…
§ 10112.2 (a) A group or individual nongrandfathered health insurance policy shall, at a minimum, provide coverage for and shall not impose any cost-sharing requirements…
§ 10112.25 (a) A health insurer that issues, sells, renews, or offers health insurance policies for health care coverage in this state, including a grandfathered health…
§ 10112.26 (a) A health insurer that issues, sells, renews, or offers a policy covering dental services shall file a report with the department, by July 31 of each year,…
§ 10112.27 (a) An individual or small group health insurance policy issued, amended, or renewed on or after January 1, 2017, shall include, at a minimum, coverage for…
§ 10112.28 (a) This section shall apply to nongrandfathered individual and group health insurance policies that provide coverage for essential health benefits, as defined…
§ 10112.281 (a) A large group health insurance policy issued, amended, or renewed on or after July 1, 2022, shall cover medically necessary basic health care services. (b)…
§ 10112.282 (a) With respect to large group health insurance, an insurer and its officials, employees, agents, and representatives shall not, directly or indirectly,…
§ 10112.29 (a) (1) For a small employer health insurance policy offered, sold, or renewed on or after January 1, 2014, the deductible under the policy shall not exceed:…
§ 10112.291 (a) For a health insurance policy issued, amended, or renewed on or after July 1, 2022, in the individual or group market, a health insurer shall monitor an…
§ 10112.295 (a) Levels of coverage for the nongrandfathered individual market are defined as follows: (1) Bronze level: A health insurance policy in the bronze level shall…
§ 10112.296 Notwithstanding paragraph (1) of subdivision (b) of Section 10112.295 and paragraph (1) of subdivision (b) of Section 10112.297, the actuarial value for a…
§ 10112.297 (a) Levels of coverage for the nongrandfathered small group market are defined as follows: (1) Bronze level: A health insurance policy in the bronze level…
§ 10112.3 (a) For purposes of this section, the following definitions shall apply: (1) “Exchange” means the California Health Benefit Exchange established in Title 22… see note
§ 10112.300 (a) (1) A small employer health benefit plan in effect on December 31, 2013, and still in effect as of the effective date of this section, that does not…
§ 10112.35 (a) An insurer providing individual coverage in the Exchange shall cooperate with requests from the Exchange to collaborate in the development of, and…
§ 10112.4 The commissioner shall, in coordination with the Director of the Department of Managed Health Care, review the Internet portal developed by the United States…
§ 10112.5 (a) (1) Notwithstanding any other provision of law, every policy or certificate of health insurance marketed, issued, or delivered to a resident of this state,…
§ 10112.6 (a) Consistent with federal law, a sponsor of a prescription drug plan authorized by the federal Medicare Prescription Drug, Improvement, and Modernization Act…
§ 10112.7 (a) A group or individual health insurance policy issued, amended, or renewed on or after January 1, 2014, that provides or covers any benefits with respect to…
§ 10112.75 (a) If a health insurer sends payment for services provided directly to the insured and not to the provider, the insurer shall send notice to the insured and…
§ 10112.8 (a) (1) Except as provided in subdivision (c), a health insurance policy issued, amended, or renewed on or after July 1, 2017, that provides benefits through…
§ 10112.81 (a) (1) By September 1, 2017, the commissioner shall establish an independent dispute resolution process for the purpose of processing and resolving a claim…
§ 10112.82 (a) (1) For services rendered subject to Section 10112.8, effective July 1, 2017, unless otherwise agreed to by the noncontracting individual health…
§ 10112.9 (a) (1) Notwithstanding Section 10273.4, an insurer, except an insurer issuing a specialized health insurance policy, issuing a policy or certificate of health…
§ 10112.95 (a) A health insurer shall provide an insured who has been displaced or whose health otherwise may be affected by a state of emergency, as declared by the…
§ 10113 Every policy of life, disability, or life and disability insurance issued or delivered within this State on or after the first day of January, 1936, by any…
§ 10113.1 The following provisions shall apply to this act: (a) “Advertisement” means any written, electronic, or printed communication or any communication by means of…
§ 10113.2 (a) This section applies to any person entering into, brokering, or soliciting life settlements pursuant to this section and Sections 10113.1 and 10113.3. (b)…
