Section 1367.010 Of Article 5. Standards From California Health And Safety Code >> Division 2. >> Chapter 2.2. >> Article 5.
1367.010
. (a) (1) A nongrandfathered health care service plan,
except a health care service plan offering a specialized health care
service plan contract, that offers, amends, or renews a large group
health care service plan contract shall not market, offer, amend, or
renew a large group plan contract that provides a minimum value of
less than 60 percent.
(2) This section shall not apply to limited wraparound coverage,
consistent with Section 146.145(b) of Title 45 of the Code of Federal
Regulations.
(b) For purposes of this section, a plan shall provide a minimum
value of at least 60 percent, as described in Section 36B(c)(2)(C) of
the federal Internal Revenue Code and any regulation or guidance
adopted under that section.
(c) The following definitions apply for purposes of this section:
(1) "Large group health care service plan contract" means a group
health care service plan contract other than a contract issued to a
"small employer," as defined in Section 1357, 1357.500, or 1357.600.
(2) "Plan year" has the meaning set forth in Section 144.103 of
Title 45 of the Code of Federal Regulations.