California Code of Regulations
Title 10 - Investment
Chapter 5.6 - Access for Infants and Mothers Program
Article 4 - Subscriber Contributions and Payment for Services
Section 2699.400 - Subscriber Contributions

Universal Citation: 10 CA Code of Regs 2699.400

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

(a) Subscriber contributions shall be:

(1) An initial fifty dollars ($50.00) to be submitted with the application, except that this pre-payment requirement shall not apply to applications received on or after January 1, 2014, and

(2) For subscribers who are enrolled prior to July 1, 2004, the difference between two per cent (2%) of the subscriber's gross household income, less deductions, as documented with the application and fifty dollars ($50.00), which amount shall be due in twelve (12) equal monthly installments beginning with the first month following enrollment; and

(3) For infants born to subscribers who are enrolled prior to July 1, 2004, one hundred dollars ($100.00) which shall be due on the infant's first birthday unless either of following apply:
(A) The infant is disenrolled from the program prior to the infant's first birthday, or

(B) The subscriber provides written proof that the infant is current for the infant's first year immunizations. Such immunizations shall be consistent with the most current version of the Recommended Childhood Immunization Schedule jointly adopted by the Advisory Committee on Immunization Practices, the American Academy of Pediatrics, and the American Academy of Family Physicians. The written proof of completed current first year immunizations shall be signed by a licensed medical doctor, licensed doctor of osteopathy, registered nurse, or licensed physician's assistant. When such written notice is provided the amount shall be fifty dollars ($50.00).

(4) For subscribers who are enrolled on or after July 1, 2004, the difference between one and one-half percent (1.5%) of the subscriber's gross household income, less deductions, as documented with the application and fifty dollars ($50.00), or one and one-half percent (1.5%) of the subscriber's annual MAGI, as applicable, pursuant to Section 2699.200(b)(1)(C), which amount may be paid in twelve (12) equal monthly installments beginning with the first month following enrollment.

(5)
(A) For subscribers who are enrolled on or after July 1, 2008, and no longer pregnant by the end of their first trimester, the subscriber contribution shall be reduced and shall be one-third ( 1/3) of the subscriber contribution calculated pursuant to subsections (a)(1) and (a)(4) of this section.

(B) As a condition of receiving this reduction, documentation by a licensed or certified healthcare professional must be submitted to the program indicating the date the pregnancy ended.

(b) There shall be no penalty for early payment of any portion of the subscriber contribution.

(c) In cases of multiple births to a subscriber, the $100 payment shall apply to each infant born to a subscriber who is enrolled prior to July 1, 2004.

(d) Subscribers shall not be reimbursed by any health care provider or state or local governmental entity for payment of the subscriber contribution and shall not have any health care provider or state or local governmental entity pay the subscriber contribution.

(e) No portion of the subscriber contribution is refundable except as provided in Sections 2699.202 and 2699.203, unless the subscriber is disenrolled pursuant to Subsection 2699.207(a)(2)(C), or unless the subscriber contribution is reduced pursuant to Section 2699.400(a)(5).

(f) A federally recognized California Indian Tribal Government may make required subscriber contributions on behalf of a member of the tribe.

(g) An applicant in arrears of subscriber contributions shall be sent a reminder notice. Applicants who become ninety (90) days in arrears on subscriber contributions will be reported to a credit reporting agency. If accounts are paid in full at a later date, the credit reporting agency's records shall be updated.

1. New article 4 and section filed 12-12-91 as an emergency; operative 12-12-91 (Register 92, No. 10). A Certificate of Compliance must be transmitted to OAL 4-10-92 or emergency language will be repealed by operation of law on the following day.
2. Certificate of Compliance as to 12-12-91 order including amendment of subsection (a)(3)(B) transmitted to OAL 4-8-92 and filed 5-20-92 (Register 92, No. 21).
3. Amendment of subsection (c) filed 6-8-92 as an emergency; operative 6-8-92 (Register 92, No. 24). A Certificate of Compliance must be transmitted to OAL 10-6-92 or emergency language will be repealed by operation of law on the following day.
4. Certificate of Compliance as to 6-8-92 order transmitted to OAL 9-24-92 and filed 11-5-92 (Register 92, No. 45).
5. Amendment of subsection (a)(3)(A), new subsection (c) and subsection redesignation, and amendment of subsection (e) filed 8-29-94 as an emergency; operative 9-1-94 (Register 94, No. 35). A Certificate of Compliance must be transmitted to OAL by 12-30-94 or emergency language will be repealed by operation of law on the following day.
6. Editorial correction inserting article heading and amending HISTORY 1 (Register 94, No. 35).
7. Certificate of Compliance as to 8-29-94 order transmitted to OAL 12-9-94 and filed 1-23-95 (Register 95, No. 4).
8. Amendment of subsection (a)(2) filed 3-17-2000 as an emergency; operative 3-17-2000 (Register 2000, No. 11). A Certificate of Compliance must be transmitted to OAL by 7-17-2000 or emergency language will be repealed by operation of law on the following day.
9. Certificate of Compliance as to 3-17-2000 order transmitted to OAL 6-12-2000 and filed 7-10-2000 (Register 2000, No. 28).
10. Amendment of subsections (a)(2) and (a)(3)(B) and new subsections (f) and (g) filed 5-20-2003; operative 5-20-2003 pursuant to Government Code section 11343.4 (Register 2003, No. 21).
11. Amendment of subsections (a)(2)-(3), new subsection (a)(4) and amendment of subsection (c) filed 7-1-2004 as an emergency; operative 7-1-2004 (Register 2004, No. 27). Pursuant to Section 80, A.B. 1762 (Chapter 230, Stats. 2003) a Certificate of Compliance must be transmitted to OAL by 12-28-2004 or emergency language will be repealed by operation of law on the following day.
12. Certificate of Compliance as to 7-1-2004 order transmitted to OAL 11-24-2004 and filed 1-7-2005 (Register 2005, No. 1).
13. Amendment of article heading filed 3-12-2008; operative 4-11-2008 (Register 2008, No. 11).
14. New subsections (a)(5)(A)-(B) and amendment of subsection (e) filed 8-14-2008; operative 8-14-2008 pursuant to Government Code section 11343.4 (Register 2008, No. 33).
15. Amendment of subsections (a)(1), (a)(4) and (f) filed 12-27-2013 as an emergency; operative 12-27-2013 (Register 2013, No. 52). A Certificate of Compliance must be transmitted to OAL by 6-25-2014 or emergency language will be repealed by operation of law on the following day. This filing is deemed an emergency and is exempt from review by OAL pursuant to Assembly Bill 82, Chapter 23, Statutes of 2013, section 77.
16. Certificate of Compliance as to 12-27-2013 order transmitted to OAL 5-29-2014 and filed 6-10-2014 (Register 2014, No. 24).

Note: Authority cited: Section 12696.05, Insurance Code. Reference: Sections 12696, 12696.05 and 12698, Insurance Code.

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