reglab/housing_qa huggingface dataset:
CA Ins Code § 10199.46 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 1.5 - Health Coverage Contract Notification|ARTICLE 2 - General Provisions|Section 10199.46.

10199.46.  (a) On or after January 1, 1994, every nonprofit hospital service plan issued, amended, or renewed that covers hospital, medical, or surgical expenses on a group basis shall notify the group contractholders in writing of the cancellation of the plan contract and shall include in their contract with group contractholders a provision requiring the group contractholder to mail promptly to each subscriber a legible, true copy of any notice of cancellation of the plan contract which may be received from the plan and to provide promptly to the plan proof of that mailing and the date thereof.(b) The notice of cancellation required by subdivision (a) shall include information regarding the conversion rights of persons covered under the plan contract upon termination of the plan contract. This information shall be in clear and easily understandable language.(Added by Stats. 1993, Ch. 1154, Sec. 3. Effective January 1, 1994.)
CA Ins Code § 10199.48 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 1.5 - Health Coverage Contract Notification|ARTICLE 2 - General Provisions|Section 10199.48.

10199.48.  (a) No health insurer shall, with regard to a group contract, change the premium rates or applicable copayments or coinsurances or deductibles for the length of the contract, except as specified in subdivision (b), during any of the following time periods:(1) After the group policyholder or group contractholder has delivered written notice of acceptance of the contract or policy.(2) After the start of the employer’s annual open enrollment period.(3) After the receipt of payment of the premium for the first month of coverage in accordance with the contract or policy effective date.(b) Changes to the premium rates or applicable copayments or coinsurances or deductibles of a contract or policy shall, subject to the insurer meeting the requirements of this chapter, be allowed in any of the following circumstances:(1) When authorized or required in the group contract or policy.(2) When the contract or policy was agreed to under a preliminary agreement that states that it is subject to execution of a definitive agreement.(3) When the insurer and the policyholder or contractholder mutually agree in writing.(Added by Stats. 2002, Ch. 336, Sec. 5. Effective January 1, 2003.)
CA Ins Code § 10199.49 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 1.5 - Health Coverage Contract Notification|ARTICLE 2 - General Provisions|Section 10199.49.

10199.49.  (a) This section shall apply to grandfathered health insurance policies and nongrandfathered health insurance policies in the individual or small group markets that are issued, amended, or renewed on or after January 1, 2017.(b) Notwithstanding paragraph (1) of subdivision (b) of Section 10199.48, a health insurance policy shall not change the cost-sharing design during the policy year, except when required by state or federal law.(c) For purposes of this section, the following definitions shall apply:(1) “Cost sharing” includes any copayment, coinsurance, deductible, or any other form of cost sharing by the insured other than the premium or share of premium.(2) “Policy year” has the meaning set forth in Section 144.103 of Title 45 of the Code of Federal Regulations. For nongrandfathered health insurance policies in the individual market, “policy year” means the calendar year.(3) “Cost-sharing design” means the amount or proportion of cost sharing applied to a covered benefit.(Added by Stats. 2016, Ch. 192, Sec. 2. (SB 923) Effective January 1, 2017.)
CA Ins Code § 10199.5 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 1.5 - Health Coverage Contract Notification|ARTICLE 3 - Administration and Enforcement|Section 10199.5.

10199.5.  The commissioner may, as conditions warrant, pursuant to Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code, adopt reasonable regulations, and amendments and additions thereto, as are necessary to administer this chapter.(Added by Stats. 1990, Ch. 949, Sec. 2.)
CA Ins Code § 10199.6 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 1.5 - Health Coverage Contract Notification|ARTICLE 3 - Administration and Enforcement|Section 10199.6.

10199.6.  (a) The commissioner shall have the administrative authority to assess penalties against insurers, nonprofit hospital service plans, administrators, and insurance producers, and other entities engaged in the business of insurance or other persons or entities for violations of this chapter.(b) Upon a showing of a violation of this chapter in any civil action, a court may also assess the penalties described in this chapter.(c) The commissioner may suspend or revoke the license or licenses issued to any production agent or administrator found, after notice and hearing, to have violated this chapter or a regulation adopted pursuant to the authority of this chapter. Notice of hearing shall be accomplished and a hearing conducted in accordance with Chapter 5 (commencing with Section 11500) of Part 1 of Division 3 of Title 2 of the Government Code, and the commissioner shall have all of the powers granted therein.(Added by Stats. 1990, Ch. 949, Sec. 2.)
CA Ins Code § 10199.7 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 1.5 - Health Coverage Contract Notification|ARTICLE 3 - Administration and Enforcement|Section 10199.7.

