California Insurance Code PART 6.6 - QUALIFIED HIGH RISK POOLS

• Section 12739.5.
  It is the intent of the Legislature to implement Section 1101 of the federal Patient Protection and Affordable Care Act (Public Law 111-148) in California...
• Section 12739.50.a.
  For the purposes of this part, the following terms have the following meanings:(a) “Applicant” means an individual who applies for high risk medical coverage through the...
• Section 12739.51.
  The Federal Temporary High Risk Pool is hereby created in the California Health and Human Services Agency. The program shall be managed by the board.(Added...
• Section 12739.52.
  The board shall have the authority to do all of the following, consistent with Section 1101 of the federal Patient Protection and Affordable Care Act...
• Section 12739.53.
  (a) The board shall, consistent with Section 1101 of the federal Patient Protection and Affordable Care Act (P.L. 111-148) and state and federal law and contingent...
• Section 12739.54.
  (a) Plan rates for high risk medical benefits approved for the program shall not be excessive, inadequate, or unfairly discriminatory, but shall be adequate to pay...
• Section 12739.55.
  The program may place a lien on compensation or benefits recovered or recoverable by a subscriber from any party or parties responsible for the compensation...
• Section 12739.56.
  Except as provided in Article 3.5 (commencing with Section 14124.70) of Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions Code,...
• Section 12739.57.
  The board shall provide coverage pursuant to this part through participating health plans or through provider networks using a third-party administrator and may contract for...
• Section 12739.58.
  A transfer of enrollment from one participating health plan to another may be made by a subscriber at times and under conditions as may be...
• Section 12739.59.
  (a) Program decisions concerning an applicant’s or subscriber’s eligibility or eligibility date may be appealed to the board, according to procedures to be established by the...
• Section 12739.60.
  Upon enrollment as a subscriber in the program, the subscriber shall be responsible for payment of the subscriber contribution.(Added by Stats. 2010, Ch. 31, Sec....
• Section 12739.61.
  (a)  Subject to subdivision (c), the board shall cease to provide coverage through the program on July 1, 2013, except as required by the contract...
• Section 12739.62.
  This part shall remain in effect only until January 1, 2020, and as of that date is repealed, unless a later enacted statute, that is...

Last modified: October 22, 2018