Section 22864 Of Article 6. Health Benefit Plans And Contracts From California Government Code >> Division 5. >> Title 2. >> Part 5. >> Chapter 1. >> Article 6.
22864
. (a) Premiums charged for enrollment in a health benefit plan
shall reasonably reflect the cost of the benefits provided.
(b) This part does not limit the board's authority to do any of
the following:
(1) Enter into contracts with carriers providing compensation
based on carrier performance.
(2) Credit premiums to an employer for expenditures that the board
determines are likely to improve the health status of employees and
annuitants or otherwise reduce health care costs.
(3) Adjust the premiums charged under any health benefit plan or
contract to reflect regional variations in the cost of health care
services and other relevant factors. Any adjustment of these premiums
shall be at the sole discretion of the board and shall only apply to
the premiums charged to employees and annuitants of contracting
agencies. The board may require a contracting agency and its
employees and annuitants to pay the premium rate established pursuant
to this paragraph, which may be different than the health benefit
plan or contract premium rate that would otherwise be applicable to
that agency.
(4) Adjust premiums as part of programs for health promotion and
disease prevention.
(5) Develop procedures for risk adjustment of premiums across
plans that encourage plans to offer benefits based upon medical and
administrative efficiency and quality of care rather than on the
employee's or annuitant's health status or service areas with
low-risk populations. Any risk adjustment program or procedure shall
be at the sole discretion of the board.