California Health and Safety Code ARTICLE 4 - Solicitation and Enrollment

  • Section 1359.
    (a) The director may require that solicitors and solicitor firms, and principal persons engaged in the supervision of solicitation for plans of solicitor firms, meet such...
  • Section 1360.
    (a)  No plan, solicitor, solicitor firm, or representative shall use or permit the use of any advertising or solicitation which is untrue or misleading, or...
  • Section 1360.1.
    It is unlawful for any person, including a plan, subject to this chapter to represent or imply in any manner that the person or plan...
  • Section 1360.5.
    (a) For purposes of this section, “Exchange” means the California Health Benefit Exchange established pursuant to Section 100500 of the Government Code.(b) It is an unfair business...
  • Section 1361.
    (a) Except as provided in subdivision (b), no plan shall publish or distribute, or allow to be published or distributed on its behalf, any advertisement not...
  • Section 1361.1.
    (a) It is an unfair business practice for a solicitor, solicitor firm, or representative of a health care service plan to sell, solicit, or negotiate the...
  • Section 1362.
    As used in Sections 1363 and 1364:(a)  “Benefits and coverage” means the health care services available under a plan contract. (b)  “Exception” means any provision...
  • Section 1363.
    (a) The director shall require the use by each plan of disclosure forms or materials containing information regarding the benefits, services, and terms of the plan...
  • Section 1363.01.
    (a) Every plan that covers prescription drug benefits shall provide notice in the evidence of coverage and disclosure form to enrollees regarding whether the plan uses...
  • Section 1363.02.
    (a)  The Legislature finds and declares that the right of every patient to receive basic information necessary to give full and informed consent is a...
  • Section 1363.03.
    (a)  Every health care service plan that covers prescription drug benefits and that issues a card to enrollees for claims processing purposes shall issue to...
  • Section 1363.05.
    (a)  For every plan contract that provides or supplements Medicare benefits, a plan shall include within its disclosure form the following statement in at least...
  • Section 1363.06.
    (a) The Department of Managed Health Care and the Department of Insurance shall compile information as required by this section and Section 10127.14 of the Insurance...
  • Section 1363.07.
    (a) Each health care service plan shall send copies of the comparative benefit matrix prepared pursuant to Section 1363.06 on an annual basis, or more frequently...
  • Section 1363.1.
    Any health care service plan that includes terms that require binding arbitration to settle disputes and that restrict, or provide for a waiver of, the...
  • Section 1363.2.
    On or before July 1, 1999, the disclosure form required pursuant to Section 1363 shall also contain a statement that enrollees are encouraged to use...
  • Section 1363.5.
    (a)  A plan shall disclose or provide for the disclosure to the director and to network providers the process the plan, its contracting provider groups,...
  • Section 1364.
    Where the director finds it necessary in the interest of full and fair disclosure, all advertising and other consumer information disseminated by a plan for...
  • Section 1364.1.
    Within 30 days of receiving the notice required by Section 1255.1, a health care service plan shall notify, or provide for the notification of, enrollees...
  • Section 1364.5.
    (a)  On or before July 1, 2001, every health care service plan shall file with the director a copy of their policies and procedures to...
  • Section 1365.
    (a) An enrollment or a subscription shall not be canceled or not renewed except for the following reasons:(1) (A) For nonpayment of the required premiums by the individual,...
  • Section 1365.5.
    (a) No health care service plan or specialized health care service plan shall refuse to enter into any contract or shall cancel or decline to renew...
  • Section 1366.
    (a)  No plan may use in its name, any of the words “insurance,” “casualty,” “surety,” “mutual,” or any other words descriptive of the insurance, casualty,...
  • Section 1366.1.
    (a)  The department shall adopt regulations on or before July 1, 2003, that establish an extended geographic accessibility standard for access to health care providers...
  • Section 1366.1.a.
    (a)  The department shall adopt regulations on or before July 1, 2003, that establish an extended geographic accessibility standard for access to health care providers...
  • Section 1366.2.
    (a)  A full health care service plan shall make available to a group subscriber, upon request, the termination date of all major health care provider...
  • Section 1366.3.
    (a) On and after January 1, 2005, a health care service plan issuing individual plan contracts that ceases to offer individual coverage in this state shall...
  • Section 1366.4.
    (a) A medical group, physician, or independent practice association that contracts with a health care service plan may enter into contracts with licensed nonphysician providers to...
  • Section 1366.6.
    (a) For purposes of this section, the following definitions shall apply:(1) “Exchange” means the California Health Benefit Exchange established in Title 22 (commencing with Section 100500) of...
  • Section 1366.6.a.
    (a) For purposes of this section, the following definitions shall apply:(1) “Exchange” means the California Health Benefit Exchange established in Title 22 (commencing with Section 100500) of...

Last modified: October 22, 2018