reglab/statecodes huggingface dataset:
California Code of Regulations › Title 10 - Investment › Chapter 5.8 - Managed Risk Medical Insurance Board Healthy Families Program › Article 3 - Health, Dental and Vision Benefits › Section 2699.6711 - Scope of Dental Benefits for Subscriber Parents

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The basic scope of benefits for
				subscriber parents offered by a participating dental plan must comply with all
				requirements of the Knox-Keene Health Care Service Plan Act of 1975, including
				amendments as well as its applicable regulations, and shall include all of the
				benefits and services listed in this section, subject to certain exclusions as
				listed in Section
				2699.6713.
The covered dental benefit is limited to the benefit level
				  for the least costly dentally appropriate alternative. If a more costly,
				  optional alternative is chosen by the applicant, the applicant will be
				  responsible for all charges in excess of the covered dental benefits.
The covered dental benefit for each subscriber is limited to
				  fifteen hundred dollars ($1,500) per benefit year effective July 1,
				  2009.
No other dental benefits shall be permitted to be offered by
				  a participating dental plan as part of the program. The basic scope of dental
				  benefits shall be as follows:
(1)
				Diagnosis and Preventive Benefits
(A) Initial
				and periodic oral examinations -- oral examinations are benefits only twice in
				a benefit year.
(B) Consultations,
				including specialist consultations
(C) Roentgenology, limited as follows:
1. Bitewing x-rays in conjunction with
				periodic examinations are limited to one series of four films in a benefit
				year.
2. Full mouth x-rays in
				conjunction with periodic examinations are limited to once in a three-year
				period unless special need is shown.
3. Panoramic film x-rays are limited to once
				in a three year-period.
(D) Prophylaxis services, not to exceed two
				in a twelve month period. A third cleaning will be provided as a benefit for
				high-risk patients in the following categories:
1. Women who are pregnant
2. Subscribers undergoing cancer
				chemotherapy
3. Subscribers with
				compromising systemic diseases such as diabetes as determined to be medically
				necessary for appropriate dental care by the provider and approved by the
				plan.
(E) Space
				maintainers, including removable acrylic and fixed band type.
(F) Preventive dental education and oral
				hygiene instructions
California Code of Regulations › Title 10 - Investment › Chapter 5.8 - Managed Risk Medical Insurance Board Healthy Families Program › Article 3 - Health, Dental and Vision Benefits › Section 2699.6719 - Waiting Periods for Receipt of Specified Benefits

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Participating dental plans may not subject enrollees to
				  waiting periods for receipt of specified benefits.
1. New section
				  filed 2-20-98 as an emergency; operative 2-20-98 (Register 98, No. 8). A
				  Certificate of Compliance must be transmitted to OAL by 6-22-98 or emergency
				  language will be repealed by operation of law on the following
				  day.
2. Certificate of Compliance as to 2-20-98 order transmitted to
				  OAL 6-5-98 and filed 7-15-98 (Register 98, No. 29).
3. Renumbering
				  of former section
				  2699.6719 to section
				  2699.6723 and renumbering of
				  former section
				  2699.6715 to section
				  2699.6719 filed 4-29-2002 as an
				  emergency; operative 4-29-2002 (Register 2002, No. 18). Pursuant to Chapter
				  946, Statutes of 2000, section
				  2, a Certificate of Compliance
				  must be transmitted to OAL by 10-28-2002 or emergency language will be repealed
				  by operation of law on the following day.
4. Certificate of
				  Compliance as to 4-29-2002 order transmitted to OAL 10-28-2002 and filed
				  12-12-2002 (Register 2002, No. 50).
Note: Authority cited: Section
					 12693.21,
					 Insurance Code. Reference: Sections
					 12693.21
					 and
					 12693.63,
					 Insurance Code.
California Code of Regulations › Title 10 - Investment › Chapter 5.8 - Managed Risk Medical Insurance Board Healthy Families Program › Article 3 - Health, Dental and Vision Benefits › Section 2699.6721 - Scope of Vision Benefits

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The basic scope of benefits offered by a
				participating vision plan must comply with all requirements of the Knox-Keene
				Health Care Service Plan Act of 1975, including amendments as well as its
				applicable regulations, and shall include all of the benefits and services
				listed in this section, subject to the exclusions listed in Section
				2699.6723. No other vision
				benefits shall be permitted to be offered by a participating vision plan as
				part of the program. The basic scope of vision benefits shall be as follows:
(1) Examinations: Each subscriber shall be
				entitled to a comprehensive vision examination, including a complete analysis
				of the eyes and related structures, as appropriate, to determine the presence
				of vision problems or other abnormalities as follows:
(A) Case history: Review of subscriber's main
				reason for the visit, past history, medications, general health, ocular
				symptoms, and family history.
(B)
				Evaluation of the health status of the visual system; including:
1. External and internal examination,
				including direct and/or indirect ophthalmoscopy;
2. Assessment of neurological integrity,
				including that of pupillary reflexes and extraocular muscles;
3. Biomicroscopy of the anterior segment of
				the eye, including observation of the cornea, lens, iris, conjunctiva, lids and
				lashes;
4. Screening of gross
				visual fields; and
5. Pressure
				testing through tonometry.
(C) Evaluation of refractive status,
				including:
1. Evaluation for visual
				acuity;
2. Evaluation of
				subjective, refractive, and accommodative function; and
3. Objective testing of a patient's
				prescription through retinoscopy.
(D) Binocular function test.
(E) Diagnosis and treatment plan, if
				needed.
(F) Examinations are
				limited to once each twelve consecutive month period.
California Code of Regulations › Title 10 - Investment › Chapter 5.8 - Managed Risk Medical Insurance Board Healthy Families Program › Article 3 - Health, Dental and Vision Benefits › Section 2699.6723 - Excluded Vision Benefits

