§ 10753.12. — 10753.12. (Amended by Stats. 2013, 1st Ex. Sess., Ch. 1, Sec. 13.)

California § 10753.12.

• Jurisdiction: California
• Code INS: Insurance Code - INS
• Div. 2.: DIVISION 2. CLASSES OF INSURANCE
• Part 2.: PART 2. LIFE AND DISABILITY INSURANCE
• Ch. 8.01.: CHAPTER 8.01. Nongrandfathered Small Employer Health Insurance
• Art. 2.: ARTICLE 2. Small Employer Carrier Requirements

Text

(a)
A carrier shall not be required to offer coverage or accept applications for benefit plan designs pursuant to this chapter where the carrier demonstrates to the satisfaction of the commissioner both of the following:
(1)
The acceptance of an application or applications would place the carrier in a financially impaired condition.
(2)
The carrier is applying this subdivision uniformly to all employers without regard to the claims experience of those employers and their employees and dependents or any health status-related factor relating to those employees and dependents.
(b)
The commissioner’s determination under subdivision (a) shall follow an evaluation that includes a certification by the commissioner that the acceptance of an application or applications would place the carrier in a financially impaired condition.
(c)
A carrier that has not offered coverage or accepted applications pursuant to this chapter shall not offer coverage or accept applications for any individual or group health benefit plan until the later of the following dates:
(1)
The 181st day after the date that coverage is denied pursuant to this section.
(2)
The date on which the carrier ceases to be financially impaired, as determined by the commissioner.
(d)
Subdivision (c) shall not limit the carrier’s ability to renew coverage
already in force or relieve the carrier of the responsibility to renew that coverage as described in Sections 10273.4, 10273.6, and 10753.13.
(e)
Coverage offered within a service area after the period specified in subdivision (c) shall be subject to the requirements of this section.

Legislative History

Amended by Stats. 2013, 1st Ex. Sess., Ch. 1, Sec. 13. (AB 2 1x) Effective September 30, 2013.