Section 1399.828 Of Article 11.7. Child Access To Health Care Coverage From California Health And Safety Code >> Division 2. >> Chapter 2.2. >> Article 11.7.
1399.828
. (a) Upon the effective date of this article, a health
care service plan shall fairly and affirmatively offer, market, and
sell all of the plan's health care service plan contracts that are
offered and sold to a child or the responsible party for a child in
each service area in which the plan provides or arranges for the
provision of health care services during any open enrollment period,
to late enrollees, and during any other period in which state or
federal law, rules, regulations, or guidance expressly provide that a
health care service plan shall not condition offer or acceptance of
coverage on any preexisting condition.
(b) No health care service plan or solicitor shall, directly or
indirectly, engage in the following activities:
(1) Encourage or direct a child or responsible party for a child
to refrain from filing an application for coverage with a plan
because of the health status, claims experience, industry,
occupation, or geographic location, provided that the location is
within the plan's approved service area, of the child.
(2) Encourage or direct a child or responsible party for a child
to seek coverage from another plan because of the health status,
claims experience, industry, occupation, or geographic location,
provided that the location is within the plan's approved service
area, of the child.
(c) A health care service plan shall not, directly or indirectly,
enter into any contract, agreement, or arrangement with a solicitor
that provides for or results in the compensation paid to a solicitor
for the sale of a health care service plan contract to be varied
because of the health status, claims experience, industry,
occupation, or geographic location of the child. This subdivision
does not apply to a compensation arrangement that provides
compensation to a solicitor on the basis of percentage of premium,
provided that the percentage shall not vary because of the health
status, claims experience, industry, occupation, or geographic area
of the child.