California Insurance Code 742.28 – A self-funded or partially self-funded multiple employer welfare …
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A self-funded or partially self-funded multiple employer welfare arrangement authorized by this article shall be limited to providing the following benefits:
(a) Medical, dental, optical, surgical, or other hospital care benefits.
Terms Used In California Insurance Code 742.28
- Multiple employer welfare arrangement: as used in this article has the same meaning as that contained in Section 1002(40)(A) of Title 29 of the United States Code. See California Insurance Code 742.21
- Partially self-funded: means a multiple employer welfare arrangement that undertook at all times and for a continuous period of five years to reimburse health benefit costs incurred by covered persons pursuant to the benefits and coverages provided by their plan exclusively from plan assets, provided, however, that these benefits are reimbursable to the multiple employer welfare arrangement by stop loss insurance only to the extent that the benefits exceed fifty thousand dollars ($50,000) per claim. See California Insurance Code 742.215
- self-funded: means a multiple employer welfare arrangement that undertook at all times and for a continuous period of five years to reimburse health benefit costs incurred by covered persons pursuant to the benefits and coverages provided by their plan exclusively from plan assets. See California Insurance Code 742.215
(b) Benefits in the event of sickness, accident, or disability.
(c) Flexible benefits under Section 125 of the Internal Revenue Code. These benefits shall not include loss from liability imposed by law upon employers to compensate employees and their dependents for injury sustained by the employees arising out of and in the course of the employment, irrespective of negligence or the fault of either party.
(Added by Stats. 1994, Ch. 1082, Sec. 1. Effective January 1, 1995.)