§ 10753.12
249 words·~1 min read·
/ca/insurance-code/10753-12A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
(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.