reglab/housing_qa huggingface dataset:
CA Ins Code § 12693.63 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 6 - Dental Benefits and Copayments|Section 12693.63.

12693.63.  (a) The board shall determine the dental benefits to be provided to subscribers by the program. These benefits shall be consistent with those provided to state employees through the Department of Personnel Administration, the predecessor to the Department of Human Resources, on July 1, 1997, except that orthodontia shall only be a benefit when it is determined to be medically necessary.(b) The board shall establish the required subscriber copayment levels for dental benefits. The copayment levels established by the board shall, to the extent possible, reflect the copayment levels provided to state employees through the Department of Personnel Administration, the predecessor to the Department of Human Resources, on July 1, 1997, except that no copayment shall be charged for medically necessary orthodontia services. There shall be no subscriber copayments for preventive and diagnostic services, including, but not limited to, examinations, teeth cleaning, X-rays, topical fluoride treatments, space maintainers, and sealants.(c) No deductible shall be charged to subscribers for dental benefits.(d) (1) The board may establish a cap on the amount of dental coverage provided to a subscriber in a given benefit year effective on and after the first day of the fifth month following enactment of the 2008–09 Budget Act. This dental coverage cap shall not be lower than one thousand five hundred dollars ($1,500) per subscriber per benefit year.(2) The board may adopt, and may only one-time readopt, regulations to implement paragraph (1). The adoption and one-time readoption of a regulation authorized by this paragraph is deemed to address an emergency, for purposes of Sections 11346.1 and 11349.6 of the Government Code, and the board is hereby exempted for this purpose from the requirements of subdivision (b) of Section 11346.1 of the Government Code.(Amended by Stats. 2018, Ch. 903, Sec. 18. (SB 1504) Effective January 1, 2019.)
CA Ins Code § 12693.64 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 6 - Dental Benefits and Copayments|Section 12693.64.

12693.64.  Notwithstanding any other provision of law, for a subscriber who is determined by the California Children’s Services Program to be eligible for benefits under the program pursuant to Article 5 (commencing with Section 123800) of Chapter 3 of Part 2 of Division 106 of the Health and Safety Code, a participating plan shall not be responsible for the provision of, or payment for, the particular services authorized by the California Children’s Services Program for the particular subscriber for the treatment of a California Children’s Services Program eligible medical condition. All other services provided under the participating plan shall be available to the subscriber.(Added by Stats. 1997, Ch. 623, Sec. 2. Effective January 1, 1998.)
CA Ins Code § 12693.65 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 7 - Vision Benefits and Copayments|Section 12693.65.

12693.65.  (a) Vision benefits shall be provided to subscribers and shall meet the federal coverage requirements in Section 2103 of Title XXI of the Social Security Act.(b) The covered benefits shall be equivalent to those provided to state employees through the Department of Human Resources, except for tinted lenses and also photochromatic lenses, unless otherwise deemed medically necessary.(c) The board shall establish the required subscriber copayment levels for vision benefits consistent with the limitations of Section 2103 of Title XXI of the Social Security Act. The copayment levels established by the board shall, to the extent possible, reflect the copayment levels provided to state employees through the Department of Human Resources.(d) From March 1, 2011, to June 30, 2012, inclusive, the adoption and readoption, by the board, of regulations to modify vision benefits pursuant to this section, including, but not limited to, restriction of providers through which covered vision benefits may be obtained, restriction of benefits for services from nonparticipating providers, or restriction of products and materials provided as benefits pursuant to this section, shall be deemed to be an emergency and necessary to avoid serious harm to the public peace, health, safety, or general welfare for purposes of Sections 11346.1 and 11349.6 of the Government Code, and the board is hereby exempted from the requirement that it describe facts showing the need for immediate action and from review by the Office of Administrative Law.(Amended by Stats. 2012, Ch. 665, Sec. 174. (SB 1308) Effective January 1, 2013.)
CA Ins Code § 12693.66 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 7 - Vision Benefits and Copayments|Section 12693.66.

12693.66.  Notwithstanding any other provision of law, for a subscriber who is determined by the California Children’s Services Program to be eligible for benefits under the program pursuant to Article 5 (commencing with Section 123800) of Chapter 3 of Part 2 of Division 106 of the Health and Safety Code, a participating plan shall not be responsible for the provision of, or payment for, the particular services authorized by the California Children’s Services Program for the particular subscriber for the treatment of a California Children’s Services Program eligible medical condition. All other services provided under the participating plan shall be available to the subscriber.(Added by Stats. 1997, Ch. 623, Sec. 2. Effective January 1, 1998.)
CA Ins Code § 12693.68 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 8 - Linkages with Public Programs|Section 12693.68.

