reglab/housing_qa huggingface dataset:
CA Govt Code § 100503.1 (2021)
2021 California Code|Government Code - GOV|TITLE 22 - CALIFORNIA HEALTH BENEFIT EXCHANGE|Section 100503.1.

100503.1.   The board shall ensure that the Internet Web site maintained under subdivision (c) of Section 100502 provides a direct link to the formulary, or formularies, for each qualified health plan offered through the Exchange that is posted by the carrier pursuant to Section 1367.205 of the Health and Safety Code or Section 10123.192 of the Insurance Code.(Added by Stats. 2014, Ch. 575, Sec. 1. (SB 1052) Effective January 1, 2015.)
CA Govt Code § 100503.2 (2021)
2021 California Code|Government Code - GOV|TITLE 22 - CALIFORNIA HEALTH BENEFIT EXCHANGE|Section 100503.2.

100503.2.  The board shall use the information received pursuant to Section 12712.5 of the Insurance Code to provide an individual a notice that he or she may be eligible for reduced-cost coverage through the Exchange or no-cost coverage through Medi-Cal. The notice shall include information on obtaining coverage pursuant to those programs.(Added by Stats. 2013, Ch. 442, Sec. 1. (SB 28) Effective January 1, 2014.)
CA Govt Code § 100503.3 (2021)
2021 California Code|Government Code - GOV|TITLE 22 - CALIFORNIA HEALTH BENEFIT EXCHANGE|Section 100503.3.

