Section 100503.4.
100503.4. (a) Upon receipt of an individual’s electronic account pursuant to subdivision (h) of Section 15926 of the Welfare and Institutions Code from the insurance affordability program coverage, as specified in subparagraphs (A) and (B) of paragraph (3) of subdivision (a) of Section 15926 of the Welfare and Institutions Code, the Exchange shall use the available […]
Section 100503.5.
100503.5. (a) The Exchange shall provide payments equaling the cost of providing coverage of services described in Section 18023(b)(1)(B)(i) of Title 42 of the United States Code to individuals enrolled in a qualified health plan through the Exchange in the individual market. The payments shall not be less than one dollar ($1) per enrollee per month. […]
Section 100503.7.
100503.7. (a) (1) If the board requires, or has previously required in its contracts with qualified health plans, a qualified health plan to report on cost reduction efforts, quality improvements, or disparity reductions, the board shall make public on the internet website of the Exchange plan-specific data on cost reduction efforts, quality improvements, and disparity reductions. (2) Data […]
Section 100503.8.
100503.8. The board shall engage in health oversight activities relating to Exchange operations, including, but not limited to, audits, investigations, inspections, evaluations, analyses, data collection through routine reporting, and any other activities for oversight of the Exchange, including qualified health plan contracts with health care service plans and health insurers. In performing those duties, the […]
Section 100503.9.
100503.9. (a) (1) Beginning no later than September 1, 2023, and at least monthly thereafter, the Exchange shall request from the Employment Development Department the following information of each new applicant for unemployment compensation, state disability, and paid family leave: (A) Last name. (B) First name. (C) Middle initial. (D) Social security number. (E) Date of birth. (F) Race or ethnicity, to the […]
Section 100504.
100504. (a) The board may do the following: (1) With respect to individual coverage made available in the Exchange, collect premiums and assist in the administration of subsidies. (2) Enter into contracts. (3) Sue and be sued. (4) Receive and accept gifts, grants, or donations of moneys from an agency of the United States, an agency of the state, and […]
Section 100504.5.
100504.5. (a) To the extent approved by the appropriate federal agency, for the purpose of implementing the option in paragraph (7) of subdivision (a) of Section 100504, the Exchange shall make available bridge plan products to individuals specified in Section 14005.70 of the Welfare and Institutions Code. In implementing this requirement, the Exchange, using the selective […]
Section 100504.6.
100504.6. (a) The Exchange shall have the authority to adopt regulations to implement the provisions of Section 100504.5. Prior to the adoption of regulations, the board and its staff shall meet the requirement of subdivision (t) of Section 100503 in implementing the bridge plan option. Until January 1, 2016, the adoption, amendment, or repeal of a […]
Section 100500.
100500. (a) There is in state government the California Health Benefit Exchange, an independent public entity not affiliated with an agency or department, which shall also be known as Covered California. Covered California shall be governed by an executive board consisting of five members who are residents of California. Of the members of the board, two […]
Section 100501.
100501. For purposes of this title, the following definitions shall apply: (a) “Board” means the board described in subdivision (a) of Section 100500. (b) “Bridge plan product” means an individual health benefit plan as defined in subdivision (f) of Section 1399.845 of the Health and Safety Code that is offered by a health care service plan licensed […]