Section 1399.832 Of Article 11.7. Child Access To Health Care Coverage From California Health And Safety Code >> Division 2. >> Chapter 2.2. >> Article 11.7.
1399.832
. No health care service plan shall be required to offer a
health care service plan contract or accept applications for the
contract pursuant to this article in the case of any of the
following:
(a) To a child, if the child who is to be covered by the plan
contract does not work or reside within the plan's approved service
areas.
(b) (1) Within a specific service area or portion of a service
area, if the plan reasonably anticipates and demonstrates to the
satisfaction of the director that it will not have sufficient health
care delivery resources to ensure that health care services will be
available and accessible to the child because of its obligations to
existing enrollees.
(2) A health care service plan that cannot offer a health care
service plan contract to individuals or children because it is
lacking in sufficient health care delivery resources within a service
area or a portion of a service area may not offer a contract in the
area in which the plan is not offering coverage to individuals to new
employer groups until the plan notifies the director that it has the
ability to deliver services to individuals, and certifies to the
director that from the date of the notice it will enroll all
individuals requesting coverage in that area from the plan.
(3) Nothing in this article shall be construed to limit the
director's authority to develop and implement a plan of
rehabilitation for a health care service plan whose financial
viability or organizational and administrative capacity has become
impaired.