100503.3.  (a) The Exchange, in consultation with stakeholders and the Legislature, shall develop options for providing financial assistance to help low- and middle-income Californians access health care coverage. On or before February 1, 2019, the Exchange shall report those developed options to the Legislature, Governor, and Council on Health Care Delivery Systems, established pursuant to Section 1001 of the Health and Safety Code, for consideration in the 2019–20 budget process.(b) In developing the options, the Exchange shall do both of the following:(1) Include options to assist low-income individuals who are paying a significant percentage of their income on premiums, even with federal financial assistance, and individuals with an annual income of up to 600 percent of the federal poverty level.(2) Consider maximizing all available federal funding and, in consultation with the State Department of Health Care Services, determine whether federal financial participation for the Medi-Cal program would otherwise be jeopardized. The report shall include options that do not require a federal waiver authorized under Section 1332 of the federal act, as defined in subdivision (e) of Section 100501, from the United States Department of Health and Human Services.(c) The Exchange shall make the report publicly available on its Internet Web site.(Added by Stats. 2018, Ch. 34, Sec. 2. (AB 1810) Effective June 27, 2018.)
CA Govt Code § 100503.4 (2021)
2021 California Code|Government Code - GOV|TITLE 22 - CALIFORNIA HEALTH BENEFIT EXCHANGE|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 information to enroll the individual or individuals in the lowest cost silver plan available, unless the Exchange has information from the county, State Department of Health Care Services, managed care plan, or another plan as determined by the Exchange that enables the Exchange to enroll the individual with the individual’s previous managed care plan within the timeframe required by subdivision (b).(b) Plan enrollment shall occur before the termination date of coverage through the insurance affordability program.(c) The plan’s premium due date shall be no sooner than the last day of the first month of enrollment.(d) The Exchange shall provide an individual who is enrolled in a plan pursuant to this section with a notice that includes the following information:(1) The plan in which the individual is enrolled.(2) The individual’s right to select another available plan and any relevant deadlines for that selection.(3) How to receive assistance to select a plan.(4) The individual’s right not to enroll in the plan.(5) Information for an individual appealing their previous coverage through an insurance affordability program.(6) A statement that services received during the first month of enrollment will only be covered by the plan if the premium is paid by the due date.(e) This section shall be implemented no later than July 1, 2021.(Added by Stats. 2019, Ch. 845, Sec. 1. (SB 260) Effective January 1, 2020.)
CA Govt Code § 100503.5 (2021)
2021 California Code|Government Code - GOV|TITLE 22 - CALIFORNIA HEALTH BENEFIT EXCHANGE|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.(b) The Exchange shall make the payments required under subdivision (a) directly to the qualified health plan issuers on behalf of the enrollees.(c) The payments required under subdivision (a) shall be made upon appropriation by the Legislature. The payments shall not be made from the California Health Trust Fund established by Section 100520.(d) Subject to appropriation, the payments shall be made for months beginning on or after January 1, 2022.(e) For purposes of this section, “qualified health plan” does not include a qualified dental plan offered through the Exchange.(f) This section does not create an entitlement program of any kind, appropriate any funds, require the Legislature to appropriate any funds, or increase or decrease taxes owed by a taxpayer.(Added by Stats. 2021, Ch. 143, Sec. 10. (AB 133) Effective July 27, 2021.)
CA Govt Code § 100503.8 (2021)
2021 California Code|Government Code - GOV|TITLE 22 - CALIFORNIA HEALTH BENEFIT EXCHANGE|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 board may exercise its authority directly or through its designees, and shall be acting as a health oversight agency, as defined in Section 164.501 of Title 45 of the Code of Federal Regulations.(Added by Stats. 2019, Ch. 812, Sec. 3. (AB 929) Effective January 1, 2020.)
CA Govt Code § 100504.5 (2021)
2021 California Code|Government Code - GOV|TITLE 22 - CALIFORNIA HEALTH BENEFIT EXCHANGE|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 contracting authority described in subdivision (c) of Section 100503, shall contract with, and certify as a qualified health plan, a bridge plan product that is, at a minimum, certified by the Exchange as a qualified bridge plan product. For purposes of this section, in order to be a qualified bridge plan product, the plan shall do all of the following:(1) Be a health care service plan or health insurer that contracts with the State Department of Health Care Services to provide Medi-Cal managed care plan services pursuant to Section 14005.70 of the Welfare and Institutions Code.(2) Meet minimum requirements to contract with the Exchange as a qualified health plan pursuant to Section 1301 of the federal Patient Protection and Affordable Care Act (Public Law 111-148) and Sections 100502, 100503, and 100507 of this code.(3) Enroll in the bridge plan product only individuals who meet the requirements of Section 14005.70 of the Welfare and Institutions Code.(4) Comply with the medical loss ratio requirements of Section 1399.864 of the Health and Safety Code or Section 10961 of the Insurance Code.(5) Demonstrate the bridge plan product has, at minimum, a substantially similar provider network as the Medi-Cal managed care plan offered by the health care service plan or health insurer.(b) The Exchange shall provide information on all of the available Exchange-qualified health plans in the area, including, but not limited to, bridge plan product options for selection by individuals eligible to enroll in a bridge plan product.(c) Nothing in this section shall be implemented in a manner that conflicts with a requirement of the federal act.(d) This section shall become inoperative on the October 1 that is five years after the date that federal approval of the bridge plan option occurs, and, as of the second January 1 thereafter, is repealed, unless a later enacted statute that is enacted before that date deletes or extends the dates on which it becomes inoperative and is repealed.(Added by Stats. 2013, 1st Ex. Sess., Ch. 5, Sec. 6. (SB 3 1x) Effective September 30, 2013. Conditionally inoperative, on date prescribed by its own provisions. Repealed, by its own provisions, on second January 1 after inoperative date.)
CA Govt Code § 100504.6 (2021)
2021 California Code|Government Code - GOV|TITLE 22 - CALIFORNIA HEALTH BENEFIT EXCHANGE|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 regulation authorized by this section shall be exempted from the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2).(b) This section shall become inoperative on the October 1 that is five years after the date that federal approval of the bridge plan option occurs, and, as of the second January 1 thereafter, is repealed, unless a later enacted statute that is enacted before that date deletes or extends the dates on which it becomes inoperative and is repealed.(Added by Stats. 2013, 1st Ex. Sess., Ch. 5, Sec. 7. (SB 3 1x) Effective September 30, 2013. Conditionally inoperative, on date prescribed by its own provisions. Repealed, by its own provisions, on second January 1 after inoperative date.)
CA Govt Code § 100505 (2021)
2021 California Code|Government Code - GOV|TITLE 22 - CALIFORNIA HEALTH BENEFIT EXCHANGE|Section 100505.