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) A vision benefits plan offered under this
				program shall exclude:
(1) Any benefits
				specified as excluded within Section
				2699.6721.
(2) Any benefits in excess of limits
				specified in Section
				2699.6721.
(3) Services, supplies, items, procedures or
				equipment, which are not medically necessary as determined by the plan, unless
				otherwise specified in Section
				2699.6721.
(4) Any benefits that were received prior to
				the subscriber's effective date of coverage.
(5) Any benefits that were received
				subsequent to the time the subscriber's coverage ends.
(6) Benefits that are not obtained in
				compliance with the rules and policies of the subscriber's vision
				plan.
(7) Orthopics or vision
				training and any associated supplemental testing.
(8) Aniseikonic lenses.
(9) Plano lenses.
(10) Tinted or photochromic lenses unless
				otherwise deemed medically necessary.
(11) Two pairs of glasses in lieu of
				bifocals, unless medically necessary and with the prior authorization of the
				vision plan.
(12) Replacement or
				repair of lost or broken lenses or frames.
(13) Medical or surgical treatment of the
				eyes.
(14) Eye examinations
				required as a condition of employment.
(15) Any additional costs over and above the
				plan's frame allowance, as specified in subsections
				2699.6725(a)(2)
				and 2699.6725(b)(2).
California Code of Regulations › Title 10 - Investment › Chapter 5.8 - Managed Risk Medical Insurance Board Healthy Families Program › Article 3 - Health, Dental and Vision Benefits › Section 2699.6725 - Share of Cost for Vision Benefits

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) A participating vision plan shall require
				copayments for benefits provided to subscribers utilizing the services of the
				vision plan's panel of approved providers subject to the following except that
				subscribers with household income at or below 150% of the Federal Poverty Level
				shall pay a $5 copayment when a copayment is required:
(1) Examinations: $10 copayment per
				examination.
(2) Frames and lenses:
				$10 copayment, for frames with lenses, or for frames or lenses when purchased
				separately. No additional copayment for tinted or photochromic lenses when
				otherwise deemed medically necessary, or polycarbonate lenses.
A frame allowance of $35 is provided by the vision plan. The
				  subscriber is responsible for any costs exceeding this allowance. The
				  participating vision plan shall ensure that a selection of frames that do not
				  cost more than the frame allowance is available to all subscribers.
The following options are considered cosmetic and any costs
				  associated with the selection of these options will be the financial
				  responsibility of the applicant.
(A)
				Blended lenses (bifocals which do not have a visible dividing line).
(B) Contact lenses except as specified in
				Section 2699.6721(a)(3).
(C) Oversized lenses (larger than standard
				lens blank to accommodate prescriptions).
(D) Progressive multifocal lenses.
(E) Coated or laminated lenses.
(F) UV protected lenses.
(G) Other optional cosmetic
				processes.
(H) A frame that costs
				more than the plan's allowance.
(3) Necessary contact lenses, as defined in
				Subsection
				2699.6721(a)(3):
				No copayment.
(4) Elective contact
				lenses: an allowance of $100 will be provided by the vision plan toward the
				cost of an examination, contact lens evaluation, fitting costs and materials.
				This allowance will be in lieu of all benefits including examination and
				material costs. The subscriber is responsible for any costs exceeding this
				allowance.
(5) Low vision benefits:
(A) Supplementary testing: No copayment;
				and
(B) Supplemental care: $10
				copayment.
California Code of Regulations › Title 10 - Investment › Chapter 5.8 - Managed Risk Medical Insurance Board Healthy Families Program › Article 4 - Risk Categories and Family Contributions › Section 2699.6800 - Risk Categories Dental and Vision

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Subscriber child rates are as follows:
(1) Dental and vision benefits plan rates
				shall be based exclusively on one risk category: geographic region of the
				subscriber's residence. The six geographic regions for subscribers residing
				within the State of California shall be as follows unless they are altered
				pursuant to (2) below:
(A) Area 1 shall
				include the counties of Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, El
				Dorado, Glenn, Humboldt, Inyo, Kings, Lake, Lassen, Mendocino, Modoc, Mono,
				Monterey, Nevada, Placer, Plumas, San Benito, Shasta, Sierra, Siskiyou, Sutter,
				Tehama, Trinity, Tulare, Tuolumne, Yuba, and Yolo.
(B) Area 2 shall include the counties of
				Fresno, Imperial, Kern, Madera, Mariposa, Merced, Napa, Sacramento, San
				Joaquin, San Luis Obispo, Santa Cruz, Solano, Sonoma, and Stanislaus.
(C) Area 3 shall include the counties of
				Alameda, Contra Costa, Marin, San Francisco, San Mateo, and Santa
				Clara.
(D) Area 4 shall include the
				counties of Orange, Santa Barbara, and Ventura.
(E) Area 5 shall include the county of Los
				Angeles.
(F) Area 6 shall include
				the counties of Riverside, San Bernardino, and San Diego.
California Code of Regulations › Title 10 - Investment › Chapter 5.8 - Managed Risk Medical Insurance Board Healthy Families Program › Article 4 - Risk Categories and Family Contributions › Section 2699.6801 - Risk Categories Health

