A stop-loss insurer shall not exclude any employee or dependent on the basis of an actual or expected health status-related factor. Health status-related factors include, but are not limited to, any of the following: health status; medical condition, including both physical and mental illnesses; claims experience; medical history; receipt of health care; genetic information; disability; evidence of insurability, including conditions arising out of acts of domestic violence of the employee or dependent; or any other health status-related factor as determined by the department.

(Added by Stats. 2013, Ch. 443, Sec. 1. (SB 161) Effective January 1, 2014.)

Terms Used In California Insurance Code 10752.1

  • Dependent: A person dependent for support upon another.
  • Dependent: means the spouse, registered domestic partner as described in §. See California Insurance Code 10752
  • Domestic: means organized under the laws of this State, whether or not admitted. See California Insurance Code 26
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • Stop-loss insurer: means an insurance company providing individual or aggregate stop-loss insurance coverage, or both, or any other assumption of risk, to a small employer for the health claims it incurs for its employees and their dependents. See California Insurance Code 10752
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