reglab/housing_qa huggingface dataset:
CA Ins Code § 10192.6 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 1 - The Contract|ARTICLE 6 - Medicare Supplement Policies|Section 10192.6.

10192.6.  (a) Except for permitted preexisting condition clauses as described in Sections 10192.7, 10192.8, and 10192.81, a policy or certificate shall not be advertised, solicited, or issued for delivery as a Medicare supplement policy if the policy or certificate contains limitations or exclusions on coverage that are more restrictive than those of Medicare.(b) A Medicare supplement policy or certificate shall not use waivers to exclude, limit, or reduce coverage or benefits for specifically named or described preexisting diseases or physical conditions.(c) A Medicare supplement policy or certificate in force shall not contain benefits that duplicate benefits provided by Medicare.(d) (1) Subject to paragraphs (4) and (5) of subdivision (a) of Section 10192.8, a Medicare supplement policy with benefits for outpatient prescription drugs that was issued prior to January 1, 2006, shall be renewed for current policyholders, at the option of the policyholder, who do not enroll in Medicare Part D.(2) A Medicare supplement policy with benefits for outpatient prescription drugs shall not be issued on and after January 1, 2006.(3) On and after January 1, 2006, a Medicare supplement policy with benefits for outpatient prescription drugs shall not be renewed after the policyholder enrolls in Medicare Part D unless both of the following conditions exist:(A) The policy is modified to eliminate outpatient prescription drug coverage for outpatient prescription drug expenses incurred after the effective date of the individual’s coverage under a Medicare Part D plan.(B) The premium is adjusted to reflect the elimination of outpatient prescription drug coverage at the time of enrollment in Medicare Part D, accounting for any claims paid if applicable.(Amended by Stats. 2009, Ch. 10, Sec. 16. Effective July 2, 2009.)
CA Ins Code § 10192.7 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 1 - The Contract|ARTICLE 6 - Medicare Supplement Policies|Section 10192.7.

10192.7.  A policy or certificate shall not be advertised, solicited, or issued for delivery as a Medicare supplement policy or certificate prior to January 1, 2001, unless it meets or exceeds requirements applicable pursuant to this code that were in effect prior to that date.(Added by Stats. 2000, Ch. 706, Sec. 4. Effective January 1, 2001.)
CA Ins Code § 10192.13 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 1 - The Contract|ARTICLE 6 - Medicare Supplement Policies|Section 10192.13.

10192.13.  (a) An issuer shall comply with Section 1882(c)(3) of the federal Social Security Act (as enacted by Section 4081(b)(2)(C) of the federal Omnibus Budget Reconciliation Act of 1987 (OBRA), Public Law 100-203) by doing all of the following and by certifying compliance on the Medicare supplement insurance experience reporting form:(1) Accepting a notice from a Medicare Administrative Contractor, formerly known as a fiscal intermediary or carrier, on dually assigned claims submitted by participating physicians and suppliers as a claim for benefits in place of any other claim form otherwise required and making a payment determination on the basis of the information contained in that notice.(2) Notifying the participating physician or supplier and the beneficiary of the payment determination.(3) Paying the participating physician or supplier directly.(4) Furnishing, at the time of enrollment, each enrollee with a card listing the policy name, number, and a central mailing address to which notices from Medicare Administrative Contractors may be sent.(5) Paying user fees for claim notices that are transmitted electronically or otherwise.(6) Providing to the secretary, at least annually, a central mailing address to which all claims may be sent by Medicare Administrative Contractors.(7) File, by June 30 of each year, with the commissioner a list of its Medicare supplement policies and certificates offered or issued or in force in California as of the end of the previous year.(A) The list shall identify the issuer by name and address, shall identify each type of form it offers by name and form number, and shall differentiate between forms approved in the previous calendar year and those approved before the previous calendar year.(B) The list shall identify all of the following:(i) Forms issued and in force but no longer offered in California.(ii) Forms that, for any reason, were not filed and approved by the commissioner.(iii) Forms for which the commissioner’s approval was withdrawn within the previous calendar year.(iv) The number of forms issued in California in the previous calendar year, and the number of forms in force in California on December 31 of the previous calendar year.(b) (1) Compliance with the requirements set forth in subdivision (a) shall be certified on the Medicare supplement insurance experience reporting form provided by the commissioner.(2) The commissioner shall, by September 1 of each year, provide the secretary with a list identifying each issuer by name and address and provide the information requested in this section.(c) No issuer that administers Medicare coverage and federal employee programs may require that more than one form be submitted per claim in order to receive payment or reimbursement under any or all of those policies or programs.(Amended by Stats. 2009, Ch. 10, Sec. 23. Effective July 2, 2009.)
CA Ins Code § 10192.16 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 1 - The Contract|ARTICLE 6 - Medicare Supplement Policies|Section 10192.16.

