California Government Code Title 22 - California Health Benefit Exchange

  • Section 100500.
    (a) There is in state government the California Health Benefit Exchange, an independent public entity not affiliated with an agency or department, which shall be...
  • Section 100501.
    For purposes of this title, the following definitions shall apply:(a) Board means the board described in subdivision (a) of Section 100500.(b) Bridge plan product means...
  • Section 100501. A.
    For purposes of this title, the following definitions shall apply:(a) Board means the board described in subdivision (a) of Section 100500.(b) Carrier means either a...
  • Section 100501.1.
    For purposes of this title, the following definitions shall apply:(a) Insurance affordability program means a program that is one of the following:(1) The state s...
  • Section 100502.
    The board shall, at a minimum, do all of the following to implement Section 1311 of the federal act:(a) Implement procedures for the certification, recertification,...
  • Section 100503.
    In addition to meeting the minimum requirements of Section 1311 of the federal act, the board shall do all of the following:(a) Determine the criteria...
  • Section 100503. A.
    In addition to meeting the minimum requirements of Section 1311 of the federal act, the board shall do all of the following:(a) Determine the criteria...
  • Section 100503.1.
    The board shall ensure that the Internet Web site maintained under subdivision (c) of Section 100502 provides a direct link to the formulary, or formularies,...
  • Section 100503.2.
    The board shall use the information received pursuant to Section 12712.5 of the Insurance Code to provide an individual a notice that he or she...
  • Section 100504.
    (a) The board may do the following:(1) With respect to individual coverage made available in the Exchange, collect premiums and assist in the administration of...
  • Section 100504.5.
    (a) To the extent approved by the appropriate federal agency, for the purpose of implementing the option in paragraph (7) of subdivision (a) of Section...
  • Section 100504.6.
    (a) The Exchange shall have the authority to adopt regulations to implement the provisions of Section 100504.5. Prior to the adoption of regulations, the board...
  • Section 100505.
    (a) The board shall establish and use a competitive process to select participating carriers and any other contractors under this title. Any contract entered into...
  • Section 100506.
    (a) The board shall establish an appeals process for prospective and current enrollees of the Exchange that complies with all requirements of the federal act...
  • Section 100506.1.
    An applicant or enrollee has the right to appeal any of the following:(a) Any action or inaction related to the individual s eligibility for or...
  • Section 100506.2.
    (a) The entity making an eligibility or enrollment determination described in Section 100506.1 shall provide notice of the appeals process at the time of application...
  • Section 100506.3.
    (a) The board shall enter into a contract with the State Department of Social Services to serve as the Exchange appeals entity designated to hear...
  • Section 100506.4.
    (a) (1) Except as provided in paragraph (2), the State Department of Social Services, acting as the appeals entity, shall allow an applicant or enrollee...
  • Section 100506.5.
    For appeals of redetermination of Exchange advance premium tax credits or cost-sharing reductions, upon receipt of notice from the appeals entity that it has received...
  • Section 100507.
    (a) Notwithstanding any other provision of law, the Exchange shall not be subject to licensure or regulation by the Department of Insurance or the Department...
  • Section 100508.
    (a) Records of the Exchange that reveal any of the following shall be exempt from disclosure under the California Public Records Act (Chapter 3.5 (commencing...
  • Section 100510.
    (a) No individual or entity shall hold himself, herself, or itself out as representing, constituting, or otherwise providing services on behalf of the Exchange unless...
  • Section 100520.
    (a) The California Health Trust Fund is hereby created in the State Treasury for the purpose of this title. Notwithstanding Section 13340, all moneys in...
  • Section 100521.
    (a) The board shall ensure that the establishment, operation, and administrative functions of the Exchange do not exceed the combination of federal funds, private donations,...

Last modified: September 9, 2016