§ 10113.3 (a) A provider entering into a life settlement contract with any owner of a policy, wherein the insured is terminally ill, shall first obtain the following:…
§ 10113.35 (a) The commissioner may adopt rules and regulations reasonably necessary to implement the provisions of this act. (b) This section shall be prospective only,…
§ 10113.4 If a group life insurance policy contains a provision that makes a certificate holder’s coverage contestable on the grounds of suicide for a period following…
§ 10113.5 (a) An individual life insurance policy delivered or issued for delivery in this state shall contain a provision that it is incontestable after it has been in…
§ 10113.6 (a) An insurer that is required to deliver a life insurance policy to the owner of the policy in order to start the period running during which the owner may…
§ 10113.7 (a) An increase of premium on an individual life insurance policy that provides for premium changes by the insurer is not effective unless written notice is…
§ 10113.70 (a) (1) Whenever a flexible premium life insurance policy is subject to an adverse change in the current scale of nonguaranteed elements, as soon as…
§ 10113.71 (a) Each life insurance policy issued or delivered in this state shall contain a provision for a grace period of not less than 60 days from the premium due…
§ 10113.72 (a) An individual life insurance policy shall not be issued or delivered in this state until the applicant has been given the right to designate at least one…
§ 10113.8 (a) Each health insurer that maintains an Internet Web site shall make a downloadable copy of the comparative benefit matrix prepared pursuant to Section…
§ 10113.9 (a) This section shall not apply to vision-only, dental-only, or CHAMPUS supplement insurance, or to hospital indemnity, hospital-only, accident-only, or…
§ 10113.95 (a) A health insurer that issues, renews, or amends individual health insurance policies shall be subject to this section. (b) An insurer subject to this… see note
§ 10114 Before an insurer may pay the proceeds of any contract of life or disability insurance to any undertaker or funeral director, as beneficiary or assignee, for…
§ 10115 When a payment is made equal to the full first premium at the time an application for life insurance other than group life insurance is signed by the applicant…
§ 10116 No group life insurance policy or disability insurance policy shall be issued or delivered in this State where the premiums or any part thereof is paid or is…
§ 10116.5 (a) Every policy of disability insurance that is issued, amended, delivered, or renewed in this state on or after January 1, 1999, that provides hospital,…
§ 10117 (a) A policy of disability insurance, self-insured employee welfare benefit plan, or nonprofit hospital service plan may not provide an exception for other…
§ 10117.5 No disability insurer contract that covers hospital, medical, or surgical benefits that is issued, amended, renewed, or delivered on and after January 1, 2002,…
§ 10117.52 (a) No health insurance contract in existence or issued, amended, or renewed on or after January 1, 2013, between a health insurer and a provider or a supplier…
§ 10118 A policy of disability insurance delivered or issued for delivery in this state more than 120 days after the effective date of this section, that provides that…
§ 10119 On and after the operative date of this section: (a) No policy of disability insurance which, in addition to covering the insured, also covers members of the…
§ 10119.1 (a) This section shall apply to a health insurer that covers hospital, medical, or surgical expenses under an individual health benefit plan, as defined in…
§ 10119.2 (a) Every health insurer that offers, issues, or renews health insurance under an individual health benefit plan, as defined in subdivision (a) of Section… see note
§ 10119.3 (a) Notwithstanding any other provision of law, an agent or broker who assists an applicant in submitting an application to a health insurer has the duty to…
§ 10119.5 (a) No individual or group policy of health insurance that is issued, amended, renewed, or delivered on or after July 1, 2003, that provides maternity coverage…
§ 10119.6 (a) (1) A large group health insurance policy that is issued, amended, or renewed on or after January 1, 2026, shall provide coverage for the diagnosis and…
§ 10119.7 No group or individual policy of disability insurance which covers hospital, medical, or surgical expenses shall be issued, amended, delivered, or renewed in…
§ 10119.8 On and after January 1, 1993, every insurer issuing, amending, or renewing a policy of individual or group disability insurance that covers hospital, medical,…
