California Insurance Code

§ 10786

INS § 10786 Effective Jan 1, 2020Div. 2 · Part 2 · Ch. 8.5

Statute text

(a)(1) On and after January 1, 2014, a health insurer providing health insurance coverage shall provide to policyholders in individual policies or certificate holders in group policies who cease to be enrolled in coverage a notice informing them that they may be eligible for reduced-cost coverage through the California Health Benefit Exchange (Exchange) established under Title 22 (commencing with Section 100500) of the Government Code or free or low-cost coverage through Medi-Cal. The notice shall include information on obtaining coverage pursuant to those programs, shall be in no less than 12-point type, and shall be developed by the department, no later than July 1, 2013, in consultation with the Department of Managed Health Care and the Exchange. The notice shall also include information that individuals eligible for the Medicare Program should examine their options carefully, as delaying Medicare enrollment may result in substantial financial implications, as well as information on how to find enrollment advice or assistance.

(2)The notice described in paragraph (1) may be incorporated into or sent simultaneously with and in the same manner as any other notices sent by the health insurer.

(b)(1) A health insurer shall annually notify a policyholder or certificate holder that if the policyholder or certificate holder ceases to be enrolled in coverage, the health insurer will provide information, including the policyholder’s or certificate holder’s name, address, and other contact information, such as email address, to the Exchange so that the policyholder or certificate holder may obtain other coverage. A policyholder or certificate holder may opt out of this transfer of information to the Exchange. This notice may be incorporated into or sent simultaneously with other notices sent by the health insurer.

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Legislative history

Amended by Stats. 2019, Ch. 845, Sec. 3. (SB 260) Effective January 1, 2020.