Cal. Health & Safety Code §§ 1374.60 through 1374.76: Knox-Keene Health Care Service Plan Act of 1975 — Point-of-Service Health Care Service Plan Contracts – California
Status: Enacted Year Enacted: 1993
For purpose of point-of-service health care Service plan contracts, the definitions as specified shall apply. A point-of-service plan contract, in which any risk for out-of-network coverage or services is transferred from a health care service …
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Cal. Ins. Code §§ 10112.8 through 10112.82: Life and Disability Insurance — The Contract – California
Status: Enacted Year Enacted: 2016
Sections provide “In-network cost-sharing amount” for services provided by noncontracting individual health professional, independent dispute resolution process for noncontracting individual health professional, and reimbursement rate for noncontracting individual health professional.
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Cal. Ins. Code §§ 10133 through 10133.11: Life and Disability Insurance — Transfer – California
Status: Enacted Year Enacted: 1951
Nothing in this section shall be construed to authorize an insurer to furnish or directly provide services of hospitals, or psychiatric health facilities, as defined in Section 1250.2 of the Health and Safety Code, or …
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Cal. Ins. Code §§ 10144.51 & 10145.4: Life and Disability Insurance — Discriminatory Practices – California
Status: Enacted Year Enacted: 2001
Every health insurer subject to this section shall maintain an adequate network that includes qualified autism service providers who supervise or employ qualified autism service professionals or paraprofessionals who provide and administer behavioral health treatment. …
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Cal. Ins. Code §§ 10192.1 through 10192.24: Medicare Supplement Policies – California
Status: Enacted Year Enacted: 2000
The following standards are applicable to all Medicare supplement policies or certificates advertised, solicited, or issued for delivery on or after January 1, 2001, and with an effective date prior to June 1, 2010. A …
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Cal. Ins. Code §§ 10702 through 10718.7: Small Employer Health Insurance — Small Employer Carrier Requirements – California
Status: Enacted Year Enacted: 1992
The premium for new business shall be determined for an eligible employee in a particular risk category after applying a risk adjustment factor to the carrier’s standard employee risk rates. The risk adjusted employee risk …
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Cal. Ins. Code §§ 10800 through 10887: The Private Health Care Voluntary Purchasing Alliance Act – California
Status: Enacted Year Enacted: 1996
The purpose of this chapter is to improve the competition in the pricing and delivering of health care coverage for employers and small employers. It does so by allowing for the establishment of private competing …
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Cal. Ins. Code §§ 12693.60 through 12693.62: Healthy Families — Health Benefits and Copayments – California
Status: Enacted Year Enacted: 1997
Except as otherwise provided in this part, the covered health benefits provided to subscribers shall be equivalent to those provided to state employees through the Public Employees’ Retirement System for the most recent plan year …
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Cal. Welf. & Inst. Code § 4620.2. Parental copayment system: Regional Center for Persons with Developmental Disabilities – California
Status: Enacted Year Enacted: 2003
The State Department of Developmental Services, after consultation with stakeholder groups, shall develop a system of enrollment fees, copayments, or both, to be assessed against the parents of each child between the ages of three …
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Cal. Welf. & Inst. Code §§ 14000 through 14029.92: Medi-Cal — General Provisions – California
Status: Enacted Year Enacted: 1965
The intent of the Legislature is to provide, to the extent practicable, through the provisions of this chapter, for health care for those aged and other persons, including family persons who lack sufficient annual income …
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Cal. Welf. & Inst. Code §§ 14081 through 14087.29: Selective Provider Contracts – California
Status: Enacted Year Enacted: 1982
It is the purpose of this article to ensure that the Medi-Cal program shall be operated in the most cost-effective and efficient manner possible with the optimum number of inpatient hospital service providers. In order …
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Cal. Welf. & Inst. Code §§ 14131 through 14138: The Medi-Cal Benefits Program – California
Status: Enacted Year Enacted: 1974
Any increase in the amount charged to the Medi-Cal program for patient care or treatment that is directly related to an identifiable provider-preventable condition is excluded from reimbursement under Medi-Cal.
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Colo. Rev. Stat. § 10-1-108. Duties of commissioner–reports–publications– fees– disposition of funds– adoption of rules–examinations and investigations: Insurance – General Provisions – Colorado
Status: Enacted Year Enacted: 2003
Requires hospitals and other providers as well as health maintenance organizations to report information about payments, fees, etc. made during the year to the insurance commissioner.
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Colo. Rev. Stat. § 10-1-109. Rules of commissioner: Insurance – General Provisions – Colorado
Status: Enacted Year Enacted: 2002
The commisioner shall make and promolgate the rules necessary to regulate insurance.
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Colo. Rev. Stat. § 10-16-102. Definitions: Colorado Health Care Coverage Act – Colorado
Status: Enacted Year Enacted: 1992
Definitions regarding the general healthcare coverage statutes for the state of Colorado. Includes the definition of “bona fide insurance plan“ and “licensed healthcare provider“ among others
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Colo. Rev. Stat. § 10-16-103.4. Essential Health Benefits-Requirements-Rules: Colorado Health Care Coverage Act – Colorado
Status: Enacted Year Enacted: 2013
Requires health plans or providers that take on insurance risk to issue evidence of coverage for the members or patients receiving insurance. States the required elements of an evidence of coverage, including no statements that …
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