reglab/housing_qa huggingface dataset:
CA Ins Code § 12693.21 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 3 - Creation of Program and Powers of the Board|Section 12693.21.

12693.21.  The board may do all of the following consistent with the standards in this part:(a) Determine eligibility criteria for the program.(b) Determine the participation requirements of applicants, subscribers, purchasing credit members, and participating health, dental, and vision plans.(c) Determine when subscribers’ coverage begins and the extent and scope of coverage.(d) Determine family contribution amount schedules and collect the contributions.(e) Determine who may be a family contribution sponsor and provide a mechanism for sponsorship.(f) Provide or make available subsidized coverage through participating health, dental, and vision plans, in a purchasing pool, which may include the use of a purchasing credit mechanism, through supplemental coverage, or through coordination with other state programs.(g) Provide for the processing of applications, the enrollment of subscribers, and the distribution of purchasing credits.(h) Determine and approve the benefit designs and copayments required by health, dental, or vision plans participating in the purchasing pool component program.(i) Approve those health plans eligible to receive purchasing credits.(j) Enter into contracts.(k) Sue and be sued.(l) Employ necessary staff.(m) Authorize expenditures from the fund to pay program expenses that exceed subscriber contributions, and to administer the program as necessary.(n) Maintain enrollment and expenditures to ensure that expenditures do not exceed amounts available in the Healthy Families Fund and if sufficient funds are not available to cover the estimated cost of program expenditures, the board shall institute appropriate measures to limit enrollment.(o) Issue rules and regulations, as necessary. Until January 1, 2000, any rules and regulations issued pursuant to this subdivision 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 of these regulations shall be deemed an emergency and necessary for the immediate preservation of the public peace, health, and safety or general welfare. The regulations shall become effective immediately upon filing with the Secretary of State.(p) Exercise all powers reasonably necessary to carry out the powers and responsibilities expressly granted or imposed by this part.(q) Notwithstanding any other provision of law, on and after January 1, 2011, impose any sanction on, and provide notice and a hearing to, participating health, dental, and vision plans consistent with Section 403 of the federal Children’s Health Insurance Program Reauthorization Act of 2009 (Public Law 111-3) by applying subsection (e) of Section 1932 of the federal Social Security Act.(Amended by Stats. 2010, Ch. 717, Sec. 26. (SB 853) Effective October 19, 2010.)
CA Ins Code § 12693.22 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 3 - Creation of Program and Powers of the Board|Section 12693.22.

12693.22.  During the 2009–10 and 2010–11 fiscal years, the adoption and readoption of regulations to modify health, dental, and vision benefits or otherwise modify program requirements and operations consistent with the provisions of this part shall be deemed to be an emergency and necessary for the immediate preservation of public peace, health and 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.(Added by Stats. 2009, Ch. 157, Sec. 2. (AB 1422) Effective September 22, 2009.)
CA Ins Code § 12693.23 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 3 - Creation of Program and Powers of the Board|Section 12693.23.

12693.23.  Until July 1, 2012, the adoption and readoption of regulations to implement subdivision (q) of Section 12693.21, subdivision (b) of Section 12693.26, or subdivision (l) of Section 56.30 of the Civil Code, or any provision of the federal Children’s Health Insurance Program Reauthorization Act of 2009 (Public Law 111-3) not addressed by those sections, shall be deemed to be an emergency and necessary for the immediate preservation of the public peace, health and 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.(Added by Stats. 2010, Ch. 717, Sec. 27. (SB 853) Effective October 19, 2010.)
CA Ins Code § 12693.25 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 4 - Administration|Section 12693.25.

12693.25.  The board may use a purchasing pool model, issuance of purchasing credits, supplemental coverage, or other means as appropriate to meet the purposes of this part.(Added by Stats. 1997, Ch. 623, Sec. 2. Effective January 1, 1998.)
CA Ins Code § 12693.26 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 4 - Administration|Section 12693.26.

