California Health and Safety Code ARTICLE 5.6 - Point-of-Service Health Care Service Plan Contracts

• Section 1374.60.
  For purpose of this article, the following definitions shall apply:(a) A “point-of-service plan contract” means any plan contract offered by a health care service plan whereby...
• Section 1374.62.
  A point-of-service plan contract, in which any risk for out-of-network coverage or services is transferred from a health care service plan through reinsurance, shall be...
• Section 1374.64.
  (a) Only a plan that has been licensed under this chapter and in operation in this state for a period of five years or more, or...
• Section 1374.65.
  Point-of-service plan contracts shall:(a)  Provide incentives, including financial incentives, for enrollees to use in-network coverage or services. (b)  Only offer coverage or services obtained out-of-network...
• Section 1374.66.
  Any health care service plan that offers a point-of-service plan contract may do all of the following:(a) Limit or exclude coverage for specific types of services...
• Section 1374.67.
  A health care service plan offering a point-of-service plan contract is subject to the following limitations:(a) A health care service plan shall limit its offering of...
• Section 1374.68.
  A health care service plan that offers a point-of-service plan contract shall do all of the following:(a) Deposit with the director or, at the discretion of...
• Section 1374.69.
  At least 20 business days prior to offering a point-of-service plan contract, a health care service plan shall file a notice of material modification in...
• Section 1374.71.
  No plan formerly registered under the Knox-Mills Health Plan Act (Article 2.5 (commencing with Section 12530) of Chapter 6 of Part 2 of Division 3...
• Section 1374.72.
  (a)  Every health care service plan contract issued, amended, or renewed on or after July 1, 2000, that provides hospital, medical, or surgical coverage shall...
• Section 1374.73.
  (a) (1) Every health care service plan contract that provides hospital, medical, or surgical coverage shall also provide coverage for behavioral health treatment for pervasive developmental disorder...
• Section 1374.74.
  (a) The department, in consultation with the Department of Insurance, shall convene an Autism Advisory Task Force by February 1, 2012, in collaboration with other agencies,...
• Section 1374.76.
  (a) No later than January 1, 2015, a large group health care service plan contract shall provide all covered mental health and substance use disorder benefits...

Last modified: October 22, 2018