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Subscriber child rates are as follows:
(1) With the exception of rates applicable to
				AIM infants in the first two calendar months of life, health benefit plan rates
				shall be based on two risk categories: geographic region of the subscriber's
				residence and the age of the subscriber. Health plan benefit rates for
				subscribers entering the program as AIM infants shall initially be determined
				in accordance with subsection (c).
(2) The age categories for subscriber
				children shall be as follows:
(A) The first
				age category is subscribers under the age of one.
(B) The second age category is subscribers of
				the age of one and over.
(3) The six geographic regions for
				subscribers residing within the State of California shall be as follows unless
				they are altered pursuant to (4) below:
(A)
				Area 1 shall include the counties of Alpine, Amador, Butte, Calaveras, Colusa,
				Del Norte, El Dorado, Glenn, Humboldt, Inyo, Kings, Lake, Lassen, Mendocino,
				Modoc, Mono, Monterey, Nevada, Placer, Plumas, San Benito, Shasta, Sierra,
				Siskiyou, Sutter, Tehama, Trinity, Tulare, Tuolumne, Yuba, and Yolo.
(B) Area 2 shall include the counties of
				Fresno, Imperial, Kern, Madera, Mariposa, Merced, Napa, Sacramento, San
				Joaquin, San Luis Obispo, Santa Cruz, Solano, Sonoma, and Stanislaus.
(C) Area 3 shall include the counties of
				Alameda, Contra Costa, Marin, San Francisco, San Mateo, and Santa
				Clara.
(D) Area 4 shall include the
				counties of Orange, Santa Barbara, and Ventura.
(E) Area 5 shall include the county of Los
				Angeles.
(F) Area 6 shall include
				the counties of Riverside, San Bernardino, and San Diego.
(4) The Board may allow one or more health
				plans to subdivide one or more geographic regions. The Board shall determine
				which region or regions may be subdivided and the number of subregions into
				which a region will be divided. No subregion shall be smaller than one county.
				Plans rates may differ between subregions.
(5) Health plan rates shall be paid on a per
				capita basis and the per capita rate shall not be differentiated on the basis
				of the number of subscribers covered by one family
				contribution.
California Code of Regulations › Title 10 - Investment › Chapter 5.8 - Managed Risk Medical Insurance Board Healthy Families Program › Article 4 - Risk Categories and Family Contributions › Section 2699.6803 - Annual Health, Dental and Vision Benefit Plan Rates

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Health, dental and vision benefit plan rates shall be
				  established for each contract term.
1. New section
				  filed 2-20-98 as an emergency; operative 2-20-98 (Register 98, No. 8). A
				  Certificate of Compliance must be transmitted to OAL by 6-22-98 or emergency
				  language will be repealed by operation of law on the following
				  day.
2. Certificate of Compliance as to 2-20-98 order transmitted to
				  OAL 6-5-98 and filed 7-15-98 (Register 98, No. 29).
3. Amendment
				  filed 3-27-2008 as an emergency; operative 3-27-2008 (Register 2008, No. 13). A
				  Certificate of Compliance must be transmitted to OAL by 9-23-2008 or emergency
				  language will be repealed by operation of law on the following
				  day.
4. Certificate of Compliance as to 3-27-2008 order transmitted
				  to OAL 8-15-2008 and filed 9-22-2008 (Register 2008, No.
				  39).
Note: Authority cited: Section
					 12693.21,
					 Insurance Code. Reference: Section
					 12693.21,
					 Insurance Code.
California Code of Regulations › Title 10 - Investment › Chapter 5.8 - Managed Risk Medical Insurance Board Healthy Families Program › Article 4 - Risk Categories and Family Contributions › Section 2699.6804 - Rural Demonstration Project(s) Payments

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
In addition to plan rates, the Board may:
(a) Pay plan rates enhancement(s) to a
				health, dental or vision benefits plan based on the plan's participation in a
				rural demonstration project(s). Such rate enhancements shall be for the same
				period as the annual health, dental and vision benefit plan rates.
(b) Provide a grant(s) to a health, dental or
				vision plan based on the plan's participation in a rural demonstration
				project(s).
1. New section
				  filed 8-5-99 as an emergency; operative 8-5-99 (Register 99, No. 32). A
				  Certificate of Compliance must be transmitted to OAL by 12-3-99 or emergency
				  language will be repealed by operation of law on the following
				  day.
2. Certificate of Compliance as to 8-5-99 order transmitted to
				  OAL 10-29-99 and filed 12-3-99 (Register 99, No.
				  49).
Note: Authority cited: Section
					 12693.21,
					 Insurance Code. Reference: Section
					 12693.91,
					 Insurance Code.
California Code of Regulations › Title 10 - Investment › Chapter 5.8 - Managed Risk Medical Insurance Board Healthy Families Program › Article 4 - Risk Categories and Family Contributions › Section 2699.6807 - Change of Risk Category