12693.26.  (a) The board shall establish a purchasing pool for coverage of program subscribers to enable applicants without access to affordable and comprehensive employer-sponsored dependent coverage to provide their eligible children with health, dental, and vision benefits. The board shall negotiate separate contracts with participating health, dental, and vision plans for each of the benefit packages described in Chapters 5 (commencing with Section 12693.60), 6 (commencing with Section 12693.63), and 7 (commencing with Section 12693.65).(b) Notwithstanding any other provision of law, on and after January 1, 2011, the board may negotiate contracts with entities that are not participating health, dental, or vision plans, including, but not limited to, interagency agreements with the State Department of Health Care Services, to provide or pay for benefits to subscribers under this part, if necessary for any of the following purposes:(1) To comply with Section 403 of the federal Children’s Health Insurance Program Reauthorization Act of 2009 (Public Law 111-3) by applying paragraph (4) of subsection (a) of Section 1932 of the federal Social Security Act.(2) To comply with Section 503 of the federal Children’s Health Insurance Program Reauthorization Act of 2009 (Public Law 111-3) by applying subsection (bb) of Section 1902 of the federal Social Security Act.(3) To ensure that subscribers have adequate access to benefits under this part.(c) Any interagency agreement entered into by a state agency with the board pursuant to subdivision (b), and any other contract or contract amendment necessary to implement that agreement, shall be exempt from any provision of law relating to competitive bidding and from the review or approval of any division of the Department of General Services in the same manner as contracts entered into by the board are exempt pursuant to Section 12693.54.(Amended by Stats. 2010, Ch. 717, Sec. 28. (SB 853) Effective October 19, 2010.)
CA Ins Code § 12693.27 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 4 - Administration|Section 12693.27.

12693.27.  (a) The board shall develop a purchasing credit mechanism to enable applicants with access to affordable and comprehensive employer-sponsored dependent coverage to have an eligible child enrolled in the employer’s health plan. Children enrolled in the purchasing credit mechanism may receive dental and vision benefits through the purchasing pool component of the program.(b) In order to be eligible for a purchasing credit, the employer shall make a meaningful contribution toward the cost of coverage for an employee’s dependents for whom an application is made for a purchasing credit. An employer’s contribution, including any increases or decreases in the contribution made after the effective date of this part, may not vary among employees based on wage base or job classification.(c) The board shall adopt appropriate mechanisms to recoup purchasing credit expenditures from an employer plan when the employees or dependents on behalf of whose coverage the payments are made are no longer enrolled in that plan.(d) An employer utilizing a purchasing credit arrangement and a participating health plan receiving a purchasing credit must use 100 percent of the funds for the purchase of coverage for purchasing credit members including dependent coverage.(e) A participating plan shall not assess the board for any portion of late fees, returned checks, or other fees in connection with an employer with group coverage who is also participating in the purchasing credit arrangement.(f) An applicant may begin coverage for dependents using a purchasing credit arrangement at any time. Purchasing credit members enrolling in employer-sponsored coverage shall not be considered late enrollees for the purposes of subdivision (d) of Section 1357 and subdivision (b) of Section 1357.50 of the Health and Safety Code, and subdivision (b) of Section 10198.6 and subdivision (l) of Section 10700.(g) Under no circumstances shall the employee’s share of cost, including, deductibles, copayments, and coinsurance, for dependent coverage, including any supplemental coverage necessary to meet the 95 percent actuarial standard established in Section 12693.15 be more than that required as the employee’s share of premium if the employee’s children were enrolled in the purchasing pool component of the program.(h) The board may limit participation in the purchasing credit program to those employers that provide employee health benefits through participation in public or private purchasing cooperatives.(Added by Stats. 1997, Ch. 623, Sec. 2. Effective January 1, 1998.)
CA Ins Code § 12693.271 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 4 - Administration|Section 12693.271.

12693.271.  (a) The Legislature finds and declares that the state faces a fiscal crisis that requires unprecedented measures to reduce General Fund expenditures.(b) Notwithstanding any other provision of law, beginning the first day of the fifth month following the enactment of the 2008–09 Budget Act, the rates for the participating health, dental, and vision plans shall be set by reducing the rates that were in effect on July 1, 2007, by 5 percent, and by adjusting the July 1, 2007, rates downward to account for any reduction in the actuarial value of the benefits provided to subscribers as of the first day of the fifth month following the enactment of the 2008–09 Budget Act, associated with annual limitations on dental benefits. This requirement does not preclude the board from making other downward adjustments that it deems appropriate as a result of its annual rate negotiation process.(Added by Stats. 2008, Ch. 758, Sec. 16. Effective September 30, 2008.)
CA Ins Code § 12693.28 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 4 - Administration|Section 12693.28.

12693.28.  The program shall be administered without regard to gender, gender identity, gender expression, race, creed, color, sexual orientation, health status, disability, or occupation.(Amended by Stats. 2011, Ch. 719, Sec. 28. (AB 887) Effective January 1, 2012.)
CA Ins Code § 12693.29 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 4 - Administration|Section 12693.29.