§ 10119.9 (a) A disability insurance policy or certificate covering hospital, surgical, or medical expenses, that meets the definition of “health benefit plan” in…
§ 10120 If a policy of disability insurance issued, issued for delivery, or renewed in this state after the effective date of this section provides in any manner for…
§ 10120.2 (a) This section shall only apply to a disability insurer that issues a dental insurance policy pursuant to this part. (b) For purposes of this section, the…
§ 10120.3 (a) With respect to a contract between an insurer covering dental services and a dentist to provide covered dental services to insureds, the contract shall not…
§ 10120.35 (a) Notwithstanding any other law, a health insurer, including a specialized health insurer and a health insurer that issues, sells, renews, or offers a…
§ 10120.4 (a) A health insurer that issues, sells, renews, or offers a policy covering dental services, including a specialized policy of health insurance covering…
§ 10120.41 (a) For purposes of this section, the following definitions shall apply: (1) “Dental waiting period provision” means a health insurance policy provision that…
§ 10120.42 (a) To assist a provider in determining if an insured’s dental coverage is regulated by the State of California, the health insurer shall disclose whether the…
§ 10120.5 Any act by a disability insurer that covers hospital, medical, or surgical expenses that violates Section 510, Section 2056, or Section 2056.1 of the Business…
§ 10121 (a) No self-insured employee welfare benefit plan, issued or renewed on or after November 23, 1970, which contains coverage for sterilization operations or…
§ 10121.5 (a) When spouses are both employed as employees, and both have enrolled themselves and their eligible family members under a group policy of disability…
§ 10121.6 (a) No policy of group disability insurance or self-insured employee welfare benefit plan which provides hospital, medical, or surgical expense benefits for…
§ 10121.7 (a) A policy of group health insurance that provides hospital, medical, or surgical expense benefits shall provide equal coverage to employers or guaranteed…
§ 10122 If a policy of group disability insurance issued or issued for delivery or amended in this state after the effective date of this section provides in any…
§ 10122.1 On and after the effective date of this section, every policy of disability insurance which covers hospital, medical, or surgical expenses on a group basis…
§ 10122.2 If a policy of group disability insurance issued, delivered, amended, or renewed in this state on or after the effective date of this section provides in any…
§ 10123 (a) No self-insured employee welfare benefit plan, issued or renewed on or after the effective date of this section, which provides coverage for an employee…
§ 10123.1 Every self-insured employee welfare benefit plan, as defined in Section 10121, issued, amended as to benefits, or renewed after January 1, 1977, shall comply…
§ 10123.2 On and after the effective date of this section, every self-insured employee welfare benefit plan which provides coverage for hospital, medical, or surgical…
§ 10123.3 (a) No self-insured employee welfare benefit plan shall refuse to enroll any person or accept any person as a subscriber or renew any person as a subscriber…
§ 10123.31 (a) In addition to any other remedy permitted by law, the commissioner shall have the administrative authority to assess penalties specified in this section…
§ 10123.35 (a) This section shall apply to the disclosure of genetic test results contained in an applicant or enrollee’s medical records by a self-insured welfare…
§ 10123.36 (a) On or before July 1, 1999, for purposes of public disclosure, every disability insurer that covers hospital, medical, or surgical expenses, and authorizes…
§ 10123.38 (a) A health insurance policy issued, amended, or renewed on or after January 1, 2025, shall provide coverage for the prophylaxis, diagnosis, and treatment of…
§ 10123.4 If a self-insured employee welfare benefit plan issued, amended, or renewed in this state on or after the effective date of this section provides in any manner…
§ 10123.5 (a) On or after January 1, 1993, every insurer issuing group disability insurance that covers hospital, medical, or surgical expenses shall provide benefits…
§ 10123.51 (a) A health insurance policy issued, amended, or renewed on or after January 1, 2022, that provides coverage for pediatric services and preventive care, as…
§ 10123.55 (a) On or after January 1, 1993, every insurer issuing group disability insurance that covers hospital, medical, or surgical expenses shall offer benefits for…
§ 10123.6 On and after January 1, 1990, every insurer issuing group disability insurance which covers hospital, medical, or surgical expenses shall offer coverage for…