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
When a subscriber changes county of residence as specified in
				  Section 2699.6800, or transfers between
				  health plans pursuant to Section
				  2699.6619, the family
				  contributions amount shall be recalculated and changed as of the first of the
				  following month, unless the applicant has a family contribution
				  sponsor.
1. New section
				  filed 2-20-98 as an emergency; operative 2-20-98 (Register 98, No. 8). A
				  Certificate of Compliance must be transmitted to OAL by 6-22-98 or emergency
				  language will be repealed by operation of law on the following
				  day.
2. Certificate of Compliance as to 2-20-98 order transmitted to
				  OAL 6-5-98 and filed 7-15-98 (Register 98, No. 29).
3. Amendment
				  filed 9-5-2000; operative 9-5-2000 pursuant to Government Code 11343.4(d)
				  (Register 2000, No. 36).
4. Amendment filed 4-29-2002 as an
				  emergency; operative 4-29-2002 (Register 2002, No. 18). Pursuant to Chapter
				  946, Statutes of 2000, section
				  2, a Certificate of Compliance
				  must be transmitted to OAL by 10-28-2002 or emergency language will be repealed
				  by operation of law on the following day.
5. Certificate of
				  Compliance as to 4-29-2002 order transmitted to OAL 10-28-2002 and filed
				  12-12-2002 (Register 2002, No. 50).
Note: Authority cited: Section
					 12693.21,
					 Insurance Code. Reference: Section
					 12693.21,
					 Insurance Code.
California Code of Regulations › Title 10 - Investment › Chapter 5.8 - Managed Risk Medical Insurance Board Healthy Families Program › Article 4 - Risk Categories and Family Contributions › Section 2699.6809 - Determination of Family Contribution for the Program

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Family child contributions for the
				program shall consist of one of the following:
(1) A flat fee in each county for a family
				value package:
(A) Seven dollars ($7) per
				subscriber child with a maximum required contribution of fourteen dollars ($14)
				per month for subscriber children with annual household incomes after income
				deductions of up to and including 150 percent of the federal poverty
				level.
(B) Through January 31,
				2009, nine dollars ($9) per subscriber child with a maximum required
				contribution of twenty-seven dollars ($27) per month for subscriber children
				with annual household incomes after income deductions if greater than 150
				percent and up to and including 200 percent of the federal poverty level; these
				rates are also applicable for subscribers who entered the program as AIM
				infants. On and after February 1, 2009, and through October 31, 2009, twelve
				dollars ($12) per subscriber child with a maximum required contribution of
				thirty-six dollars ($36) per month. On and after November 1, 2009, sixteen
				dollars ($16) per subscriber child with a maximum required contribution of
				forty-eight dollars ($48) per month.
(C) Through January 31, 2009, fifteen dollars
				($15) per subscriber child with a maximum required contribution of forty-five
				dollars ($45) per month for subscriber children with annual household incomes
				after income deductions greater than 200 percent and up to and including 250
				percent of the federal poverty level; these rates are also applicable, through
				the first year of eligibility, for subscribers who entered the program as AIM
				infants and for those AIM infants whose annual household income after
				deductions remains above 200 percent of the federal poverty level after each
				Annual Eligibility Review. On and after February 1, 2009, and through October
				31, 2009, seventeen dollars ($17) per subscriber child with a maximum required
				contribution of fifty-one dollars ($51) per month. On and after November 1,
				2009, twenty-four dollars ($24) per subscriber child with a maximum required
				contribution of seventy-two dollars ($72) per month.
California Code of Regulations › Title 10 - Investment › Chapter 5.8 - Managed Risk Medical Insurance Board Healthy Families Program › Article 4 - Risk Categories and Family Contributions › Section 2699.6811 - Notification of Family Contributions Changes

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
The program shall notify applicants in writing of change in
				  family child contributions and/or family parent
				  contributions.
1. New section
				  filed 2-20-98 as an emergency; operative 2-20-98 (Register 98, No. 8). A
				  Certificate of Compliance must be transmitted to OAL by 6-22-98 or emergency
				  language will be repealed by operation of law on the following
				  day.
2. Certificate of Compliance as to 2-20-98 order transmitted to
				  OAL 6-5-98 and filed 7-15-98 (Register 98, No. 29).
3. Amendment of
				  section heading, section and NOTE filed 4-29-2002 as an emergency; operative
				  4-29-2002 (Register 2002, No. 18). Pursuant to Chapter 946, Statutes of 2000,
				  section 2, a Certificate of Compliance
				  must be transmitted to OAL by 10-28-2002 or emergency language will be repealed
				  by operation of law on the following day.
4. Certificate of
				  Compliance as to 4-29-2002 order transmitted to OAL 10-28-2002 and filed
				  12-12-2002 (Register 2002, No. 50).
Note: Authority cited: Sections
					 12693.21
					 and
					 12693.755,
					 Insurance Code. Reference: Sections
					 12693.21
					 and
					 12693.755,
					 Insurance Code.
California Code of Regulations › Title 10 - Investment › Chapter 5.8 - Managed Risk Medical Insurance Board Healthy Families Program › Article 4 - Risk Categories and Family Contributions › Section 2699.6817 - Family Contribution Sponsor Registration

