Section 100506 Of Title 22. California Health Benefit Exchange From California Government Code >> Title 22.
100506
. (a) The board shall establish an appeals process for
prospective and current enrollees of the Exchange that complies with
all requirements of the federal act concerning the role of a state
Exchange in facilitating federal appeals of Exchange-related
determinations. In no event shall the scope of those appeals be
construed to be broader than the requirements of the federal act.
Once the federal regulations concerning appeals have been issued in
final form by the United States Secretary of Health and Human
Services, the board may establish additional requirements related to
appeals, provided that the board determines, prior to adoption, that
any additional requirement results in no cost to the General Fund and
no increase in the charge imposed under subdivision (n) of Section
100503.
(b) The board shall not be required to provide an appeal if the
subject of the appeal is within the jurisdiction of the Department of
Managed Health Care pursuant to the Knox-Keene Health Care Service
Plan Act of 1975 (Chapter 2.2 (commencing with Section 1340) of
Division 2 of the Health and Safety Code) and its implementing
regulations, or within the jurisdiction of the Department of
Insurance pursuant to the Insurance Code and its implementing
regulations.