12693.29.  (a) The board shall use appropriate and efficient means to notify families of the availability of health coverage from the program.(b) The State Department of Health Services in conjunction with the board shall conduct a community outreach and education campaign in accordance with Section 14067 of the Welfare and Institutions Code to assist in notifying families of the availability of health coverage for their children.(c) The board shall use appropriate materials, which may include brochures, pamphlets, fliers, posters, and other promotional items, to notify families of the availability of coverage through the program.(Added by Stats. 1997, Ch. 623, Sec. 2. Effective January 1, 1998.)
CA Ins Code § 12693.30 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 4 - Administration|Section 12693.30.

12693.30.  (a) The board shall assure that written enrollment information issued or provided by the program is available to program subscribers and applicants in each of the languages identified pursuant to Chapter 17.5 (commencing with Section 7290) of Division 7 of Title 1 of the Government Code.(b) The board shall assure that phone services provided to program subscribers and applicants by the program are available in all of the languages identified pursuant to Chapter 17.5 (commencing with Sec. 7290) of Division 7 of Title 1 of the Government Code.(c) The board shall assure that interpreter services are available between subscribers and contracting plans. The board shall assure that subscribers are provided information within provider network directories of available linguistically diverse providers.(d) The board shall assure that participating health, dental, and vision plans provide documentation on how they provide linguistically and culturally appropriate services, including marketing materials, to subscribers.(Added by Stats. 1997, Ch. 623, Sec. 2. Effective January 1, 1998.)
CA Ins Code § 12693.31 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 4 - Administration|Section 12693.31.

12693.31.  No participating health, dental, or vision plan shall, in an area served by the program, directly, or through an employee, agent, or contractor, provide an applicant, or a child with any marketing material relating to benefits or rates provided under the program unless the material has been both reviewed and approved by the board.(Added by Stats. 1997, Ch. 623, Sec. 2. Effective January 1, 1998.)
CA Ins Code § 12693.326 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 4 - Administration|Section 12693.326.

12693.326.  Notwithstanding any other provision of this part, a new subscriber in the program shall be allowed to switch his or her choice of plans once within the first three months of coverage for any reason.(Amended by Stats. 2004, Ch. 234, Sec. 3. Effective January 1, 2005.)
CA Ins Code § 12693.33 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 4 - Administration|Section 12693.33.

12693.33.  To the extent feasible and permissible under federal law and with receipt of necessary federal approvals, the State Department of Health Services and the board shall develop a joint Medi-Cal and program application and enrollment form for children. The department shall seek any federal approval necessary to implement a combined application form.(Added by Stats. 1997, Ch. 623, Sec. 2. Effective January 1, 1998.)
CA Ins Code § 12693.34 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 4 - Administration|Section 12693.34.

12693.34.  (a) The board may establish geographic areas within which participating health, dental, and vision plans may offer coverage to subscribers.(b) Nothing in this section shall restrict a county organized health system or a local initiative from providing service to program subscribers in their licensed geographic service area.(Added by Stats. 1997, Ch. 623, Sec. 2. Effective January 1, 1998.)
CA Ins Code § 12693.35 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 4 - Administration|Section 12693.35.

12693.35.  Participating health, dental, and vision plans shall have, but need not be limited to, all of the following operating characteristics satisfactory to the board in consultation with the plan’s licensing or regulatory oversight agency:(a) Strong financial condition, including the ability to assume the risk of providing and paying for covered services. A participating plan may utilize reinsurance, provider risk sharing, and other appropriate mechanisms to share a portion of the risk.(b) Adequate administrative management.(c) A satisfactory grievance procedure.(d) Participating plans that contract with or employ health care providers shall have mechanisms to accomplish all of the following, in a manner satisfactory to the board:(1) Review the quality of care covered.(2) Review the appropriateness of care covered.(3) Provide accessible health care services.(e) (1) Before the effective date of the contract, the participating health plan shall have devised a system for identifying in a simple and clear fashion both in its own records and in the medical records of subscribers the fact that the services provided are provided under the program.(2) Throughout the duration of the contract, the plan shall use the system described in paragraph (1).(f) Plans licensed by the Department of Managed Health Care shall be deemed to meet the requirements of subdivisions (a) to (d), inclusive, of this section.(Amended by Stats. 2015, Ch. 190, Sec. 67. (AB 1517) Effective January 1, 2016.)
CA Ins Code § 12693.36 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 4 - Administration|Section 12693.36.