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Family contribution sponsors must
				register with the Board.
(b) To be
				registered, a family contribution sponsor must:
(1) complete and return a Healthy Families
				Program Family Contribution Sponsor Registration form (HFP-Sponsor 1 (new
				7/00)), which is hereby incorporated by this reference, and
(2) receive a sponsor identification number
				from the Board.
California Code of Regulations › Title 10 - Investment › Chapter 5.8 - Managed Risk Medical Insurance Board Healthy Families Program › Article 4 - Risk Categories and Family Contributions › Section 2699.6819 - Family Contribution Sponsor Payments

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) For each applicant being sponsored, the
				family contribution sponsor shall submit payment for twelve (12) months of
				family child contributions if the family contribution sponsor is sponsoring a
				subscriber child, and twelve (12) months of family parent contributions if the
				family contribution sponsor is sponsoring a subscriber parent. The family
				contribution sponsor shall also submit the completed and signed Healthy
				Families Program Family Contribution Sponsorship Payment form (HFP-Sponsor 2
				(new 7/00)) which is hereby incorporated by this reference.
(b) The payment for twelve (12) months of
				family child contributions shall be the family child contributions amount
				determined pursuant to Subsection
				2699.6809(e)
				multiplied by 12. The payment for twelve (12) months of family parent
				contributions shall be the family parent contributions amount determined
				pursuant to Subsection
				2699.6809(f)
				multiplied by 12.
(c) Payment of
				the amount specified in subsection (b) above shall be considered payment in
				full for the applicant for the twelve (12) consecutive months in the Program
				or, as of the parental coverage start date, for any twelve consecutive months
				in the program. No premium adjustments will be made for any reason during the
				period.
1. New section
				  filed 9-5-2000; operative 9-5-2000 pursuant to Government Code 11343.4(d)
				  (Register 2000, No. 36).
2. Amendment of section and NOTE filed
				  4-29-2002 as an emergency; operative 4-29-2002 (Register 2002, No. 18).
				  Pursuant to Chapter 946, Statutes of 2000, section
				  2, a Certificate of Compliance
				  must be transmitted to OAL by 10-28-2002 or emergency language will be repealed
				  by operation of law on the following day.
3. Certificate of
				  Compliance as to 4-29-2002 order transmitted to OAL 10-28-2002 and filed
				  12-12-2002 (Register 2002, No. 50).
4. Amendment of subsection (c)
				  filed 7-31-2003 as an emergency; operative 7-31-2003 (Register 2003, No. 31). A
				  Certificate of Compliance must be transmitted to OAL by 1-27-2004 or emergency
				  language will be repealed by operation of law on the following
				  day.
5. Certificate of Compliance as to 7-31-2003 order transmitted
				  to OAL 11-17-2003 and filed 12-30-2003 (Register 2004, No.
				  1).
Note: Authority cited: Sections
					 12693.21
					 and
					 12693.755,
					 Insurance Code. Reference: Sections
					 12693.21
					 and
					 12693.755,
					 Insurance Code.
California Code of Regulations › Title 10 - Investment › Chapter 5.8 - Managed Risk Medical Insurance Board Healthy Families Program › Article 4 - Risk Categories and Family Contributions › Section 2699.6821 - Eligibility as a Family Contribution Sponsor

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The following persons or entities are not
				eligible to be family Contribution sponsor:
(1) a person that is a health care, dental
				care or vision care provider that participates in the Healthy Families Program
				or an organization composed primarily of or controlled by such
				persons,
(2) an entity, including
				governmental, school, non-profit and charitable organizations, that is, or that
				operates, an institution or facility that is a health care, dental care or
				vision care provider that participates in the Healthy Families
				Program.
(3) a participating
				plan.
(4) any person or entity
				acting on behalf of or representing a person or entity identified in (1)
				through (3) above.
California Code of Regulations › Title 10 - Investment › Chapter 5.8 - Managed Risk Medical Insurance Board Healthy Families Program › Article 4 - Risk Categories and Family Contributions › Section 2699.6823 - Family Contribution Sponsor Certification Requirement

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Any person or entity seeking to provide
				payment as a family contribution sponsor must certify both of the following:
(1) that the person or entity is not
				ineligible to be a family contribution sponsor under Section
				2699.6821, and
(2) that the person or entity acknowledges
				that the Board has taken no position as to whether payment of premiums as a
				family contribution sponsor by any person or entity would be in violation of
				federal fraud and abuse laws.
California Code of Regulations › Title 10 - Investment › Chapter 5.8 - Managed Risk Medical Insurance Board Healthy Families Program › Article 4 - Risk Categories and Family Contributions › Section 2699.6825 - Family Contribution Sponsor Disqualification

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
The Board may refuse to allow a registered family
				  contribution sponsor to sponsor any additional applicants if the Board
				  determines that the sponsor has violated or encouraged an applicant to violate
				  program rules. The sponsor will be notified in writing of such a determination.
				  The sponsor may appeal the determination by filing a written request for review
				  by the Executive Director.
1. New section
				  filed 9-5-2000; operative 9-5-2000 pursuant to Government Code 11343.4(d)
				  (Register 2000, No. 36).
Note: Authority cited: Section
					 12693.21,
					 Insurance Code. Reference: Section
					 12693.21,
					 Insurance Code.
California Code of Regulations › Title 10 - Investment › Chapter 5.8 - Managed Risk Medical Insurance Board Healthy Families Program › Article 4 - Risk Categories and Family Contributions › Section 2699.6827 - Payment of State Supported Services

