Section 1366.3 Of Article 4. Solicitation And Enrollment From California Health And Safety Code >> Division 2. >> Chapter 2.2. >> Article 4.
1366.3
. (a) On and after January 1, 2005, a health care service
plan issuing individual plan contracts that ceases to offer
individual coverage in this state shall offer coverage to the
subscribers who had been covered by those contracts at the time of
withdrawal under the same terms and conditions as provided in
paragraph (3) of subdivision (a), paragraphs (2) to (4), inclusive,
of subdivision (b), subdivisions (c) to (e), inclusive, and
subdivision (h) of Section 1373.6.
(b) A health care service plan that ceases to offer individual
coverage in a service area shall offer the coverage required by
subdivision (a) to subscribers who had been covered by those
contracts at the time of withdrawal, if the plan continues to offer
group coverage in that service area. This subdivision shall not apply
to coverage provided pursuant to a preferred provider organization.
(c) The department may adopt regulations to implement this
section.
(d) This section shall not apply when a plan participating in
Medi-Cal, Healthy Families, Access for Infants and Mothers, or any
other contract between the plan and a government entity no longer
contracts with the government entity to provide health coverage in
the state, or a specified area of the state, nor shall this section
apply when a plan ceases entirely to market, offer, and issue any and
all forms of coverage in any part of this state after the effective
date of this section.
(e) (1) On and after January 1, 2014, and except as provided in
paragraph (2), the reference to Section 1373.6 in subdivision (a)
shall not apply to any health plan contracts.
(2) If Section 5000A of the Internal Revenue Code, as added by
Section 1501 of the federal Patient Protection and Affordable Care
Act (Public Law 111-148), as amended by the federal Health Care and
Education Reconciliation Act of 2010 (Public Law 111-152), is
repealed or amended to no longer apply to the individual market, as
defined in Section 2791 of the federal Public Health Service Act (42
U.S.C. Section 300gg-91), paragraph (1) shall become inoperative on
the date of that repeal or amendment.