(a) Upon the effective date of this chapter, a carrier shall fairly and affirmatively offer, market, and sell all of the carrier’s health benefit plans that are offered and sold to a child or the responsible party for a child in each service area in which the plan provides or arranges for health care coverage during any open enrollment period, to late enrollees, and during any other period in which state or federal law, rules, regulations, or guidance expressly provide that a carrier shall not condition offer or acceptance of coverage on any preexisting condition.

(b) No carrier or solicitor shall, directly or indirectly, engage in the following activities:

Terms Used In California Insurance Code 10953

  • Child: means any individual under 19 years of age. See California Insurance Code 10950
  • Contract: A legal written agreement that becomes binding when signed.
  • Open enrollment period: means the annual open enrollment period subsequent to the initial open enrollment period, applicable to each individual child that is the month of the child's birth date. See California Insurance Code 10950
  • Responsible party for a child: means an adult having custody of the child or with responsibility for the financial needs of the child, including the responsibility to provide health care coverage. See California Insurance Code 10950
  • State: means the State of California, unless applied to the different parts of the United States. See California Insurance Code 28

(1) Encourage or direct a child or responsible party for a child to refrain from filing an application for coverage with a carrier because of the health status, claims experience, industry, occupation, or geographic location, provided that the location is within the carrier’s approved service area, of the child.

(2) Encourage or direct a child or responsible party for a child to seek coverage from another carrier because of the health status, claims experience, industry, occupation, or geographic location, provided that the location is within the carrier’s approved service area, of the child.

(c) A carrier shall not, directly or indirectly, enter into any contract, agreement, or arrangement with a solicitor that provides for or results in the compensation paid to a solicitor for the sale of a health benefit plan to be varied because of the health status, claims experience, industry, occupation, or geographic location of the child. This subdivision does not apply to a compensation arrangement that provides compensation to a solicitor on the basis of percentage of premium, provided that the percentage shall not vary because of the health status, claims experience, industry, occupation, or geographic area of the child.

(Added by Stats. 2010, Ch. 656, Sec. 6. (AB 2244) Effective January 1, 2011. Inoperative, pursuant to Section 10960.5, on January 1, 2014, subject to condition for resuming operation.)

  Previous section
Next section  
 Chapter 9.7 Contents