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
State Supported Services shall be paid for by State dollars
				  only. No Federal dollars provided to the State pursuant to title XXI of the
				  Social Security Act shall be used.
1. New section
				  filed 7-31-2003 as an emergency; operative 7-31-2003 (Register 2003, No. 31). A
				  Certificate of Compliance must be transmitted to OAL by 1-27-2004 or emergency
				  language will be repealed by operation of law on the following
				  day.
2. Certificate of Compliance as to 7-31-2003 order transmitted
				  to OAL 11-17-2003 and filed 12-30-2003 (Register 2004, No.
				  1).
Note: Authority cited: Section
					 12693.21,
					 Insurance Code. Reference: Section
					 12693.21,
					 Insurance Code; and 42 CFR
					 Section
					 457.475.
California Code of Regulations › Title 10 - Investment › Chapter 5.8 - Managed Risk Medical Insurance Board Healthy Families Program › Article 5 - Child Health and Disability Prevention Program Payments › Section 2699.6900 - Child Health and Disability Prevention Program Providers

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) For purposes of meeting the requirements
				of Insurance Code Section
				12693.41,
				regarding reimbursement of providers who participate in the Child Health and
				Disability Prevention (CHDP) Program, providers are defined as:
(1) CHDP health assessment providers, are
				those individuals and entities described in Title 17, California Code of
				Regulations, Section
				6860 and
				6862, who provide well-child
				health assessment and immunizations.
(2) CHDP initial treatment providers, are
				those providers that participate in the Medi-Cal and Denti-Cal program and
				provide initial treatment of a condition that has been identified during the
				well-child health assessment.
California Code of Regulations › Title 10 - Investment › Chapter 5.8 - Managed Risk Medical Insurance Board Healthy Families Program › Article 5 - Child Health and Disability Prevention Program Payments › Section 2699.6903 - Reimbursable Services

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) For
				purposes of meeting the requirements of Insurance Code Section
				12693.41
				relating to the Healthy Families Program reimbursements, a "CHDP well-child
				health assessment" is as defined in Title 17, California Code of Regulations,
				Section 6800 and shall include those
				services specified in Title 17, California Code of Regulations, Section
				6846.
(b) For purposes of meeting the requirements
				of Insurance Code Section
				12693.41
				relating to the Healthy Families Program reimbursement, "initial treatment"
				means those services provided in the 90 days prior to a person's effective date
				of coverage by a Healthy Families Program participating health plan that are
				necessary for diagnosis and treatment of a condition identified during the
				"CHDP well-child health assessment". These services may include, but are not
				limited to:
(1) Outpatient physician services
				including referral to outpatient specialty care, laboratory services, x-ray
				services, prescription drugs and those medical supplies and equipment necessary
				to administer prescribed medication.
(2) Inpatient hospital care.
(3) Emergency dental services that are
				medically necessary for the relief of pain and treatment of
				infection.
California Code of Regulations › Title 10 - Investment › Chapter 5.8 - Managed Risk Medical Insurance Board Healthy Families Program › Article 5 - Child Health and Disability Prevention Program Payments › Section 2699.6905 - Reimbursement Rates

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) For
				the purposes of meeting the requirement of Insurance Code section
				12693.41
				relating to the Healthy Families Program, well-child health assessments and
				immunizations provided to persons who subsequently enroll in the Healthy
				Families Program pursuant to Article 2, shall be reimbursed at the rates
				specified in Title 17, California Code of Regulations, Section
				6868. CHDP health assessment
				providers shall submit claims for these services in accordance with Title 17,
				California Code of regulations, Section
				6866 to the State Department of
				Health Services (DHS).
(b) For the
				purposes of meeting the requirement of Insurance Code Sections
				12693.41
				relating to the Healthy Families Program, providers shall be reimbursed for
				initial treatment provided to persons who subsequently enroll in the Healthy
				Families Program pursuant to Article 2, at the Medi-Cal rate, as specified in
				Title 22, California Code of Regulations, Sections
				51501 et. seq. A county that
				reimburses a provider at a county-specific rate that is less than the Medi-Cal
				rate for treatment services for a condition identified in a CHDP health
				assessment will be reimbursed by the Healthy Families Program at the rate the
				county reimburses the treatment provider. Providers shall submit claims to the
				DHS for these services on the Health Insurance Claim Form (HCFA 1500, revised
				version 12/90), accompanied by a legible copy of any DHS approved version of
				the Confidential Screening/Billing Report (PM 160).
1. New section
				  filed 8-28-98 as an emergency; operative 8-28-98 (Register 98, No. 35). A
				  Certificate of Compliance must be transmitted to OAL by 12-28-98 or emergency
				  language will be repealed by operation of law on the following
				  day.
2. Certificate of Compliance as to 8-28-98 order, including
				  amendment of subsection (b), transmitted to OAL 12-18-98 and filed 2-2-99
				  (Register 99, No. 6).
Note: Authority cited: Section
					 12693.21,
					 Insurance Code. Reference: Section
					 12693.41,
					 Insurance Code.
California Code of Regulations › Title 10 - Investment › Chapter 6 - Real Estate Commissioner › Article 1 - General Provisions › Section 2700 - Offices. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. Amendment
				  filed 11-30-77; effective thirtieth day thereafter (Register 77, No. 49). For
				  prior history, see Register 77, No. 7.
2. Amendment filed 1-17-80;
				  effective thirtieth day thereafter (Register 80, No. 3).
3. Repealer
				  filed 7-1-83; effective thirtieth day thereafter (Register 83, No.
				  30).
Note: Authority cited: Sections
					 10080,
					 10170.4,
					 10226,
					 10249.2,
					 10312,
					 11001,
					 11011.8
					 and
					 11018.9,
					 Business and Professions Code. Reference: Section
					 10077,
					 Business and Professions Code.
California Code of Regulations › Title 10 - Investment › Chapter 6 - Real Estate Commissioner › Article 1 - General Provisions › Section 2708 - Permit Reform Act Definitions. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New section
				  filed 5-26-92; operative 6-25-92 (Register 92, No. 22).
2. Repealer
				  filed 2-28-2006; operative 3-30-2006 (Register 2006, No.
				  9).
Note: Authority cited: Section
					 10080,
					 Business and Professions Code; Section
					 15376,
					 Government Code. Reference: Section
					 15376,
					 Government Code.
California Code of Regulations › Title 10 - Investment › Chapter 6 - Real Estate Commissioner › Article 1 - General Provisions › Section 2709 - Permit Processing Times. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New section
				  filed 5-26-92; operative 6-25-92 (Register 92, No. 22).
2. Amendment
				  filed 11-27-96; operative 12-27-96 (Register 96, No. 48).
3.
				  Amendment filed 12-30-97; operative 1-29-98 (Register 98, No. 1).
4.
				  Repealer filed 2-28-2006; operative 3-30-2006 (Register 2006, No.
				  9).
Note: Authority cited: Section
					 10080,
					 Business and Professions Code; Section
					 15376,
					 Government Code. Reference: Section
					 15376,
					 Government Code.
California Code of Regulations › Title 10 - Investment › Chapter 6 - Real Estate Commissioner › Article 3 - License Applications, Fees and Changes › Section 2710 - Applications and Notices of Change of Status