100505.  (a) The board shall establish and use a competitive process to select participating carriers and any other contractors under this title. Any contract entered into pursuant to this title shall be exempt from Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code, and shall be exempt from the review or approval of any division of the Department of General Services. The board shall adopt a Health Benefit Exchange Contracting Manual incorporating procurement and contracting policies and procedures that shall be followed by the Exchange. The policies and procedures in the manual shall be substantially similar to the provisions contained in the State Contracting Manual.(b) The adoption, amendment, or repeal of a regulation by the board to implement this section, including the adoption of a manual pursuant to subdivision (a) and any procurement process conducted by the Exchange in accordance with the manual, is exempt from the rulemaking provisions of the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2).(Amended by Stats. 2015, Ch. 323, Sec. 6. (SB 102) Effective September 22, 2015.)
CA Govt Code § 100506 (2021)
2021 California Code|Government Code - GOV|TITLE 22 - CALIFORNIA HEALTH BENEFIT EXCHANGE|Section 100506.

100506.  (a) The board shall establish an appeals process for prospective and current enrollees of the Exchange that complies with all requirements of the federal act concerning the role of a state Exchange in facilitating federal appeals of Exchange-related determinations. Once the federal regulations concerning appeals have been issued in final form by the United States Secretary of Health and Human Services, the board may establish additional requirements related to appeals, provided that the board determines, prior to adoption, that any additional requirement results in no cost to the General Fund and no increase in the charge imposed under subdivision (n) of Section 100503.(b) The board shall not be required to provide an appeal if the subject of the appeal is within the jurisdiction of the Department of Managed Health Care pursuant to the Knox-Keene Health Care Service Plan Act of 1975 (Chapter 2.2 (commencing with Section 1340) of Division 2 of the Health and Safety Code) and its implementing regulations, or within the jurisdiction of the Department of Insurance pursuant to the Insurance Code and its implementing regulations.(Amended by Stats. 2019, Ch. 38, Sec. 4. (SB 78) Effective June 27, 2019.)
CA Govt Code § 100506.1 (2021)
2021 California Code|Government Code - GOV|TITLE 22 - CALIFORNIA HEALTH BENEFIT EXCHANGE|Section 100506.1.

100506.1.  An applicant or enrollee has the right to appeal any of the following:(a) Any action or inaction related to the individual’s eligibility for or enrollment in an insurance affordability program, or for advance payment of premium tax credits and cost-sharing reductions, or the amount of the advance payment of the premium tax credit and level of cost sharing, or eligibility for affordable plan options, or eligibility for state financial assistance, or the amount of the advanced premium assistance subsidy.(b) An eligibility determination for an exemption from the individual responsibility penalty pursuant to Section 1311(d)(4)(H) of the federal act or an eligibility determination for an exemption from the Minimum Essential Coverage Individual Mandate, as specified in Section 100715.(c) A failure to provide timely or adequate notice of an eligibility determination or redetermination or an enrollment-related determination.(Amended by Stats. 2019, Ch. 38, Sec. 5. (SB 78) Effective June 27, 2019.)
CA Govt Code § 100506.2 (2021)
2021 California Code|Government Code - GOV|TITLE 22 - CALIFORNIA HEALTH BENEFIT EXCHANGE|Section 100506.2.