10192.16.  (a) An issuer or other entity may provide commission or other compensation to an agent or other representative for the sale of a Medicare supplement policy or certificate only if the first year commission or other first year compensation is no more than 200 percent of the commission or other compensation paid for selling or servicing the policy or certificate in the second year or period. Every insurer shall file with the commissioner its commission structure or an explanation of the insurer’s plan to comply with this provision.(b) The commission or other compensation provided in subsequent renewal years must be the same as that provided in the second year or period and must be provided for no fewer than five renewal years.(c) No issuer or other entity shall provide compensation to its agents or other producers, and no agent or producer shall receive compensation, greater than the renewal compensation payable by the replacing issuer on renewal policies or certificates if an existing policy or certificate is replaced.(d) For purposes of this section, “commission” or “compensation” includes pecuniary or nonpecuniary remuneration of any kind relating to the sale or renewal of the policy or certificate, including, but not limited to, bonuses, gifts, prizes, awards, and finders’ fees.(Added by Stats. 2000, Ch. 706, Sec. 4. Effective January 1, 2001.)
CA Ins Code § 10192.185 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 1 - The Contract|ARTICLE 6 - Medicare Supplement Policies|Section 10192.185.

10192.185.  In addition to any other requirements of law, the following shall apply to a Medicare supplement policy:(a) The issuer 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 issuer 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 issuer shall notify the applicant within 60 days from the date the issuer or issuer’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 issuer or issuer’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 issuer or issuer’s authorized representative or producer received those funds until they are refunded to the applicant or are applied toward the premium.(Added by Stats. 2000, Ch. 706, Sec. 4. Effective January 1, 2001.)
CA Ins Code § 10192.195 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 1 - The Contract|ARTICLE 6 - Medicare Supplement Policies|Section 10192.195.

10192.195.  The commissioner may prescribe by regulation a standard form and the contents of an informational brochure for persons eligible for Medicare by reason of age which is intended to improve the buyer’s ability to select the most appropriate coverage and improve the buyer’s understanding of Medicare. Except in the case of direct response insurance policies, the commissioner may require by regulation that the information brochure be provided to any applicant eligible for Medicare concurrently with delivery of the outline of coverage. With respect to direct response insurance policies, the commissioner may require by regulation that the prescribed brochure be provided upon request to any applicant eligible for Medicare by reason of age, but in no event later than the time of policy delivery.(Added by Stats. 2000, Ch. 706, Sec. 4. Effective January 1, 2001.)
CA Ins Code § 10192.21 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 1 - The Contract|ARTICLE 6 - Medicare Supplement Policies|Section 10192.21.

10192.21.  (a) In recommending the purchase or replacement of any Medicare supplement policy or certificate, an agent shall make reasonable efforts to determine the appropriateness of a recommended purchase or replacement.(b) Any sale of a Medicare supplement policy or certificate that will provide an individual more than one Medicare supplement policy or certificate is prohibited.(c) An issuer shall not issue a Medicare supplement policy or certificate to an individual enrolled in Medicare Part C unless the effective date of the coverage is after the termination date of the individual’s coverage under Medicare Part C.(Amended by Stats. 2005, Ch. 206, Sec. 31. Effective January 1, 2006.)
CA Ins Code § 10192.22 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 1 - The Contract|ARTICLE 6 - Medicare Supplement Policies|Section 10192.22.

10192.22.  (a) On or before March 1 of each year, an issuer shall report the following information for every individual resident of this state for which the issuer has in force more than one Medicare supplement policy or certificate:(1) Policy and certificate number.(2) Date of issuance.(b) The items set forth above must be grouped by individual policyholder.(Added by Stats. 2000, Ch. 706, Sec. 4. Effective January 1, 2001.)
CA Ins Code § 10192.23 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 1 - The Contract|ARTICLE 6 - Medicare Supplement Policies|Section 10192.23.

