California Code of Regulations › Title 28 - Managed Health Care › Division 1 - The Department of Managed Health Care › Chapter 2 - Health Care Service Plans › Article 6 - Appeals on Cancellation › Section 1300.65.1 - Cancellations, Rescissions, or Nonrenewals for Reasons Other than Nonpayment of Premiums

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a)
				  General Requirements
(1) Applicability. This
				  section shall apply to all cancellations for reasons other than for nonpayment
				  of premiums.
(2) The plan shall
				  send a Notice of Cancellation, Rescission, or Nonrenewal for all cancellations
				  other than cancellations due to the nonpayment of premium. At a minimum, this
				  Notice shall contain the information set forth in California Code of
				  Regulations, title 28, section
				  1300.65.1(b)(1).
				  The Notice of Cancellation, Rescission, or Nonrenewal shall be sent to the
				  enrollee, subscriber, or group contract holder:
(A) At least 30 days before the cancellation,
				  rescission, or nonrenewal for fraud or intentional misrepresentation of
				  material fact pursuant to Health and Safety Code sections
				  1365(a)(2)
				  or
				  1389.21,
				  subject to limitations imposed by Health and Safety Code section
				  1389.21.
(B) At least 30 days before the cancellation,
				  rescission, or nonrenewal for a cancellation or nonrenewal pursuant to Health
				  and Safety Code sections
				  1365(a)(3), (4) or
				  (7).
(C) At least 180 days before the
				  discontinuation or termination of a contract if the cancellation or nonrenewal
				  is due to the plan ceasing to provide or arrange for the provision of health
				  benefits for new plan contracts in the individual or group market in this state
				  pursuant to Health and Safety Code section
				  1365(a)(5).
				  A notice sent pursuant to this subdivision shall also be sent concurrently to
				  the Director.
(D) At least 90 days
				  before the withdrawal of a health benefit plan from the market pursuant to
				  Health and Safety Code section
				  1365(a)(6).
				  A notice sent pursuant to this subdivision shall also be sent concurrently to
				  the Director.
(3) The
				  plan shall send a Notice of Cancellation, Rescission, or Nonrenewal to each
				  subscriber in a group contract unless:
(A)
				  The plan contract requires the group contract holder to promptly send any such
				  Notice to each subscriber; and
(B)
				  The plan sends the Notice to the group contract holder designated in the plan
				  contract.
(4) The plan
				  shall send a Notice of End of Coverage for all cancellations. This Notice shall
				  be sent to the enrollee, subscriber, or group contract holder after the date
				  coverage ended, and no later than five (5) calendar days after the date
				  coverage ended. At a minimum, this Notice shall contain the information set
				  forth in California Code of Regulations, title 28, section
				  1300.65.1(b)(2).
(5) When required pursuant to Health and
				  Safety Code section
				  1373.96(m),
				  notice as to the availability of the right to request completion of covered
				  services shall be part of, accompany, or be sent simultaneously with both the
				  Notice of Cancellation, Rescission, or Nonrenewal and the Notice of End of
				  Coverage.