§ 10123.61 (a) Commencing January 1, 2019, a health insurer shall not issue, amend, sell, renew, or offer a policy of short-term limited duration health insurance in this…
§ 10123.65 (a) The maximum amount a health insurer may require an insured to pay at the point of sale for a covered prescription drug is the lesser of the following: (1)…
§ 10123.67 (a) On or before July 1, 1997, every disability insurer that covers hospital, medical, or surgical expenses, as described in subdivision (b), shall file with…
§ 10123.68 (a) When requested by an insured or contracting health professional who is treating an insured, a disability insurer that covers hospital, medical, or surgical…
§ 10123.7 (a) On or after January 1, 1986, an insurer issuing group health insurance shall offer coverage for orthotic and prosthetic devices and services under the…
§ 10123.8 (a) Every policy of disability insurance that provides coverage for hospital, medical, or surgical expenses, that is issued, amended, delivered, or renewed on…
§ 10123.81 (a) An individual or group policy of disability insurance or self-insured employee welfare benefit plan shall be deemed to provide coverage for mammography for…
§ 10123.82 Every policy of disability insurance which provides for the surgical procedure known as a laryngectomy and which is issued, amended, delivered, or renewed in…
§ 10123.83 (a) On or after January 1, 1995, every policy of disability insurance that covers hospital, medical, or surgical expenses and is issued, amended, delivered, or…
§ 10123.835 (a) Every individual or group policy of disability insurance that covers hospital, medical, or surgical benefits that is issued, amended, or renewed on or…
§ 10123.84 (a) The Legislature finds and declares that the unique, private, and personal relationship between women patients and their obstetricians and gynecologists…
§ 10123.85 (a) For purposes of this section, the definitions in subdivision (a) of Section 2290.5 of the Business and Professions Code apply. (b) It is the intent of the…
§ 10123.855 (a) (1) A contract between a health insurer and a health care provider for an alternative rate of payment pursuant to Section 10133 shall specify that the…
§ 10123.856 (a) If a health insurer offers a service via telehealth to an insured through a third-party corporate telehealth provider, all of the following conditions…
§ 10123.857 (a) A health insurer that issues, sells, renews, or offers a policy covering dental services, including a specialized health insurance policy covering dental…
§ 10123.86 (a) Every policy of disability insurance covering hospital, surgical, or medical expenses that is issued, amended, renewed, or delivered on or after January 1,…
§ 10123.861 (a) A health insurance policy that provides outpatient prescription drug benefits and is issued, amended, or renewed on or after the operative date of this…
§ 10123.862 (a) A health insurer shall base a medical necessity determination or the utilization review criteria that the insurer, and an entity acting on the insurer’s…
§ 10123.864 The provision of medically necessary pasteurized donor human milk obtained from a tissue bank licensed pursuant to Chapter 4.1 (commencing with Section 1635)…
§ 10123.865 (a) Commencing no later than July 1, 2012, an individual health insurance policy shall provide coverage for maternity services for all insureds covered under…
§ 10123.866 (a) Commencing no later than July 1, 2012, a group health insurance policy shall provide coverage for maternity services for all insureds covered under the…
§ 10123.867 (a) A health insurer shall develop a maternal mental health program designed to promote quality and cost-effective outcomes. The program shall consist of at…
§ 10123.868 On or before January 1, 2025, a health insurer shall develop a maternal and infant health equity program that addresses racial health disparities in maternal…
§ 10123.869 (a) A contract between a health insurer and a health care provider issued, amended, or renewed on or after January 1, 2025, shall authorize a provider to…
§ 10123.87 (a) No individual or group policy of disability insurance that provides coverage for hospital, medical, and surgical benefits that is issued, amended, renewed,…
§ 10123.88 (a) Every policy of health insurance covering hospital, medical, or surgical expenses that is issued, amended, renewed, or delivered in this state on or after…
§ 10123.89 (a) On and after July 1, 2000, every policy of disability insurance issued, amended, delivered, or renewed in this state that provides coverage for hospital,…
§ 10123.9 On and after January 1, 1980, every group policy of disability insurance which covers hospital, medical, or surgical expenses on a group basis, and which…