10199.7.  (a) Any production agent, administrator, or other person or entity engaged in the business of insurance, other than an insurer, who violates this chapter is liable for administrative penalties of not less than two hundred fifty dollars ($250) for the first violation.(b) Any production agent, administrator, or other person or other entity engaged in the business of insurance, other than an insurer, who engages in practices prohibited by this chapter a second or subsequent time, or who commits a knowing violation of this chapter, is liable for administrative penalties of not less than one thousand dollars ($1,000) and not more than two thousand five hundred dollars ($2,500) for each violation.(c) Any insurer who violates this chapter is liable for administrative penalties of not less than two thousand five hundred dollars ($2,500) for the first violation.(d) Any insurer who violates this chapter with a frequency that indicates a general business practice, or commits a knowing violation of this chapter, is liable for administrative penalties of not less than ten thousand dollars ($10,000) and not more than one hundred thousand dollars ($100,000) for each violation.(Added by Stats. 1990, Ch. 949, Sec. 2.)
CA Ins Code § 10199.8 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 1.5 - Health Coverage Contract Notification|ARTICLE 3 - Administration and Enforcement|Section 10199.8.

10199.8.  In addition to any other penalty provided by law or the availability of any administrative procedure, if an insurer, after notice and hearing, is found to have violated this chapter, or regulations adopted pursuant to this chapter, or knowingly permits any person to do so, the commissioner, in accordance with the procedures provided in Section 704, may suspend the insurer’s certificate of authority to transact disability insurance. Section 740.7 shall apply in any proceeding conducted pursuant to this section.(Added by Stats. 1990, Ch. 949, Sec. 2.)
CA Ins Code § 10199.9 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 1.5 - Health Coverage Contract Notification|ARTICLE 3 - Administration and Enforcement|Section 10199.9.

10199.9.  This chapter applies to all master group policies and master group nonprofit hospital service plan contracts providing hospital, medical, or surgical benefits, regardless of policy or contract situs, coverage under which is solicited in any manner in this state.(Added by Stats. 1990, Ch. 949, Sec. 2.)
CA Ins Code § 10231 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 2.6 - Long-Term Care Insurance|ARTICLE 1 - Definitions|Section 10231.

10231.  Unless the context requires otherwise, the definitions in this article shall govern the construction of this chapter.(Added by Stats. 1988, Ch. 1342, Sec. 1.)
CA Ins Code § 10231.2 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 2.6 - Long-Term Care Insurance|ARTICLE 1 - Definitions|Section 10231.2.

10231.2.  “Long-term care insurance” includes any insurance policy, certificate, or rider advertised, marketed, offered, solicited, or designed to provide coverage for diagnostic, preventive, therapeutic, rehabilitative, maintenance, or personal care services that are provided in a setting other than an acute care unit of a hospital. Long-term care insurance includes all products containing any of the following benefit types: coverage for institutional care including care in a nursing home, convalescent facility, extended care facility, custodial care facility, skilled nursing facility, or personal care home; home care coverage including home health care, personal care, homemaker services, hospice, or respite care; or community-based coverage including adult day care, hospice, or respite care. Long-term care insurance includes disability based long-term care policies but does not include insurance designed primarily to provide Medicare supplement or major medical expense coverage.Long-term care policies, certificates, and riders shall be regulated under this chapter. The commissioner shall review and approve individual and group policies, certificates, riders, and outlines of coverage. Other applicable laws and regulations shall also apply to long-term care insurance insofar as they do not conflict with the provisions in this chapter. Long-term care benefits designed to provide coverage of 12 months or more that are contained in or amended to Medicare supplement or other disability policies and certificates shall be regulated under this chapter.(Amended by Stats. 2001, Ch. 159, Sec. 147. Effective January 1, 2002.)
CA Ins Code § 10231.4 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 2.6 - Long-Term Care Insurance|ARTICLE 1 - Definitions|Section 10231.4.

10231.4.  “Applicant” means either of the following:(a) In the case of an individual long-term care insurance policy, the person who seeks to contract for benefits.(b) In the case of a group long-term care insurance policy, the proposed certificate holder.(Added by Stats. 1988, Ch. 1342, Sec. 1.)
CA Ins Code § 10231.5 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 2.6 - Long-Term Care Insurance|ARTICLE 1 - Definitions|Section 10231.5.

10231.5.  “Certificate” means any certificate issued under a group long-term care insurance policy, which policy has been delivered or issued for delivery in this state.(Added by Stats. 1988, Ch. 1342, Sec. 1.)
CA Ins Code § 10231.8 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 2.6 - Long-Term Care Insurance|ARTICLE 1 - Definitions|Section 10231.8.

