California Code of Regulations
Title 10 - Investment
Chapter 5.7 - Voluntary Alliance Uniting Employers Purchasing Pool (the Health Insurance Plan of California)
Article 2 - Participation Requirements, Application and Enrollment
Section 2699.6123 - Application for Guaranteed Associations
Universal Citation: 10 CA Code of Regs 2699.6123
Current through Register 2024 Notice Reg. No. 38, September 20, 2024
(a) To apply for the program a guaranteed association shall submit:
(1) The name, position,
and phone number of a designated contact person who is legally authorized to sign
and date required declarations on behalf of the guaranteed association stating that
the information given is true and correct and complete to the best of their
knowledge.
(2) All information,
documentation, and declarations necessary to determine program qualification as
follows:
(A) A list of all members of the
association including their name, address, beginning date of membership, membership
category and tax identification number, if available.
(B) A list of the member employers, member
employees and dependents, and individual members and dependents who currently have
coverage sponsored by the guaranteed association or through the guaranteed
association's trust through which the guaranteed association sponsors
coverage.
(C) A declaration that the
guaranteed association has one or more employers which meets the definition of a
sole employer.
(D) A declaration that
the guaranteed association does not condition membership directly or indirectly on
the health or claims history of any person.
(E) A declaration that the guaranteed association
uses membership dues solely for and in consideration of the membership and
membership benefits, except that the amount of the dues shall not depend on whether
the member applies for or purchases insurance offered by the association.
(F) A declaration that the guaranteed association
is organized and maintained in good faith for purposes unrelated to providing
insurance to members.
(G) A declaration
that the guaranteed association has a constitution and bylaws or other analogous
governing documents that provide for election of the governing board of the
association by its members.
(H) Written
proof that the guaranteed association was in active existence on January 1, 1992 and
for at least five years prior to that date.
(I) Written proof that the guaranteed association
has been offering health insurance to its members for at least five years prior to
January 1, 1992.
(J) A declaration by
the guaranteed association that the guaranteed association will notify all
association members as well as any other person known to the association who,
although not an association member, is in a category of persons who pursuant to
Section 2699.6109(a)(9) will
be eligible for coverage through the guaranteed association of the guaranteed
association's intention to offer coverage through the program and provide member
employers and individual members with at least a 30 day period to respond.
(K) A declaration stating when the period for
informing member employers and individual members of the availability of coverage in
the program will be and for how long it will be.
(L) A declaration stating that the guaranteed
association will meet the requirements of Section
2699.6109(a)(2) and
(a)(3).
(M) A declaration that the guaranteed association
will not offer coverage to member employers and their employees or to individual
members anywhere but in the program.
(N)
A declaration disclosing to the program the number of persons currently receiving
coverage through the guaranteed association and when that coverage
commenced.
(O) A specification by the
guaranteed association of which of the members, employees of members, association
staff, retired members, retired employees of members, and surviving spouses and
dependents of deceased members the association shall commit to offering coverage to
in the program.
(3) A
description of the guaranteed association's plan for offering coverage. This shall
include at least the following:
(A) The method for
providing notice of the offering of coverage in the program.
(B) The date the initial offering by the
guaranteed association will expire.
(C)
Whether applications and premiums will be submitted through the guaranteed
association or directly to the program.
(D) If the applications and premiums will be
submitted through the guaranteed association, whether the guaranteed association
will be utilizing the services of an agent or broker. If the guaranteed association
will be utilizing the services of an agent or broker, the name, license number, tax
identification number, and address of the agent or
broker.
1. Renumbering and
amendment of former section
2699.623.5 to section 2699.6123 filed
5-27-94; operative 5-27-94 (Register 94, No. 21).
2. Amendment of
subsection (a)(2)(O) filed 4-25-96; operative 5-25-96 (Register 96, No.
17).
3. Amendment of subsection (a)(3)(D) filed 7-3-98 as an emergency;
operative 7-3-98 (Register 98, No. 27). A Certificate of Compliance must be
transmitted to OAL by 11-2-98 or emergency language will be repealed by operation of
law on the following day.
4. Certificate of Compliance as to 7-3-98 order
transmitted to OAL 10-2-98 and filed 11-16-98 (Register 98, No.
47).
Note: Authority cited: Section 10731, Insurance Code. Reference: Section 10731, Insurance Code.
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