§ 10123.91 (a) On or after January 1, 2009, every insurer that issues, amends, or renews an individual or group policy of health insurance that covers hospital, medical,…
§ 10123.10 (a) Every disability insurer transacting business in this state shall, on or after January 1, 1979, make available and offer to include in every group…
§ 10123.11 (a) No insurer shall deny a claim under a group disability policy for hospital, medical, surgical, dental, or optometric services for the sole reason that the…
§ 10123.12 Every health insurer, including those insurers that contract for alternative rates of payment pursuant to Section 10133, and every self-insured employee…
§ 10123.13 (a) Every insurer issuing group or individual policies of health insurance that cover hospital, medical, or surgical expenses, including those telehealth…
§ 10123.131 (a) An insurer shall pay a provider for duplicating all information it requests in connection with a contested claim, and for patient records, as follows: (1)…
§ 10123.132 (a) Every disability insurer that covers hospital, medical, or surgical expenses and that reviews and approves the medical necessity or appropriateness of…
§ 10123.135 (a) Every disability insurer, or an entity with which it contracts for services that include utilization review or utilization management functions, that…
§ 10123.137 (a) Each contract between a health insurer and a provider shall contain provisions requiring a fast, fair, and cost-effective dispute resolution mechanism…
§ 10123.14 On and after January 1, 1990, every self-insured employee welfare benefit plan containing hospital, medical, or surgical expense benefits or service benefits…
§ 10123.141 (a) Every policy of expense incurred hospital, medical, or surgical insurance issued, amended, or renewed on or after January 1, 1991, on a group basis, except…
§ 10123.145 (a) (1) Whenever an insurer issuing group or individual policies of disability insurance which covers hospital, medical, or surgical expenses determines that…
§ 10123.146 (a) The following definitions shall apply for purposes of this section: (1) (A) “Affirmative consent” means a dental provider’s express consent to opt in or…
§ 10123.147 (a) Every insurer issuing group or individual policies of health insurance that cover hospital, medical, or surgical expenses, including those telehealth…
§ 10123.15 Every group policy of disability insurance which covers hospital, medical, and surgical expenses on a group basis, and which offers coverage for disorders of…
§ 10123.16 Except for a preexisting condition, every disability insurer issuing policies of individual or group disability insurance in this state that offers group or…
§ 10123.17 Except for a preexisting condition, every self-insured employee welfare benefit plan in this state that offers group coverage for long-term care facility…
§ 10123.18 (a) A disability insurance policy issued, amended, or renewed on or after January 1, 2024, and that provides coverage for hospital, medical, or surgical…
§ 10123.184 (a) Every group policy of disability insurance that covers hospital, medical, or surgical expenses, and that provides maternity benefits, that is issued,…
§ 10123.185 (a) Every policy of disability insurance that covers hospital, medical, or surgical expenses and is issued, amended, delivered, or renewed in this state and…
§ 10123.19 (a) Any disability insurance policy that includes terms that require binding arbitration to settle disputes and that restrict, or provide for a waiver of, the…
§ 10123.191 (a) Notwithstanding any other law, on and after January 1, 2013, a health insurer that provides coverage for prescription drugs shall utilize and accept only…
§ 10123.192 (a) A health insurer that provides prescription drug benefits and maintains one or more drug formularies shall do all of the following: (1) Post the formulary…
§ 10123.193 (a) The Legislature hereby finds and declares all of the following: (1) The federal Patient Protection and Affordable Care Act, its implementing regulations…
§ 10123.1932 (a) (1) With respect to an individual or group policy of health insurance subject to Section 10112.28, the copayment, coinsurance, or any other form of cost…
§ 10123.1933 (a) (1) Notwithstanding Section 10123.201, a health insurer shall not subject antiretroviral drugs that are medically necessary for the prevention of AIDS/HIV,…
§ 10123.1935 (a) Notwithstanding any other law, a group or individual health insurer offering an outpatient prescription drug benefit shall provide coverage for at least…
§ 10123.194 (a) Every disability insurer that covers hospital, medical, or surgical expenses, and, as part of that coverage, also covers prescription drug benefits, and…