100506.2.  (a) The entity making an eligibility or enrollment determination described in Section 100506.1 shall provide notice of the appeals process at the time of application and at the time of eligibility or enrollment determination or redetermination.(b) The entity making an eligibility or enrollment determination described in Section 100506.1 shall also issue a combined eligibility notice after the Director of Health Care Services determines in writing that the California Healthcare Eligibility, Enrollment, and Retention System (CalHEERS) has been programmed for the implementation of this section, but no later than July 1, 2017. The combined eligibility notice shall contain all of the following:(1) Information about eligibility or ineligibility for Medi-Cal, premium tax credits and cost-sharing reductions, state financial assistance, and, if applicable, for the Medi-Cal Access Program, for each individual, or multiple family members of a household, that has applied, including all of the following:(A) An explanation of the action reflected in the notice, including the effective date of the action.(B) Any factual bases upon which the decision is made.(C) Citations to, or identification of, the legal authority supporting the action.(D) Contact information for available customer service resources, including local legal aid and welfare rights offices.(E) The effective date of eligibility and enrollment.(2) Information regarding the bases of eligibility for non-modified adjusted gross income (MAGI) Medi-Cal and the benefits and services afforded to individuals eligible on those bases, sufficient to enable the individual to make an informed choice as to whether to appeal the eligibility determination or the date of enrollment, which may be included with the notice in a separate document.(3) An explanation that the applicant or enrollee may appeal any action or inaction related to an individual’s eligibility for or enrollment in an insurance affordability program or state financial assistance with which the applicant or enrollee is dissatisfied by requesting a state fair hearing consistent with this title and the provisions of Chapter 7 (commencing with Section 10950) of Part 2 of Division 9 of the Welfare and Institutions Code.(4) Information on the applicant or enrollee’s right to represent themselves or to be represented by legal counsel or an authorized representative as provided in subdivision (f) of Section 100506.4.(5) An explanation of the circumstances under which the applicant’s or enrollee’s eligibility shall be maintained or reinstated pending an appeal decision, pursuant to Section 100506.5.(c) This section shall be implemented only to the extent it does not conflict with federal law.(Amended by Stats. 2019, Ch. 38, Sec. 6. (SB 78) Effective June 27, 2019.)
CA Govt Code § 100506.3 (2021)
2021 California Code|Government Code - GOV|TITLE 22 - CALIFORNIA HEALTH BENEFIT EXCHANGE|Section 100506.3.

100506.3.  (a) The board shall enter into a contract with the State Department of Social Services to serve as the Exchange appeals entity designated to hear appeals of eligibility or enrollment determination or redetermination for persons in the individual market, or exemption determinations within the Exchange’s jurisdiction. To the extent applicable, the provisions of this title, Subpart F of Part 155 of Title 45 of the Code of Federal Regulations, and Article 7 of Chapter 12 of Title 10 of the California Code of Regulations shall govern the Exchange hearing process. If those provisions are not applicable, the Medi-Cal hearing process established in Chapter 7 (commencing with Section 10950) of Part 2 of Division 9 of the Welfare and Institutions Code shall govern the Exchange hearing process.(b) This section shall be implemented only to the extent it does not conflict with federal law.(Added by Stats. 2014, Ch. 869, Sec. 4. (AB 617) Effective January 1, 2015.)
CA Govt Code § 100506.5 (2021)
2021 California Code|Government Code - GOV|TITLE 22 - CALIFORNIA HEALTH BENEFIT EXCHANGE|Section 100506.5.

100506.5.  For appeals of redetermination of Exchange advance premium tax credits, cost-sharing reductions, or state financial assistance, upon receipt of notice from the appeals entity that it has received an appeal, the entity that made the redetermination shall continue to consider the applicant or enrollee eligible for the same level of advance premium tax credits, cost-sharing reductions, or state financial assistance while the appeal is pending in accordance with the level of eligibility immediately before the redetermination being appealed.(Amended by Stats. 2019, Ch. 38, Sec. 8. (SB 78) Effective June 27, 2019.)
CA Govt Code § 100507 (2021)
2021 California Code|Government Code - GOV|TITLE 22 - CALIFORNIA HEALTH BENEFIT EXCHANGE|Section 100507.

