§ 1363.3
218 words·~1 min read·
/ca/health-and-safety-code/1363-3A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
(a)The department may develop standard templates for a schedule of benefits, an explanation of benefits, a cost-sharing summary, or any similar document. The standard template or templates may include standard definitions, notice and explanatory language, benefit and limitation descriptions, and any other information or formatting in the template that the director determines would provide the public, subscribers, and enrollees with a full and fair disclosure of the provisions of the plan in readily understood language and in a clearly organized manner. The department shall consult with the Department of Insurance and interested stakeholders in developing standard templates under this section.
(b)The department may require health care service plans to utilize the standard templates developed by the department pursuant to subdivision
(a)for any schedule of benefits, explanation of benefits, cost-sharing summaries, or similar documents published or distributed.
(c)Notwithstanding Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, the department may implement, interpret, or make specific this section by means of issuing and modifying templates and all-plan letters or similar instructions, without taking regulatory action.
(d)The director may require a health care service plan to file any document the health care service plan developed using a standard template developed by the department for compliance review.