10231.8.  “Policy” means any policy, contract, subscriber agreement, rider or endorsement delivered or issued for delivery in this state by an insurer, fraternal benefit society, nonprofit hospital service plan, or any similar organization, regulated by the commissioner.(Added by Stats. 1988, Ch. 1342, Sec. 1.)
CA Ins Code § 10232.1 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 2.6 - Long-Term Care Insurance|ARTICLE 3 - General Provisions|Section 10232.1.

10232.1.  (a) Every policy that is intended to be a qualified long-term care insurance contract as provided by Public Law 104-191 shall be identified as such by prominently displaying and printing on page one of the policy form and the outline of coverage and in the application the following words: “This contract for long-term care insurance is intended to be a federally qualified long-term care insurance contract and may qualify you for federal and state tax benefits.” Every policy that is not intended to be a qualified long-term care insurance contract as provided by Public Law 104-191 shall be identified as such by prominently displaying and printing on page one of the policy form and the outline of coverage and in the application the following words: “This contract for long-term care insurance is not intended to be a federally qualified long-term care insurance contract.”(b) Any policy or certificate in which benefits are limited to the provision of institutional care shall be called a “nursing facility and residential care facility only” policy or certificate and the words “Nursing Facility and Residential Care Facility Only” shall be prominently displayed on page one of the form and the outline of coverage. The commissioner may approve alternative wording if it is more descriptive of the benefits.(c) Any policy or certificate in which benefits are limited to the provision of home care services, including community-based services, shall be called a “home care only” policy or certificate and the words “Home Care Only” shall be prominently displayed on page one of the form and the outline of coverage. The commissioner may approve alternative wording if it is more descriptive of the benefits.(d) Any policy, certificate, or rider in which benefits are limited to the provision of all care settings, except nursing facility care, and that is offered under the California Partnership for Long-Term Care Program established by Section 22000 of the Welfare and Institutions Code shall be called a home care, community-based services, and residential care facility only policy, certificate, or rider and the words “Home Care, Community-Based Services, and Residential Care Facility Only” shall be prominently displayed on the first page of the form and the outline of coverage. The commissioner may approve an alternative version of those words if the alternative version is more descriptive of the benefits provided. (e) Only those policies or certificates providing benefits for both institutional care and home care may be called “comprehensive long-term care” insurance.(Amended by Stats. 2018, Ch. 565, Sec. 1. (SB 1248) Effective January 1, 2019.)
CA Ins Code § 10232.2 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 2.6 - Long-Term Care Insurance|ARTICLE 3 - General Provisions|Section 10232.2.

10232.2.  (a) Every insurer that offers policies or certificates that are intended to be federally qualified long-term care insurance contracts, including riders to life insurance policies providing long-term care coverage, shall fairly and affirmatively concurrently file, offer, and market long-term care insurance policies or certificates not intended to be federally qualified, as described in subdivision (a) of Section 10232.1.(b) All long-term care insurance contracts, including riders to life insurance contracts providing long-term care coverage, approved after the effective date of this section shall meet all of the requirements of this chapter.(c) Until October 1, 2001, or 90 days after approval of contracts submitted for approval pursuant to subdivision (b), whichever comes first, insurers may continue to offer and market previously approved long-term care insurance contracts.(d) Group policies issued prior to January 1, 1997, shall be allowed to remain in force and not be required to meet the requirements of this chapter, as amended during the 1997 portion of the 1997–98 Regular Session, unless those policies cease to be treated as federally qualified long-term care insurance contracts. If a policy or certificate issued on a group policy of that type ceases to be a federally qualified long-term care insurance contract under the grandfather rules issued by the United States Department of the Treasury pursuant to Section 7702B(f) of the Internal Revenue Code, the insurer shall offer the policy and certificate holders the option to convert, on a guaranteed-issue basis, to a policy or certificate that is federally tax qualified if the insurer sells tax-qualified policies.(e) It is the intent of the Legislature that the commissioner approve by July 1, 2001, all accurate and complete contracts submitted for approval pursuant to subdivision (b). It is the further intent of the Legislature that insurers submit contracts for approval and resolve further outstanding issues pursuant to subdivision (b) in a timely manner in order for the commissioner to approve the contracts by July 1, 2001.(Amended (as amended by Stats. 1999, Ch. 947) by Stats. 2001, Ch. 51, Sec. 3. Effective July 9, 2001.)
CA Ins Code § 10232.4 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 2.6 - Long-Term Care Insurance|ARTICLE 3 - General Provisions|Section 10232.4.

