California Insurance Code 10752.2 – A stop-loss insurer shall renew, at the option of the small employer, …
A stop-loss insurer shall renew, at the option of the small employer, all stop-loss insurance policies written, issued, administered, or renewed on or after January 1, 2014, and all small employer stop-loss insurance policies in force on or after January 1, 2014, except as follows:
(a) (1) For nonpayment of the required premiums by the small employer, if the small employer has been duly notified and billed for the charge and at least a 30-day grace period has elapsed since the date of notification.
Terms Used In California Insurance Code 10752.2
- Commissioner: means the Insurance Commissioner of this State. See California Insurance Code 20
- Financially impaired: means , for the purposes of this chapter, a carrier that, on or after the effective date of this chapter, is not insolvent and is either:
California Insurance Code 10700
- Fraud: Intentional deception resulting in injury to another.
- Grace period: The number of days you'll have to pay your bill for purchases in full without triggering a finance charge. Source: Federal Reserve
- Small employer: means either of the following:
California Insurance Code 10700
- State: means the State of California, unless applied to the different parts of the United States. See California Insurance Code 28
- Stop-loss insurance policy: means a policy, contract, certificate, or statement of coverage between a stop-loss insurer and small employer providing individual or aggregate stop-loss insurance coverage, or both, or any other assumption of risk, to a small employer for the liability the small employer incurs related to the covered health claims of its employees and their dependents. See California Insurance Code 10752
- 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
(2) A stop-loss insurer shall continue to provide coverage as required by the small employer’s policy during the grace period described in paragraph (1). Nothing in this section shall be construed to affect or impair the small employer’s or the stop-loss insurer’s other rights and responsibilities pursuant to the policy.
(b) Where the stop-loss insurer demonstrates fraud or an intentional misrepresentation of material fact by the small employer under the terms of the stop-loss insurance policy.
(c) Where the stop-loss insurer has been determined by the commissioner to be financially impaired.
(d) Where the stop-loss insurer ceases to write, issue, or administer new stop-loss insurance policies in this state; provided, however, that the following conditions are satisfied:
(1) Notice of the decision to cease writing, issuing, or administering new or existing stop-loss insurance policies in this state is provided to the commissioner, and to the small employer, at least 180 days prior to the discontinuation of the coverage.
(2) Stop-loss insurance policies subject to this article shall not be canceled until 180 days after the date of the notice required under paragraph (1). During that time, the stop-loss insurer shall continue to comply with this article.
(Added by Stats. 2013, Ch. 443, Sec. 1. (SB 161) Effective January 1, 2014.)