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) A person shall apply for an original
				license under the provisions of the Real Estate Law on the form of application
				prescribed by the Bureau. The applicant shall complete and sign the application
				form and submit it and the fee for the license in question to an office of the
				Bureau.
(b) A licensee applying for
				renewal of a real estate license shall comply with the provisions of
				subdivision (a) and with the following provisions:
(1) The application shall be submitted to the
				Bureau not more than 90 days before the expiration of the license to be
				renewed.
(2) The applicant shall
				submit on forms prescribed by the Bureau, information to establish that the
				applicant has satisfied the continuing education prerequisites for license
				renewal in Article 2.5 of Chapter 3 of the Real Estate Law.
California Code of Regulations › Title 10 - Investment › Chapter 6 - Real Estate Commissioner › Article 3 - License Applications, Fees and Changes › Section 2711 - Fingerprints. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. Amendment
				  filed 3-1-68; effective thirtieth day thereafter (Register 68, No.
				  9).
2. Amendment filed 10-14-68; effective thirtieth day thereafter
				  (Register 68, No. 39).
3. Amendment filed 1-16-76; effective
				  thirtieth day thereafter (Register 76, No. 3).
4. Repealer filed
				  7-1-83; effective thirtieth day thereafter (Register 83, No.
				  30).
California Code of Regulations › Title 10 - Investment › Chapter 6 - Real Estate Commissioner › Article 3 - License Applications, Fees and Changes › Section 2712 - Fingerprints

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
An original applicant for a real estate license may submit
				  his or her fingerprints
(a) with the
				application to take the license examination;
(b) at anytime after submitting the
				application to take the license examination; or
(c) with the application for a real estate
				license.
1. New section
				  filed 3-17-2005; operative 4-16-2005 (Register 2005, No. 11). For prior
				  history, see Register 83, No. 30.
Note: Authority cited: Section
					 10080,
					 Business and Professions Code. Reference: Section
					 10152,
					 Business and Professions Code.
California Code of Regulations › Title 10 - Investment › Chapter 6 - Real Estate Commissioner › Article 3 - License Applications, Fees and Changes › Section 2713 - Electronic Signature

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
When a signature is required in an electronic transaction
				  through the Bureau of Real Estate Web site the person seeking to submit the
				  transaction shall make the certification(s) in the appropriate fields and in
				  the manner specified by the Bureau on the Bureau's Web site. Submission of a
				  transaction in this manner through the Bureau's Web site shall constitute
				  irrefutable evidence of legal signature by any individual submitting such
				  transaction to the Bureau.
1. New section
				  filed 2-28-2006; operative 3-30-2006 (Register 2006, No. 9). For prior history,
				  see Register 83, No. 30.
2. Change without regulatory effect
				  amending section filed 6-30-2014 pursuant to section
				  100, title 1, California Code of
				  Regulations (Register 2014, No. 27).
Note: Authority cited: Section
					 10080,
					 Business and Professions Code. Reference: Sections
					 10150
					 and
					 10151,
					 Business and Professions Code.
California Code of Regulations › Title 10 - Investment › Chapter 6 - Real Estate Commissioner › Article 3 - License Applications, Fees and Changes › Section 2714 - Successive Original Licenses. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New section
				  filed 2-19-57; effective thirtieth day thereafter (Register 57, No.
				  4).
2. Amendment filed 2-25-60; effective thirtieth day thereafter
				  (Register 60, No. 4).
3. Repealer filed 9-17-65; designated
				  effective 1-2-66 (Register 65, No. 17).
California Code of Regulations › Title 10 - Investment › Chapter 6 - Real Estate Commissioner › Article 3 - License Applications, Fees and Changes › Section 2715 - Business and Residence Addresses of Licensees