10232.4.  (a) No long-term care insurance policy or certificate other than a group policy or certificate, as described in subdivision (a) of Section 10231.6, shall use a definition of preexisting condition which is more restrictive than a condition for which medical advice or treatment was recommended by, or received from a provider of health care services, within six months preceding the effective date of coverage of an insured person.(b) Every long-term care insurance policy or certificate shall cover preexisting conditions that are disclosed on the application no later than six months following the effective date of the coverage of an insured, regardless of the date the loss or confinement begins.(c) The definition of preexisting condition does not prohibit an insurer from using an application form designed to elicit the complete health history of an applicant, and on the basis of the answers on that application, from underwriting in accordance with that insurer’s established underwriting standards. Unless otherwise provided in the policy or certificate a preexisting condition, regardless of whether it is disclosed on the application, need not be covered until the waiting period described in subdivision (b) expires. Unless a waiver or rider has been specifically approved by the commissioner, no long-term care insurance policy or certificate may exclude or use waivers or riders of any kind to exclude, limit, or reduce coverage or benefits for specifically named or described preexisting diseases or physical conditions beyond the waiting period described in subdivision (b).(Amended by Stats. 1999, Ch. 947, Sec. 4. Effective January 1, 2000.)
CA Ins Code § 10232.5 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 2.6 - Long-Term Care Insurance|ARTICLE 3 - General Provisions|Section 10232.5.

10232.5.  On or after January 1, 1990, no long-term care insurance policy may be delivered or issued for delivery in this state which does any of the following:(a) Preconditions the availability of benefits on prior hospitalization.(b) Conditions eligibility for benefits provided in an institutional care setting on the receipt of a higher level of institutional care.(c) Preconditions the availability of benefits for community-based care, home health care, or home care on prior institutionalization.(d) Conditions eligibility for noninstitutional benefits, other than those in subdivision (c), on a prior institutional stay of more than 30 days.(Repealed and added by Stats. 1989, Ch. 1273, Sec. 4.2.)
CA Ins Code § 10232.6 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 2.6 - Long-Term Care Insurance|ARTICLE 3 - General Provisions|Section 10232.6.

10232.6.  The commissioner may adopt regulations establishing loss ratio standards for long-term care insurance policies provided that a specific reference to long-term care insurance policies is contained in the regulation. Any regulations adopted by the commissioner shall substantially reflect the loss ratio standards contained in Section 10 of the National Association of Insurance Commissioners Long-Term Care Insurance Model Regulations, as most recently revised.(Added by Stats. 1988, Ch. 1342, Sec. 1.)
CA Ins Code § 10232.65 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 2.6 - Long-Term Care Insurance|ARTICLE 3 - General Provisions|Section 10232.65.

10232.65.  In addition to any other requirements of law, the following shall apply to a long-term care insurance policy:(a) The insurer shall not require an amount greater than one month’s premium to be submitted with an application for the policy of insurance if interim coverage is not provided. If interim coverage is provided, the insurer shall not require an amount greater than two months’ premium for that purpose. No further premiums may be collected until the policy is delivered to the applicant.(b) The insurer shall notify the applicant within 60 days from the date the insurer or insurer’s authorized representative or producer receives the application and the amount as to whether or not the applicant will be issued a policy of insurance. If the applicant is not so notified, the insurer or insurer’s authorized representative or producer shall pay interest to the applicant on the funds that the applicant submitted with the application, at the legal rate of interest on judgments as provided in Section 685.010 of the Code of Civil Procedure, from the date the insurer or insurer’s authorized representative or producer received those funds until they are refunded to the applicant or are applied toward the premium.(Added by Stats. 2001, Ch. 328, Sec. 5. Effective January 1, 2002.)
CA Ins Code § 10232.7 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 2.6 - Long-Term Care Insurance|ARTICLE 3 - General Provisions|Section 10232.7.

10232.7.  (a) An applicant for a long-term care insurance policy or a certificate, other than an applicant for a certificate issued under a group long-term care insurance policy issued to a group as described in subdivisions (a) and (b) of Section 10231.6, shall have the right to return the policy or certificate by first-class United States mail within 30 days of its delivery and to have the premium refunded if, after examination of the policy or certificate, the applicant is not satisfied for any reason.(b) The return of a policy or certificate shall void the policy or certificate from the beginning and the parties shall be in the same position as if no policy, certificate, or contract had been issued. All premiums paid and any policy fee paid for the policy shall be fully refunded directly to the applicant by the insurer within 30 days after the policy or certificate is returned.(c) Notwithstanding Section 10276 or any other law, long-term care insurance policies or certificates to which this section applies shall have a notice prominently printed on the first page of the policy or certificate, or attached thereto, stating in substance the conditions described in subdivisions (a) and (b).(Amended by Stats. 1989, Ch. 1273, Sec. 5.)