10192.23.  (a) If a Medicare supplement policy or certificate replaces another Medicare supplement policy or certificate, the replacing issuer shall waive any time periods applicable to preexisting conditions, waiting periods, elimination periods, and probationary periods in the new Medicare supplement policy or certificate for similar benefits to the extent that time was spent under the original policy.(b) If a Medicare supplement policy or certificate replaces another Medicare supplement policy or certificate that has been in effect for at least six months, the replacing policy shall not provide any time period applicable to preexisting conditions, waiting periods, elimination periods and probationary periods for benefits similar to those contained in the original policy or certificate.(Added by Stats. 2000, Ch. 706, Sec. 4. Effective January 1, 2001.)
CA Ins Code § 10198.61 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 1 - The Contract|ARTICLE 7 - Preexisting Condition Provisions|Section 10198.61.

10198.61.  (a) For purposes of this article, “health benefit plan” does not include policies or certificates of specified disease or hospital confinement indemnity provided that the carrier offering those policies or certificates complies with the following:(1) The carrier files, on or before March 1 of each year, a certification with the commissioner that contains the statement and information described in paragraph (2).(2) The certification required in paragraph (1) shall contain the following:(A) A statement from the carrier certifying that policies or certificates described in this section (i) are being offered and marketed as supplemental health insurance and not as a substitute for coverage that provides essential health benefits as defined by the state pursuant to Section 1302 of PPACA, and (ii) the disclosure form as described in Section 10603 contains the following statement prominently on the first page: “This is a supplement to health insurance. It is not a substitute for essential health benefits or minimum essential coverage as defined in federal law.”(B) A summary description of each policy or certificate described in this section, including the average annual premium rates, or range of premium rates in cases where premiums vary by age, gender, or other factors, charged for the policies and certificates issued or delivered in this state.(3) In the case of a policy or certificate described in this section and that is offered for the first time in this state for plan years on or after January 1, 2014, the carrier files with the commissioner the information and statement required in paragraph (2) at least 30 days prior to the date such a policy or certificate is issued or delivered in this state.(b) As used in this section, “policies or certificates of specified disease” and “policies or certificates of hospital confinement indemnity” mean policies or certificates of insurance sold to an insured to supplement other health insurance coverage as specified in this section. An insurer issuing a “policy or certificate of specified disease” or a “policy or certificate of hospital confinement indemnity” shall require that the person to be insured is covered by an individual or group policy or contract that arranges or provides medical, hospital, and surgical coverage not designed to supplement other private or governmental plans.(Repealed (in Sec. 12) and added by Stats. 2012, Ch. 852, Sec. 11. (AB 1083) Effective January 1, 2013. Section operative January 1, 2014, pursuant to Section 10198.10.)
CA Ins Code § 10198.7 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 1 - The Contract|ARTICLE 7 - Preexisting Condition Provisions|Section 10198.7.

10198.7.  (a) A health benefit plan for group coverage shall not impose any preexisting condition provision or waivered condition provision upon any individual.(b) (1) A nongrandfathered health benefit plan for individual coverage shall not impose any preexisting condition provision or waivered condition provision upon any individual.(2)  A grandfathered health benefit plan for individual coverage shall not exclude coverage on the basis of a waivered condition provision or preexisting condition provision for a period greater than 12 months following the individual’s effective date of coverage, nor limit or exclude coverage for a specific insured by type of illness, treatment, medical condition, or accident, except for satisfaction of a preexisting condition provision or waivered condition provision pursuant to this article. Waivered condition provisions or preexisting condition provisions contained in individual grandfathered health benefit plans may relate only to conditions for which medical advice, diagnosis, care, or treatment, including use of prescription drugs, was recommended or received from a licensed health practitioner during the 12 months immediately preceding the effective date of coverage.(3) In determining whether a preexisting condition provision or a waivered condition provision applies to an individual under this subdivision, a health benefit plan shall credit the time the individual was covered under creditable coverage, provided that the individual becomes eligible for coverage under the succeeding health benefit plan within 62 days of termination of prior coverage and applies for coverage under the succeeding plan within the applicable enrollment period.(c) A health benefit plan for group or individual coverage shall not impose a waiting period.(Amended by Stats. 2021, Ch. 764, Sec. 8. (SB 326) Effective January 1, 2022.)
CA Ins Code § 10198.8 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 1 - The Contract|ARTICLE 7 - Preexisting Condition Provisions|Section 10198.8.