12693.68.  The board shall encourage all plans, including those receiving purchasing credits, that provide services under the program to have viable protocols for screening and referring children needing supplemental services outside of the scope of the screening, preventive, and medically necessary and therapeutic services covered by the contract to public programs providing such supplemental services for which they may be eligible, as well as for coordination of care between the plan and the public programs. The public programs for which plans may be required to develop screening, referral, and care coordination protocols may include the California Children’s Services Program, the regional centers, county mental health programs, substance use disorder programs administered by the State Department of Health Care Services, and programs administered by local education agencies.(Amended by Stats. 2013, Ch. 22, Sec. 75. (AB 75) Effective June 27, 2013. Operative July 1, 2013, by Sec. 110 of Ch. 22.)
CA Ins Code § 12693.69 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 8 - Linkages with Public Programs|Section 12693.69.

12693.69.  A child enrolled in the Healthy Families Program who has a medical condition that is eligible for services pursuant to the California Children’s Services Program, and whose family is not financially eligible for the California Children’s Services Program, shall have the medically necessary treatment services for their California Children’s Services Program eligible medical condition authorized and paid for by the California Children’s Services Program. County expenditures for the payment of services for the child shall be waived and these expenditures shall be paid for by the state from Title XXI funds that are applicable and state general funds.(Added by Stats. 1999, Ch. 146, Sec. 18. Effective July 22, 1999.)
CA Ins Code § 12693.71 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 9 - Eligibility|Section 12693.71.

12693.71.  (a) The board shall monitor applications to determine whether employers and employees have dropped employer-sponsored dependent coverage in order to participate in the program.(b) The board may disapprove an application if it is determined that the children to be covered under the application were covered by an employer-sponsored insurance within the last three months.(c) If the board imposes the limitation identified in subdivision (b) or (d), it shall also establish exceptions to this limitation in cases where prior coverage ended due to reasons unrelated to the availability of the program. This shall include, but not be limited to:(1) Loss of employment due to factors other than voluntary termination.(2) Change to a new employer that does not provide an option for dependent coverage.(3) Change of address so that no employer sponsored coverage is available.(4) Discontinuation of health benefits to all employees of the applicant’s employer.(5) Expiration of COBRA coverage period.(6) Coverage provided pursuant to an exemption authorized under subdivision (i) of Section 1367 of the Health and Safety Code.(d) If the board determines, based on evidence gathered during a reasonable period of program operation, that a substantial share of funds expended for the program are providing health coverage for children that have discontinued employer-based coverage in order to enter the program or if required by the federal government for state plan approval, the board may take actions to increase the three-month time limit specified in subdivision (b), to such a time limit that cannot exceed six months.(Added by Stats. 1997, Ch. 623, Sec. 2. Effective January 1, 1998.)
CA Ins Code § 12693.72 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 9 - Eligibility|Section 12693.72.

12693.72.  (a) The board may disapprove an application if it is determined that the children to be covered under the application were covered by an individual health care service plan contract or individual disability insurance policy during a specified period of time prior to the date of application only if required by the federal government for state plan approval. This time limitation period shall not exceed the time period required by the federal government.(b) If the board imposes the time limitation identified in subdivision (a), it shall also establish exceptions to this limitation in cases where the prior coverage ended due to reasons unrelated to the availability of the program. This shall include, but not be limited to, the prior coverage being pursuant to a health plan operating pursuant to an exemption authorized by subdivision (i) of Section 1367 of the Health and Safety Code.(Added by Stats. 1997, Ch. 623, Sec. 2. Effective January 1, 1998.)
CA Ins Code § 12693.73 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 9 - Eligibility|Section 12693.73.

12693.73.  Notwithstanding any other provision of law, children excluded from coverage under Title XXI of the Social Security Act are not eligible for coverage under the program, except as specified in clause (ii) of subparagraph (A) of paragraph (6) of subdivision (a) of Section 12693.70 and Section 12693.76.(Amended by Stats. 2003, Ch. 230, Sec. 19. Effective August 11, 2003.)
CA Ins Code § 12693.74 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 9 - Eligibility|Section 12693.74.

