General Provisions
Cal. INS § 10112.9
California Statutes
(a)
(1) Notwithstanding
Section 10273.4, an insurer, except an insurer issuing a specialized health insurance policy, issuing a policy or certificate of health insurance, as defined in subdivision (
b) of
Section 106, shall not market, offer, amend, issue, or renew a large group plan contract that provides a minimum value of less than percent.
(2) This
section shall not apply to limited wraparound coverage, that is consistent with
Section 146.145(
b) of Title of the Code of Federal Regulations. This
section also shall not apply to a policy that provides coverage of Medicare services pursuant to contracts with the United States government.
(3) This
section shall not apply to a grandfathered health insurance policy that provides basic health care services, as defined in subdivision (
b) of
Section of the Health and Safety Code, without annual or lifetime limits for any of the basic health care services. (
b) For purposes of this section, a plan shall provide a minimum value of at least percent, as described in
Section 36B(c)(2)(
C) of the federal Internal Revenue Code and any regulations or guidance adopted under that section. (
c) This
section shall not apply to an insurer that is subject to the disclosure requirements described in
Section 10198.61. (
d) For purposes of this section, the following
definitions apply: (1) “Large group” means a group that is not a “small employer,” as defined in