10198.8.  This article applies to all health benefit plans that provide benefits to residents of this state regardless of the situs of the contract or group master policyholder.(Repealed (in Sec. 12) and added by Stats. 2012, Ch. 852, Sec. 11. (AB 1083) Effective January 1, 2013. Section operative January 1, 2014, pursuant to Section 10198.10.)
CA Ins Code § 10198.9 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 1 - The Contract|ARTICLE 7 - Preexisting Condition Provisions|Section 10198.9.

10198.9.  A health benefit plan for group coverage shall not establish rules for eligibility, including continued eligibility, of an individual, or dependent of an individual, to enroll under the terms of the plan based on any of the following health status-related factors:(a) Health status.(b) Medical condition, including physical and mental illnesses.(c) Claims experience.(d) Receipt of health care.(e) Medical history.(f) Genetic information.(g) Evidence of insurability, including conditions arising out of acts of domestic violence.(h) Disability.(i) Any other health status-related factor as determined by any federal regulations, rules, or guidance issued pursuant to Section 2705 of the federal Public Health Service Act.(Repealed (in Sec. 12) and added by Stats. 2012, Ch. 852, Sec. 11. (AB 1083) Effective January 1, 2013. Section operative January 1, 2014, pursuant to Section 10198.10.)
CA Ins Code § 10198.10 (2021)
2021 California Code|Insurance Code - INS|DIVISION 2 - CLASSES OF INSURANCE|PART 2 - LIFE AND DISABILITY INSURANCE|CHAPTER 1 - The Contract|ARTICLE 7 - Preexisting Condition Provisions|Section 10198.10.

10198.10.  This article shall become operative on January 1, 2014.(Repealed (in Sec. 12) and added by Stats. 2012, Ch. 852, Sec. 11. (AB 1083) Effective January 1, 2013. Note: This section prescribes a delayed operative date (Jan. 1, 2014) for Article 7, commencing with Section 10198.6.)
CA Ins Code § 10199 (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 1 - Purpose and Title|Section 10199.

10199.  The purpose of the chapter is to promote the public interest, to prevent unfair and unlawful health care business practices, and to promote adequate consumer and employer advance notice of changes in the cost and benefits of health coverage in order to allow for comparative shopping and to reduce the cost of health coverage.(Added by Stats. 1990, Ch. 949, Sec. 2.)
CA Ins Code § 10199.2 (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 10199.2.

10199.2.  (a)  The written notice described in subdivisions (a) and (b) of Section 10199.1 shall state in italics and in 12-point type the actual dollar amount and the specific percentage of the premium rate increase. Further, the notice shall describe in plain understandable English and highlighted in italics any changes in the plan design or change in benefits with reduction in benefits, waivers, exclusions, or conditions.(b) The written notice shall specify in a minimum of 10-point bold typeface the reason or reasons for premium rate changes, plan design, or plan benefit changes.(Amended by Stats. 2010, Ch. 661, Sec. 9. (SB 1163) Effective January 1, 2011.)
CA Ins Code § 10199.3 (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 10199.3.

10199.3.  There shall be no liability on the part of, and no cause of action of any nature shall arise against, any entity required to provide the notice or its authorized representatives, or agents, for any statement made, unless shown to have been made with malice in fact, by any of them in (a) any written notice or in any other oral or written communication specifying the reasons for the notice, (b) any communication providing information pertaining to such notice, or (c) evidence submitted at any court proceeding or informal inquiry in which such notice is at issue.(Added by Stats. 1990, Ch. 949, Sec. 2.)
CA Ins Code § 10199.4 (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 10199.4.

10199.4.  Proof of mailing a notice and the reason therefor to the appropriate entity or individual at the last known mailing address shall be sufficient proof of the notice required by this chapter.(Added by Stats. 1990, Ch. 949, Sec. 2.)
CA Ins Code § 10199.44 (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 10199.44.

10199.44.  (a) On or after January 1, 1994, every insurer issuing, amending, or renewing group disability insurance which covers hospital, medical, or surgical expenses shall notify the group policyholders in writing of the cancellation of the group policy and shall include in their contract with group policyholders, regardless of the situs of that contract, a provision requiring the group policyholder to mail promptly to each person covered under the group policy a legible, true copy of any notice of cancellation of the policy which may be received from the insurer and to provide promptly to the insurer 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 group policy upon termination of the group policy. This information shall be in clear and easily understandable language.(Added by Stats. 1993, Ch. 1154, Sec. 2. Effective January 1, 1994.)