§ 10123.1945 (a) (1) A disability insurance policy issued, amended, renewed, or delivered on or after January 1, 2024, except for a grandfathered health plan or a…
§ 10123.195 (a) A group or individual disability insurance policy issued, delivered, or renewed in this state or certificate of group disability insurance issued,…
§ 10123.196 (a) An individual or group policy of disability insurance issued, amended, renewed, or delivered on or after January 1, 2000, through December 31, 2015,…
§ 10123.1961 (a) (1) The requirements of this section shall apply to a group or individual policy or certificate of health insurance or student blanket disability insurance…
§ 10123.197 (a) A request for an exception to a health insurer’s step therapy process for prescription drugs may be submitted in the same manner as a request for prior…
§ 10123.198 (a) On and after July 1, 2011, in accordance with the requirements of subdivision (b), a health insurer that provides coverage for professional mental health…
§ 10123.199 (a) A health insurer that provides coverage for professional mental health services shall establish an Internet Web site. Each Internet Web site shall include,…
§ 10123.1991 (a) (1) A health insurer shall provide to insureds a written or electronic notice regarding the benefits of a behavioral health and wellness screening for…
§ 10123.20 (a) A health insurance policy that is issued, amended, delivered, or renewed on or after July 1, 2000, shall be deemed to provide coverage for all generally…
§ 10123.201 (a) A policy of health insurance that covers outpatient prescription drugs shall cover medically necessary drugs. The policy may provide for step therapy and…
§ 10123.202 (a) A health insurance policy issued, amended, renewed, or delivered on or after January 1, 2017, excluding specialized health insurance policies, shall be…
§ 10123.203 Commencing January 1, 2019, an insurer shall prorate an insured’s cost sharing for a partial fill of a prescription dispensed pursuant to Section 4052.10 of…
§ 10123.204 (a) A health insurance policy issued, amended, delivered, or renewed on or after July 1, 2023, that provides prescription drug benefits and maintains one or…
§ 10123.2045 (a) A health insurance policy issued, amended, or renewed on or after January 1, 2026, that provides prescription drug coverage shall not calculate an…
§ 10123.205 (a) (1) A health insurer that reports rate information pursuant to Section 10181.3 or 10181.45 shall report the information described in paragraph (2) to the…
§ 10123.206 (a) Notwithstanding any other law, an individual or group health insurance policy issued, amended, or renewed on or after January 1, 2015, that provides…
§ 10123.207 (a) Every health insurance policy, except a specialized health insurance policy, that is issued, amended, or renewed on or after January 1, 2022, shall provide…
§ 10123.208 (a) A health insurance policy issued, amended, renewed, or delivered on or after January 1, 2022, excluding specialized health insurance policies, shall…
§ 10123.209 (a) A health insurance policy that is issued, amended, delivered, or renewed on or after July 1, 2024, shall include coverage for medically necessary biomarker…
§ 10123.210 (a) A health insurer that provides health coverage to the employees of a religious employer that does not include coverage and benefits for both abortion and…
§ 10123.211 (a) (1) A health insurance policy that is issued, amended, or renewed on or after July 1, 2025, excluding a specialized health insurance policy, shall provide…
§ 10123.21 On or after July 1, 1995, every individual or group policy of disability insurance that provides hospital, medical, or surgical coverage entered into, amended,…
§ 10123.22 (a) A health insurer shall not deny coverage that is otherwise available under the health insurance policy for the costs of solid organ or other tissue…
§ 10124 (a) A self-insured employee welfare benefit plan delivered or issued for delivery in this state more than 120 days after the effective date of this section,…
§ 10124.7 Each self-insured employee benefit plan issued or renewed on or after the effective date of this section shall provide, where feasible, that benefits for…
§ 10125 (a) On and after January 1, 1974, every insurer issuing group disability insurance which covers hospital, medical, or surgical expenses shall offer coverage…
§ 10125.1 (a) Every insurer issuing disability insurance that covers hospital, medical, or surgical expenses that offers coverage for a service that is within the scope…
§ 10125.2 (a) A pharmacy benefit manager that contracts with a health insurer shall comply with Article 6.1 (commencing with Section 1385.001) of Chapter 2.2 of Division…