100507.  (a) Notwithstanding any other provision of law, the Exchange shall not be subject to licensure or regulation by the Department of Insurance or the Department of Managed Health Care.(b) Carriers that contract with the Exchange shall have a license or certificate of authority from, and shall be in good standing with, their respective regulatory agencies.(Added by Stats. 2010, Ch. 655, Sec. 11. (AB 1602) Effective January 1, 2011.)
CA Govt Code § 100508 (2021)
2021 California Code|Government Code - GOV|TITLE 22 - CALIFORNIA HEALTH BENEFIT EXCHANGE|Section 100508.

100508.  (a) Notwithstanding subdivision (b), records of the Exchange that reveal either of the following shall be exempt from disclosure under the California Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1):(1) The deliberative processes, discussions, communications, or any other portion of the negotiations with entities contracting or seeking to contract with the Exchange, entities with which the Exchange is considering a contract, or entities with which the Exchange is considering or enters into any other arrangement under which the Exchange provides, receives, or arranges services or reimbursement.(2) Records that reveal claims data, encounter data, cost detail, information about payment methods, contracted rates paid by qualified health plans to providers, and enrollee coinsurance or other cost sharing that can be used to determine contracted rates paid by plans to providers.(b) Subject to subdivision (a), the following records of the Exchange shall be exempt from disclosure under the California Public Records Act (Chapter 3.5 (commencing with Section 6250) of Division 7 of Title 1) as follows:(1) Contracts with participating carriers entered into pursuant to this title on or after October 1, 2013, shall be open to inspection one year after the effective dates of the contracts.(2) If contracts with participating carriers entered into pursuant to this title are amended, the amendments shall be open to inspection one year after the effective date of the amendments.(c) Notwithstanding any other law, entire contracts with participating carriers or amendments to contracts with participating carriers shall be open to inspection by the Joint Legislative Audit Committee. The committee shall maintain the confidentiality of the contracts and amendments until the contracts or amendments to a contract are open to inspection pursuant to subdivision (b).(Amended by Stats. 2019, Ch. 812, Sec. 4. (AB 929) Effective January 1, 2020. Superseded on January 1, 2023; see amendment by Stats. 2021, Ch. 615.)
CA Govt Code § 100508 (2021)
2021 California Code|Government Code - GOV|TITLE 22 - CALIFORNIA HEALTH BENEFIT EXCHANGE|Section 100508.

100508.  (a) Notwithstanding subdivision (b), records of the Exchange that reveal either of the following shall be exempt from disclosure under the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1):(1) The deliberative processes, discussions, communications, or any other portion of the negotiations with entities contracting or seeking to contract with the Exchange, entities with which the Exchange is considering a contract, or entities with which the Exchange is considering or enters into any other arrangement under which the Exchange provides, receives, or arranges services or reimbursement.(2) Records that reveal claims data, encounter data, cost detail, information about payment methods, contracted rates paid by qualified health plans to providers, and enrollee coinsurance or other cost sharing that can be used to determine contracted rates paid by plans to providers.(b) Subject to subdivision (a), the following records of the Exchange shall be exempt from disclosure under the California Public Records Act (Division 10 (commencing with Section 7920.000) of Title 1) as follows:(1) Contracts with participating carriers entered into pursuant to this title on or after October 1, 2013, shall be open to inspection one year after the effective dates of the contracts.(2) If contracts with participating carriers entered into pursuant to this title are amended, the amendments shall be open to inspection one year after the effective date of the amendments.(c) Notwithstanding any other law, entire contracts with participating carriers or amendments to contracts with participating carriers shall be open to inspection by the Joint Legislative Audit Committee. The committee shall maintain the confidentiality of the contracts and amendments until the contracts or amendments to a contract are open to inspection pursuant to subdivision (b).(Amended by Stats. 2021, Ch. 615, Sec. 219. (AB 474) Effective January 1, 2022. Operative January 1, 2023, pursuant to Sec. 463 of Stats. 2021, Ch. 615.)