12693.74.  Subscribers shall continue to be eligible for the program for a period of 12 months from the month eligibility is established.(Added by Stats. 1997, Ch. 623, Sec. 2. Effective January 1, 1998.)
CA Ins Code § 12693.75 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 9 - Eligibility|Section 12693.75.

12693.75.  (a) The program shall make use of a simple and easy to understand mail-in application process.(b) For children referred pursuant to Section 14005.41 of the Welfare and Institutions Code, the program shall utilize the school lunch application and any supplemental forms received pursuant to Section 14005.41 of the Welfare and Institutions Code to make an eligibility determination and shall request additional information only as needed to complete the eligibility process.(c) The Managed Risk Medical Insurance Board may adopt emergency regulations to implement subdivision (b) and coordinate with all other state and local government entities in the implementation of Section 49557.2 of the Education Code and Section 14005.41 of the Welfare and Institutions Code. Any rules and regulations issued by the board pertaining to the implementation of this section may be adopted as emergency regulations in accordance with the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code). The adoption and one readoption of these regulations shall be deemed to be an emergency and necessary for the immediate preservation of the public peace, health, and safety, or general welfare, and shall be exempt from review by the Office of Administrative Law. Any emergency regulations authorized by this section shall be submitted to the Office of Administrative Law for filing with the Secretary of State and publication in the California Code of Regulations, and shall remain in effect for not more than 180 days unless the department readopts those regulations. The regulations shall become effective immediately upon filing with the Secretary of State.(Amended by Stats. 2004, Ch. 729, Sec. 2. Effective January 1, 2005.)
CA Ins Code § 12693.755 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 9 - Eligibility|Section 12693.755.

12693.755.  (a) Subject to subdivision (b), commencing four months after the initial federal approval is obtained pursuant to the waiver described in subdivision (b), the board shall expand eligibility under this part to uninsured parents of, and as defined by the board, adults responsible for, children enrolled to receive coverage under this part or who are enrolled to receive the full scope of Medi-Cal services with no share of cost and whose income does not exceed 250 percent of the federal poverty level, before applying the income disregard provided for in subparagraph (B) of paragraph (6) of subdivision (a) of Section 12693.70.(b) (1) The board shall implement a program to provide coverage under this part to any uninsured parent or responsible adult who is eligible pursuant to subdivision (a), pursuant to the waiver identified in paragraph (2).(2) The program shall be implemented only in accordance with a State Child Health Insurance Program waiver pursuant to Section 1397gg(e)(2)(A) of Title 42 of the United States Code, to provide coverage to uninsured parents and responsible adults, and shall be subject to the terms, conditions, and duration of the waiver. The services shall be provided under the program only if the waiver is approved by the federal Centers for Medicare and Medicaid Services, and, except as provided under the terms and conditions of the waiver, only to the extent that federal financial participation is available and funds are appropriated specifically for this purpose.(Amended by Stats. 2001, Ch. 171, Sec. 15. Effective August 10, 2001.)
CA Ins Code § 12693.76 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 9 - Eligibility|Section 12693.76.

12693.76.  (a) Notwithstanding any other provision of law, a child who meets the definition of the term defined in subsection (b) or (c) of Section 1641 of Title 8 of the United States Code shall not be determined ineligible solely on the basis of the child’s date of entry into the United States.(b) Notwithstanding any other provision of law, subdivision (a) may only be implemented to the extent provided in the annual Budget Act.(c) Notwithstanding any other provision of law, any uninsured parent or responsible adult who meets the definition of the term defined in subsection (b) or (c) of Section 1641 of Title 8 of the United States Code shall not be determined to be ineligible solely on the basis of that person’s date of entry into the United States.(d) Notwithstanding any other provision of law, subdivision (c) may only be implemented to the extent of funding provided in the annual Budget Act.(Amended by Stats. 2021, Ch. 296, Sec. 37. (AB 1096) Effective January 1, 2022.)
CA Ins Code § 12693.765 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 9 - Eligibility|Section 12693.765.

12693.765.  (a) Notwithstanding any other provision of law and subject to subdivision (b), a child described in clause (ii) of subparagraph (A) of paragraph (6) of subdivision (a) of Section 12693.70 shall be deemed eligible to participate in the program at birth.(b) Notwithstanding any other provision of law, subdivision (a) and clause (ii) of subparagraph (A) of paragraph (6) of subdivision (a) of Section 12693.70 may only be implemented to the extent that funds are appropriated for that purpose in the annual Budget Act or other statute.(Added by Stats. 2003, Ch. 230, Sec. 20. Effective August 11, 2003.)
CA Ins Code § 12693.77 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 10 - Fiscal Integrity|Section 12693.77.

