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 also 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 an individual...
• 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 private health...
• 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 Medi-Cal program under...
• 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, and...
• 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) (1) Determine the criteria and...
• 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) (1) Determine the criteria and...
• 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 subsidies.(2) Enter into...
• 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 100504,...
• 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 and...
• 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 pursuant...
• 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 concerning...
• 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 enrollment in...
• 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 and...
• 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 appeals...
• 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 to request...
• 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 of...
• 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 with...
• 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 that...
• 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, and...
• Section 100522.
  (a) (1) The Exchange shall apply to the United States Department of Health and Human Services for a waiver authorized under Section 1332 of the federal act...

Last modified: October 22, 2018