Source: http://leginfo.legislature.ca.gov/faces/billCompareClient.xhtml?bill_id=201320140AB18&showamends=false
Timestamp: 2020-02-23 07:41:35
Document Index: 763940679

Matched Legal Cases: ['art 3', 'art 6', 'art 6', 'art 6', 'art 6', 'art 5', 'art 3', 'art 6', 'art 6', 'art 6', 'art 6']

(a) Beginning on January 1, 2014, a specialized health care service plan contract described in Section 1311(d)(2)(B)(ii) of PPACA (42 U.S.C. Sec. 18031(d)(2)(B)(ii)) that provides pediatric oral care benefits, whether or not it is bundled with a qualified health plan or standing alone, shall be subject to Sections 1367 and 1367.03.
(b) Beginning on January 1, 2015, a specialized health care service plan contract described in Section 1311(d)(2)(B)(ii) of PPACA (42 U.S.C. Sec. 18031(d)(2)(B)(ii)) that provides pediatric oral care benefits, whether or not it is bundled with a qualified health plan or standing alone, shall be subject to Article 6.2 (commencing with Section 1385.01).
(a) (1) Notwithstanding Section 1367.003, beginning on January 1, 2015, every specialized health care service plan contract described in Section 1311(d)(2)(B)(ii) of PPACA (42 U.S.C. Sec. 18031(d)(2)(B)(ii)), as defined in Section 1367.005, providing pediatric oral care benefits, whether or not it is bundled with a qualified health plan or standing alone, shall provide an annual rebate to each enrollee under that coverage, on a pro rata basis, if the ratio of the amount of premium revenue expended by the specialized health care service plan on the costs for reimbursement for services provided to enrollees under that coverage and for activities that improve dental care quality to the total amount of premium revenue, excluding federal and state taxes and licensing or regulatory fees, and after accounting for payments or receipts for risk adjustment, risk corridors, and reinsurance, is less than 75 percent.
This article shall apply to a health care service plan contract contracts offered in the individual or group market in California. However, this article shall not apply to a specialized health care service plan contract, a other than one providing pediatric oral care benefits, whether or not it is bundled with a qualified health plan or standing alone, as described in Section 1367.013; a Medicare supplement contract subject to Article 3.5 (commencing with Section 1358.1), 1358.1); a health care service plan contract offered in the Medi-Cal program (Chapter 7 (commencing with Section 14000) of Part 3 of Division 9 of the Welfare and Institutions Code), Code); a health care service plan contract offered in the Healthy Families Program (Part 6.2 (commencing with Section 12693) of Division 2 of the Insurance Code), the Access for Infants and Mothers Program (Part 6.3 (commencing with Section 12695) of Division 2 of the Insurance Code), the California Major Risk Medical Insurance Program (Part 6.5 (commencing with Section 12700) of Division 2 of the Insurance Code), or the Federal Temporary High Risk Pool (Part 6.6 (commencing with Section 12739.5) of Division 2 of the Insurance Code); a health care service plan conversion contract offered pursuant to Section 1373.6, 1373.6; or a health care service plan contract offered to a federally eligible defined individual under Article 4.6 (commencing with Section 1366.35) or Article 10.5 11.5 (commencing with Section 1399.801), or a Mexican prepaid health plan subject to Section 1351.2. This article does not limit, impair, or interfere with the authority of the California Public Employees’ Retirement System, as set forth in Section 22794 of the Government Code and Article 6 (commencing with Section 22850) of Part 5 of Division 5 of Title 2 of the Government Code. 1399.801).
(a) Beginning on January 1, 2014, a specialized health insurance policy described in Section 1311(d)(2)(B)(ii) of PPACA (42 U.S.C. Sec. 18031(d)(2)(B)(ii)) that provides pediatric oral care benefits, whether or not it is bundled with a qualified health plan or standing alone, shall be subject to Section 10133.5.
(b) Beginning on January 1, 2015, a specialized health insurance policy described in Section 1311(d)(2)(B)(ii) of PPACA (42 U.S.C. Sec. 18031(d)(2)(B)(ii)) that provides pediatric oral care benefits, whether or not it is bundled with a qualified health plan or standing alone, shall be subject to Article 4.5 (commencing with Section 10181).
(a) (1) Notwithstanding Section 10112.25, beginning on January 1, 2015, every specialized health insurance policy described in Section 1311(d)(2)(B)(ii) of PPACA (42 U.S.C. Sec. 18031(d)(2)(B)(ii)), as defined in Section 10112.27, providing pediatric oral care benefits, whether or not it is bundled with a qualified health plan or standing alone, shall provide an annual rebate to each insured under that coverage, on a pro rata basis, if the ratio of the amount of premium revenue expended by the health insurer on the costs for reimbursement for services provided to insureds under that coverage and for activities that improve dental care quality to the total amount of premium revenue, excluding federal and state taxes and licensing or regulatory fees and after accounting for payments or receipts for risk adjustment, risk corridors, and reinsurance, is less than 75 percent.
This article shall apply to a health insurance policy policies offered in the individual or group market in California. However, this article shall not apply to a specialized health insurance policy, a other than one providing pediatric oral care benefits, whether or not it is bundled with a qualified health plan or standing alone, as described in Section 10112.35; a Medicare supplement policy subject to Article 6 (commencing with Section 10192.05), 10192.05); a health insurance policy offered in the Medi-Cal program (Chapter 7 (commencing with Section 14000) of Part 3 of Division 9 of the Welfare and Institutions Code), Code); a health insurance policy offered in the Healthy Families Program (Part 6.2 (commencing with Section 12693)), the Access for Infants and Mothers Program (Part 6.3 (commencing with Section 12695)), the California Major Risk Medical Insurance Program (Part 6.5 (commencing with Section 12700)), or the Federal Temporary High Risk Pool (Part 6.6 (commencing with Section 12739.5)); a health insurance conversion policy offered pursuant to Section 12682.1, 12682.1; or a health insurance policy offered to a federally eligible defined individual under Chapter 9.5 (commencing with Section 10900), or a Mexican prepaid health plan subject to Section 1351.2 of the Health and Safety Code. 10900).