California Insurance Code ARTICLE 4.7 - Multiple Employer Welfare Arrangements

• Section 742.20.
  The Legislature finds and declares the following:(a) An alternative to insurance programs, health care maintenance organizations, and panel provider organizations was established by Congress in 1974...
• Section 742.21.
  “Multiple employer welfare arrangement” as used in this article has the same meaning as that contained in Section 1002(40)(A) of Title 29 of the United...
• Section 742.215.
  As used in this article, “self-funded” means a multiple employer welfare arrangement that undertook at all times and for a continuous period of five years...
• Section 742.22.
  It is the intent of the Legislature in enacting this article to allow a self-funded or partially self-funded multiple employer welfare arrangement to meet the...
• Section 742.23.
  (a) After December 31, 1995, a self-funded or partially self-funded multiple employer welfare arrangement shall not provide any benefits for any resident of this state without...
• Section 742.24.
  To be eligible for a certificate of compliance, a self-funded or partially self-funded multiple employer welfare arrangement shall meet all of the following requirements:(a) Be nonprofit.(b) Be...
• Section 742.245.
  (a) A self-funded or partially self-funded multiple employer welfare arrangement shall maintain at least 25 percent of the surplus required by subdivision (n) of Section 742.24...
• Section 742.25.
  In determining the qualification of a multiple employer welfare arrangement, the commissioner will consider, among other things:(a) The history of the multiple employer welfare arrangement.(b) The competency,...
• Section 742.26.
  The multiple employer welfare arrangement shall issue to each covered employee a certificate evidencing coverage and a summary plan description of benefits and coverages provided....
• Section 742.27.
  The department shall have the authority to revoke a certificate of compliance to any self-funded or partially self-funded multiple employer welfare arrangement if the department...
• Section 742.28.
  A self-funded or partially self-funded multiple employer welfare arrangement authorized by this article shall be limited to providing the following benefits:(a) Medical, dental, optical, surgical, or...
• Section 742.29.
  An association seeking to establish an employee welfare benefit plan by the use of a self-funded or partially self-funded multiple employer welfare arrangement shall apply...
• Section 742.30.
  The commissioner shall not issue a certificate of compliance to a self-funded or partially self-funded multiple employer welfare arrangement unless the employers participating in the...
• Section 742.31.
  Each self-funded or partially self-funded multiple employer welfare arrangement transacting business in the state shall file all of the following with the commissioner:(a) No later than...
• Section 742.32.
  The commissioner or any persons designated by the commissioner shall have the power to examine the affairs of any self-funded or partially self-funded multiple employer...
• Section 742.33.
  Books, records, and documents pertaining to the business of the multiple employer welfare arrangement shall be maintained by the administrator for a period of five...
• Section 742.34.
  (a) The following notice shall be provided to employers and employees who obtain coverage from a multiple employer welfare arrangement:“NOTICE(A) THE MULTIPLE EMPLOYER WELFARE ARRANGEMENT IS NOT...
• Section 742.35.
  The department may conduct an examination of the financial condition of a self-funded or partially self-funded multiple employer welfare arrangement, and if it determines that...
• Section 742.36.
  Subject to the annual fee provisions of Section 742.39, every certificate of compliance shall be for an indefinite term and shall expire with the expiration...
• Section 742.37.
  (a) The commissioner may suspend the certificate of compliance of a holder thereof for not exceeding one year whenever he or she finds, after proper hearing...
• Section 742.38.
  The commissioner, in any proceeding under Section 742.37 for any of the violations specified in that section, may by alternative order permit the holder of...
• Section 742.39.
  The commissioner shall require the payment of five thousand two hundred twenty-nine dollars ($5,229), in advance, as a fee for filing an application for each...
• Section 742.40.
  (a) A multiple employer welfare arrangement shall offer health care coverage benefits to any new eligible person and his or her dependents under terms and conditions...
• Section 742.405.
  (a) No multiple employer welfare arrangement shall refuse to enroll any person or accept any person as a subscriber or renew any person as a subscriber...
• Section 742.407.
  (a) This section shall apply to the disclosure of genetic test results contained in an applicant or enrollee’s medical records by a multiple employer welfare arrangement.(b) Any...
• Section 742.41.
  All employer groups who have health care coverage benefits provided by a multiple employer welfare arrangement for their employees and their dependents, regardless of individual...
• Section 742.42.
  The provisions of this code governing domestic incorporated insurers, their business, and their contracts shall, so far as applicable and not inconsistent, govern multiple employer...
• Section 742.425.
  The provisions of this article shall not apply to multiple employer welfare arrangements as defined in Section 1144(b)(6)(D) of Title 29 of the United States...
• Section 742.43.
  The commissioner may adopt reasonable rules and regulations for the implementation and administration of this article.(Added by Stats. 1994, Ch. 1082, Sec. 1. Effective January...

Last modified: October 22, 2018