12693.36.  (a) Notwithstanding any other provision of law, the board shall not be subject to licensure or regulation by the Department of Insurance or the Department of Managed Health Care, as the case may be.(b) Participating health, dental, and vision plans that contract with the program and are regulated by either the Insurance Commissioner or the Department of Managed Health Care shall be licensed and in good standing with their respective licensing agencies. In their application to the program, those entities shall provide assurance of their standing with the appropriate licensing entity.(Amended by Stats. 2005, Ch. 80, Sec. 4. Effective July 19, 2005.)
CA Ins Code § 12693.37 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 4 - Administration|Section 12693.37.

12693.37.  (a) The board shall contract with a broad range of health plans in an area, if available, to ensure that subscribers have a choice from among a reasonable number and types of competing health plans. The board shall develop and make available objective criteria for health plan selection and provide adequate notice of the application process to permit all health plans a reasonable and fair opportunity to participate. The criteria and application process shall allow participating health plans to comply with their state and federal licensing and regulatory obligations, except as otherwise provided in this chapter. Health plan selection shall be based on the criteria developed by the board.(b) (1) In its selection of participating plans the board shall take all reasonable steps to assure the range of choices available to each applicant, other than a purchasing credit member, shall include plans that include in their provider networks and have signed contracts with traditional and safety net providers.(2) Participating health plans shall be required to submit to the board on an annual basis a report summarizing their provider network. The report shall provide, as available, information on the provider network as it relates to:(A) Geographic access for the subscribers.(B) Linguistic services.(C) The ethnic composition of providers.(D) The number of subscribers who selected traditional and safety net providers.(c) (1) The board shall not rely solely on the Department of Managed Health Care’s determination of a health plan network’s adequacy or geographic access to providers in the awarding of contracts under this part. The board shall collect and review demographic, census, and other data to provide to prospective local initiatives, health plans, or specialized health plans, as defined in this act, specific provider contracting target areas with significant numbers of uninsured children in low-income families. The board shall give priority to those plans, on a county-by-county basis, that demonstrate that they have included in their prospective plan networks significant numbers of providers in these geographic areas.(2) Targeted contracting areas are those ZIP Codes or groups of ZIP Codes or census tracts or groups of census tracts that have a percentage of uninsured children in low-income families greater than the overall percentage of uninsured children in low-income families in that county.(d) In each geographic area, the board shall designate a community provider plan that is the participating health plan which has the highest percentage of traditional and safety net providers in its network. Subscribers selecting such a plan shall be given a family contribution discount as described in Section 12693.43.(e) The board shall establish reasonable limits on health plan administrative costs.(Amended by Stats. 2000, Ch. 857, Sec. 75. Effective January 1, 2001.)
CA Ins Code § 12693.38 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 4 - Administration|Section 12693.38.

12693.38.  (a) The board shall contract with a sufficient number of dental and vision plans to assure that dental and vision benefits are available to all subscribers. The board shall develop and make available objective criteria for dental and vision plan selection and provide adequate notice of the application process to permit all dental and vision plans a reasonable and fair opportunity to participate. The criteria and application process shall allow participating dental and vision plans to comply with their state and federal licensing and regulatory obligations, except as otherwise provided in this part. Dental and vision plan selection shall be based on the criteria developed by the board.(b) Participating dental plans shall be required to submit to the board on an annual basis a report summarizing their provider network. The report shall provide, as available, information on the provider network as it relates to each of the following:(1) Geographic access for the subscribers.(2) Linguistic services.(3) The ethnic composition of providers.(c) The board shall establish reasonable limits on dental plan administrative costs.(Amended by Stats. 1998, Ch. 285, Sec. 1. Effective August 13, 1998.)
CA Ins Code § 12693.39 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 6.2 - HEALTHY FAMILIES|CHAPTER 4 - Administration|Section 12693.39.

12693.39.  The board shall establish a process for determining which employer-sponsored health plans are eligible to receive a purchasing credit issued by the program. The process shall assure that the benefits, copayments, coinsurance, and deductibles are no less than 95 percent actuarially equivalent to those provided to program subscribers enrolled in the purchasing pool.(Added by Stats. 1997, Ch. 623, Sec. 2. Effective January 1, 1998.)