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
Every real estate broker, except a broker acting in the
				  capacity of a salesperson to another broker under written agreement, shall
				  maintain on file with the commissioner the address of his or her principal
				  place of business for brokerage activities, the address of each branch business
				  office and his or her current mailing address, if different from the business
				  address.
Every broker who is acting in the capacity of a salesperson
				  to another broker under written agreement shall maintain on file with the
				  Commissioner the address of the business location where he or she expects to
				  conduct most of the activities for which a license is required and his or her
				  current mailing address.
A real estate salesperson shall maintain on file with the
				  Commissioner his current mailing address, and when applicable, the address of
				  the principal business office of the broker to whom the salesperson is at the
				  time licensed.
Whenever there is a change in the location or address of the
				  principal place of business or of a branch office of a broker, that broker
				  shall notify the Commissioner thereof not later than the next business day
				  following the change.
This section shall apply to those who are licensed and to
				  those who have license rights under Section
				  10201 of the
				  Code.
1. New section
				  filed 7-16-64; effective thirtieth day thereafter (Register 64, No.
				  15).
2. Repealer and new section filed 10-14-68; effective thirtieth
				  day thereafter (Register 68, No. 39).
3. Repealer and new section
				  filed 12-7-73; effective thirtieth day thereafter (Register 73, No.
				  49).
4. Amendment filed 2-10-77; effective thirtieth day thereafter
				  (Register 77, No. 7).
5. Amendment filed 1-17-80; effective
				  thirtieth day thereafter (Register 80, No. 3).
6. Amendment filed
				  1-9-85; effective thirtieth day thereafter (Register 85, No. 2).
7.
				  Amendment of section and NOTE filed 4-1-93; operative 5-1-93 (Register 93, No.
				  14).
8. Amendment filed 11-13-96; operative 11-13-96 pursuant to
				  Government Code section
				  11343.4(d)
				  (Register 96, No. 46).
9. Amendment of second paragraph filed
				  10-26-99; operative 11-25-99 (Register 99, No. 44).
10. Amendment
				  filed 5-31-2018; operative 5-31-2018 pursuant to Government Code section
				  11343.4(b)
				  (Register 2018, No. 22).
Note: Authority cited: Section
					 10080,
					 Business and Professions Code. Reference: Sections
					 10162,
					 10163
					 and
					 10201,
					 Business and Professions Code.
California Code of Regulations › Title 10 - Investment › Chapter 6 - Real Estate Commissioner › Article 3 - License Applications, Fees and Changes › Section 2715.5 - Additional Information-Examination and License Applications

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
The Commissioner may require a person, who has filed a
				  salesperson exam/license application or a broker exam/license application, to
				  file updated information concerning the applicant's mailing address, main
				  office address, broker affiliation of record, prior criminal history, or
				  professional license disciplinary history.
1. New section
				  filed 2-28-2006; operative 3-30-2006 (Register 2006, No.
				  9).
Note: Authority cited: Section
					 10080,
					 Business and Professions Code. Reference: Sections
					 10150,
					 10151
					 and
					 10152,
					 Business and Professions Code.
California Code of Regulations › Title 10 - Investment › Chapter 6 - Real Estate Commissioner › Article 3 - License Applications, Fees and Changes › Section 2716 - License Fees. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New section
				  filed 12-10-71; designated effective 4-1-72 (Register 71, No.
				  50).
2. Amendment and new subsection (3) filed 12-2-74; effective
				  thirtieth day thereafter (Register 74, No. 49).
3. Amendment filed
				  7-9-80; designated effective thirtieth day thereafter (Register 80, No.
				  28).
4. Amendment filed 1-21-83; effective thirtieth day thereafter
				  (Register 83, No. 4).
5. Repealer of section, new section and
				  amendment of NOTE filed 11-1-96; operative 1-1-97 (Register 96, No.
				  44).
6. Amendment of subsection (4), new subsections (5) and (6),
				  and subsection renumbering filed 12-30-97; operative 1-29-98 (Register 98, No.
				  1).
7. Amendment of subsections (1)-(6) filed 6-18-98; operative
				  8-1-98. Submitted to OAL for printing only pursuant to Business and Professions
				  Code section
				  10226
				  (Register 98, No. 26).
8. Amendment of subsections (1)-(6) filed
				  6-1-99; amended and refiled 7-14-99; operative 8-1-99. Submitted to OAL for
				  printing only pursuant to Business and Professions Code section
				  10226
				  (Register 99, No. 29).
9. Amendment of subsections (1)-(6) filed
				  5-16-2001; operative 6-15-2001 (Register 2001, No. 20).
10. Repealer
				  filed 5-1-2007; operative 5-31-2007 (Register 2007, No.
				  18).
Note: Authority cited: Sections
					 10080
					 and
					 10226,
					 Business and Professions Code. Reference: Sections
					 10153.4,
					 10201,
					 10209.5,
					 10210,
					 10214.5
					 and
					 10215,
					 Business and Professions Code.