§ 10126 Every policy of group disability insurance issued, amended, or renewed on or after January 1, 1977, which provides hospital, medical, or surgical expense…
§ 10126.5 If a disability insurance policy between an insurer that covers hospital, medical, or surgical expenses and a provider requires that the provider accept, as…
§ 10126.6 (a) Every policy of disability insurance that provides hospital, medical, or surgical coverage under a health benefit plan, defined in subdivision (a) of…
§ 10126.61 (a) A health insurance policy issued, amended, or renewed on or after July 1, 2025, shall establish a process to reimburse for services provided by a community…
§ 10126.65 (a) (1) Notwithstanding Section 10352, a health insurance policy issued, amended, or renewed on or after January 1, 2020, shall provide that if an insured or…
§ 10126.66 (a) (1) Unless otherwise required by this chapter, a health insurance policy issued, amended, or renewed on or after January 1, 2024, shall require an insured…
§ 10127 On and after January 1, 1974, every self-insured employee welfare benefit plan that provides coverage for hospital, medical, or surgical expenses shall offer…
§ 10127.09 Notwithstanding any other law, a disability insurance policy that provides hospital, medical, surgical, prescription drug, or nursing benefits, except a policy…
§ 10127.1 (a) No policy of disability insurance providing loss of time benefits shall contain any provision for a reduction of such benefits during a benefit period…
§ 10127.15 Any provision contained in a policy of disability insurance or a self-insured employee welfare benefit plan for a reduction of loss of time benefits during a…
§ 10127.2 Each policy of disability insurance issued or renewed on or after the effective date of this section, which policy provides benefits that accrue after a…
§ 10127.21 Any data submitted by a health insurer to the United States Secretary of Health and Human Services, or his or her designee, for purposes of the risk adjustment…
§ 10127.3 On and after January 1, 1985, every insurer issuing group disability insurance which covers hospital, medical, or surgical expenses shall offer coverage for…
§ 10127.4 (a) Except as provided in subdivisions (b) and (c), no contract that is issued, amended, renewed, or delivered on or after January 1, 1999, between a…
§ 10127.5 Every application for, certificate of, and policy of credit life or credit disability insurance shall set forth a statement in bold capital letters indicating…
§ 10127.7 Every policy of individual life insurance with a face value of less than ten thousand dollars ($10,000) which is delivered or issued for delivery in this state…
§ 10127.8 (a) The purpose of this section is to assure truthful and adequate disclosure of all material and relevant information in the advertising of term life…
§ 10127.9 (a) (1) Every individual life insurance policy and every individual annuity contract that is initially delivered or issued for delivery in this state on and…
§ 10127.10 (a) Every policy of individual life insurance and every individual annuity contract that is initially delivered or issued for delivery to a senior citizen in…
§ 10127.11 Every insurer and life agent offering for sale individual life insurance policies or individual annuity contracts that are initially delivered or issued for…
§ 10127.12 Whenever an insurer provides an annual statement to a senior citizen policyowner of an individual life insurance policy or an individual annuity contract…
§ 10127.13 (a) All individual life insurance policies and individual annuity contracts for senior citizens that contain a charge upon surrender, partial surrender, excess…
§ 10127.14 (a) The department and the Department of Managed Health Care shall compile information required by this section and Section 1363.06 of the Health and Safety…
§ 10127.16 (a) (1) After the termination of the pilot program under Section 10127.15, a health insurer shall continue to provide coverage under the same terms and…
§ 10127.17 (a) The Life and Annuity Consumer Protection Fund is hereby created as a special account within the Insurance Fund. Each insurer admitted to transact insurance…
§ 10127.18 (a) On and after January 1, 2005, a health insurer issuing individual policies of health insurance that ceases to offer individual coverage in this state shall…
§ 10127.19 (a) Commencing March 1, 2013, and at least annually thereafter, a health insurer, not including a health insurer offering specialized health insurance…
§ 10127.20 (a) Beginning on July 1, 2023, and annually thereafter, a health insurer offering a qualified health plan through the Exchange shall report to the commissioner…