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. 12, March 22, 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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