12693.77.  (a) The board shall develop safeguards to assure the fiscal integrity of the program.(b) The program shall ensure that subscribers are not eligible for no-cost full-scope Medi-Cal coverage. The board may provide data on applicants and subscribers to the State Department of Health Services for determination of Medi-Cal eligibility. The State Department of Health Services shall identify those subscribers enrolled in the program who are concurrently enrolled in Medi-Cal with no share of cost.(c) Any person who intentionally makes false declarations as to his or her eligibility or any person who intentionally makes false declarations as to eligibility on behalf of any other person seeking eligibility under this part for which that person is not eligible shall be guilty of a misdemeanor.(d) Plans and providers shall be subject to Section 550 of the Penal Code.(e) Any person who intentionally makes false declarations as to his or her eligibility or any person who intentionally makes false declarations as to eligibility on behalf of any other person seeking eligibility under this part for which that person is not eligible may be denied coverage for up to one year from the date of the denial of coverage by the board.(Added by Stats. 1997, Ch. 623, Sec. 2. Effective January 1, 1998.)
CA Ins Code § 12693.80 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 11 - Protection Against Substitution of Benefits|Section 12693.80.

12693.80.  The board shall use due diligence in the creation of participation standards for the program that minimize the incentive for employers or applicants to drop or reduce dependent health coverage.(Added by Stats. 1997, Ch. 623, Sec. 2. Effective January 1, 1998.)
CA Ins Code § 12693.81 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 11 - Protection Against Substitution of Benefits|Section 12693.81.

12693.81.  (a) It shall constitute unfair competition for purposes of Chapter 5 (commencing with Section 17200) of Part 2 of Division 7 of the Business and Professions Code for an insurer, an insurance agent or broker, or an administrator, as defined in Section 1759, to refer an individual employee or employee’s dependent to the program, or arrange for an individual employee or employee’s dependent to apply for the program, for the purpose of separating that employee or employee’s dependent from group health coverage in connection with the employee’s employment.(b) Any employee applicant in subdivision (a) shall have personal right of action to enforce subdivision (a).(Added by Stats. 1997, Ch. 623, Sec. 2. Effective January 1, 1998.)
CA Ins Code § 12693.82 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 11 - Protection Against Substitution of Benefits|Section 12693.82.

12693.82.  It shall constitute an unfair labor practice contrary to public policy, and enforceable under Section 95 of the Labor Code, for any employer to refer an individual employee or employee’s dependent to the program, or to arrange for an individual employee or employee’s dependent to apply to the program, for the purpose of separating that employee or employee’s dependent from group health coverage provided in connection with the employee’s employment.(Added by Stats. 1997, Ch. 623, Sec. 2. Effective January 1, 1998.)
CA Ins Code § 12693.83 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 11 - Protection Against Substitution of Benefits|Section 12693.83.

12693.83.  (a) It shall constitute an unfair labor practice contrary to public policy and enforceable under Section 95 of the Labor Code for any employer to change the employee-employer share-of-cost ratio based upon the employee’s wage base or job classification or to make any modification of coverage for employees and employee’s dependents in order that the employees or employee’s dependents enroll in the program established pursuant to this part.(Added by Stats. 1997, Ch. 623, Sec. 2. Effective January 1, 1998.)
CA Ins Code § 12693.84 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 11 - Protection Against Substitution of Benefits|Section 12693.84.

12693.84.  For purposes of Sections 12693.82 and 12693.83, group health coverage includes any group disability insurance policy covering hospital, medical, or surgical expenses, group health care service plan contract, or self-insured employee welfare benefit plan.(Added by Stats. 1997, Ch. 623, Sec. 2. Effective January 1, 1998.)
CA Ins Code § 12693.85 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 12 - Appeals|Section 12693.85.

12693.85.  Program decisions described in this section may be appealed to the board. If an applicant believes that a written decision on one of the following specified issues was made in violation of the program statutes or regulations, or other written representation of program policy made to the individual by the program or the board, that individual may file an appeal with the board. Decisions that may be appealed are the following:(a) A decision that a child is not qualified to participate or continue to participate in the program.(b) A decision that a child is not eligible for enrollment or continuing enrollment in the program.(c) A decision as to the effective date of coverage.(Added by Stats. 1997, Ch. 623, Sec. 2. Effective January 1, 1998.)