California Insurance Code 10731 – The board may do any of the following:(a) Enter into contracts …
The board may do any of the following:
(a) Enter into contracts with carriers to provide health benefits coverage to eligible employees and their dependents. Any contract entered into pursuant to this part shall be exempt from any provision of law relating to competitive bidding, and shall be exempt from the review or approval of any division of the Department of General Services. The board shall not be required to specify the amounts encumbered for each contract, but may allocate funds to each contract based on projected and actual subscriber enrollments.
Terms Used In California Insurance Code 10731
- Board: means the Major Risk Medical Insurance Board. See California Insurance Code 10700
- Carrier: means any disability insurance company or any other entity that writes, issues, or administers health benefit plans that cover the employees of small employers, regardless of the situs of the contract or master policyholder. See California Insurance Code 10700
- Contract: A legal written agreement that becomes binding when signed.
- Enrollee: means an eligible employee or dependent who receives health coverage through the program from a participating carrier. See California Insurance Code 10700
- Fund: means the California Small Group Reinsurance Fund. See California Insurance Code 10700
- Program: means the Health Insurance Plan of California. See California Insurance Code 10700
(b) Enter into other contracts as are necessary or proper to carry out the provisions of this part.
(c) Employ necessary staff.
(d) Sue or be sued, including taking any legal actions necessary or proper for recovering any penalties for, on behalf of, or against, the program or any board member.
(e) Define the health benefits coverage which the program will contract to purchase from participating carriers.
(f) Appoint committees, as necessary, to provide technical assistance in the operation of the program.
(g) Assess participating employers a reasonable fee for necessary costs in connection with the program.
(h) Undertake activities necessary to administer the program, including marketing and publicizing the program, and assuring carrier, employer, and enrollee compliance with program requirements.
(i) Establish rules, conditions, and procedures for participation for small employers.
(j) Establish rules, conditions, and procedures for participation for participating carriers.
(k) Establish a financial relationship directly with agents or brokers to provide services pursuant to this program.
(l) Approve the benefit plan designs sold by carriers participating in the pool.
(m) Issue rules and regulations as necessary to administer the program. Any rules and regulations issued pursuant to this subdivision may be adopted as emergency regulations in accordance with the Administrative Procedure Act (Chapter 3.5 (commencing with Section 11340) of Part 1 of Division 3 of Title 2 of the Government Code). Until December 31, 1994, the adoption of these regulations shall be deemed an emergency and necessary for the immediate preservation of the public peace, health, and safety, or general welfare.
(n) Exercise all powers reasonably necessary to carry out the powers and responsibilities expressly granted or imposed by this part.
(o) From money appropriated to the Major Risk Medical Insurance Fund, the Major Risk Medical Insurance Board may loan funds for operating expenses to establish the program. These funds shall be repaid to the Major Risk Medical Insurance Fund prior to transitioning administrative and financial responsibility for the program to a qualified nonprofit entity pursuant to Sections 10748.5 and 10748.6.
(Amended by Stats. 1993, Ch. 1146, Sec. 9.7. Effective October 11, 1993.)