California Code of Regulations
Title 10 - Investment
Chapter 5.5 - Major Risk Medical Insurance Board
Article 5 - Appeals
Section 2698.500 - Appeals to the Board

Universal Citation: 10 CA Code of Regs 2698.500

Current through Register 2024 Notice Reg. No. 38, September 20, 2024

(a) Any subscriber, enrolled dependent or dependent subscriber who is dissatisfied with any action or failure to act which has occurred in connection with a participating health plan's coverage may file an appeal with the Board.

(b) In addition, the following decisions may be appealed to the Executive Director only:

(1) A program determination as to eligibility of any applicant or the applicant's dependents.

(2) A program determination to disenroll a subscriber, enrolled dependent or dependent subscriber from the program.

(3) A program determination to deny a subscriber or dependent subscriber request or to grant a participating health plan request to transfer the subscriber to a different participating health plan.

1. New section filed 12-20-90 as an emergency; operative 12-20-90 (Register 91, No. 11). A Certificate of Compliance must be transmitted to OAL by 4-19-91 or emergency language will be repealed by operation of law on the following day.
2. Certificate of Compliance as to 12-20-90 order transmitted to OAL on 4-18-91 and filed 5-17-91 (Register 91, No. 27).
3. Amendment of subsection (b) and NOTE filed 1-10-95 as an emergency; operative 1-10-95 (Register 95, No. 2). A Certificate of Compliance must be transmitted to OAL 5-10-95 or emergency language will be repealed by operation of law on the following day.
4. Certificate of Compliance as to 1-10-95 order transmitted to OAL 4-25-95 and filed 6-7-95 (Register 95, No. 23).
5. Amendment of subsections (a), (b)(2) and (b)(3) filed 8-4-2003 as an emergency; operative 8-4-2003 (Register 2003, No. 32). Amendments to remain in effect for 180 days pursuant to section 21, chapter 794, Statutes of 2002 (AB 1401). A Certificate of Compliance must be transmitted to OAL by 2-2-2004 or emergency language will be repealed by operation of law on the following day.
6. Certificate of Compliance as to 8-4-2003 order transmitted to OAL 1-23-2004 and filed 3-1-2004 (Register 2004, No. 10).

Note: Authority cited: Sections 12711 and 12712, Insurance Code. Reference: Sections 12711 and 12732, Insurance Code.

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