California Code of Regulations
Title 10 - Investment
Chapter 5.7 - Voluntary Alliance Uniting Employers Purchasing Pool (the Health Insurance Plan of California)
Article 4 - Employer Premiums
Section 2699.6300 - Risk Categories
Universal Citation: 10 CA Code of Regs 2699.6300
Current through Register 2024 Notice Reg. No. 12, March 22, 2024
Health benefits plan rates shall be based exclusively on the following risk categories:
(a) Geographic region of sole employee's or guaranteed association member's residence.
(1) The six geographic regions for
sole employee's or guaranteed association members residing within the State of
California shall be as follows:
(A) Area 1
shall include the counties of Alpine, Amador, Butte, Calaveras, Colusa, Del
Norte, El Dorado, Glenn, Humboldt, Inyo, Kings, Lake, Lassen, Mendocino, Modoc,
Mono, Monterey, Nevada, Placer, Plumas, San Benito, Shasta, Sierra, Siskiyou,
Sutter, Tehama, Trinity, Tulare, Tuolumne, Yuba, and Yolo.
(B) Area 2 shall include the counties of
Fresno, Imperial, Kern, Madera, Mariposa, Merced, Napa, Sacramento, San
Joaquin, San Luis Obispo, Santa Cruz, Solano, Sonoma, and Stanislaus.
(C) Area 3 shall include the counties of
Alameda, Contra Costa, Marin, San Francisco, San Mateo, and Santa
Clara.
(D) Area 4 shall include the
counties of Orange, Santa Barbara, and Ventura.
(E) Area 5 shall include the county of Los
Angeles.
(F) Area 6 shall include
the counties of Riverside, San Bernardino, and San Diego.
(2) The eight geographic regions for sole
employees or member employees residing in areas of the United States except the
State of California shall be as follows:
(A)
Area A shall consist of the States of Maine, New Hampshire, Vermont, the State
of New York except Bronx, Kings, Manhattan, Nassau, Queens, Richmond, Rockland,
Westchester and Suffolk Counties and the Territory of Guam.
(B) Area B shall consist of the States of
Arkansas, Iowa, Kentucky, Montana, North Carolina, Oregon, South Carolina, and
the Commonwealth of Puerto Rico.
(C) Area C shall consist of the States of
Delaware, Hawaii, Idaho, Mississippi, Nebraska, North Dakota, Ohio, South
Dakota, Tennessee, Washington, West Virginia, Wisconsin, and the State of
Illinois except the counties of Cook, Dupage, Kane, Lake and McHenry.
(D) Area D shall consist of the States of
Colorado, Georgia, Indiana, Kansas, Maryland, Massachusetts, Michigan,
Missouri, Oklahoma, Pennsylvania, Rhode Island, Utah, Wyoming, and the State of
Florida except Dade and Broward counties.
(E) Area E shall consist of the States of
Alabama, Connecticut, Minnesota, New Jersey, New Mexico, Virginia, and counties
of Cook, Dupage, Kane, Lake, and McHenry in the State of Illinois.
(F) Area F shall consist of the States of
Alaska, Arizona, Louisiana, and the District of Columbia, and the State of
Texas except Galveston and Harris counties.
(G) Area G shall consist of the State of
Nevada and the counties of Bronx, Kings, Manhattan, Nassau, Queens, Richmond,
Rockland, Westchester and Suffolk in the State of New York, and the counties of
Galveston and Harris in the State of Texas.
(H) Area H shall consist of the counties of
Dade and Broward in the State of Florida.
(b) Age of enrolled sole employee or guaranteed association member. The seven (7) age groups shall be as follows:
(1) Under 30;
(2) 30-39 years of age;
(3) 40-49 years of age;
(4) 50-54 years of age;
(5) 55-59 years of age;
(6) 60-64 years of age; and
(7) 65 years of age and
over.
(c) Family size category of enrolled sole employee or guaranteed association member. The four (4) family size categories shall be as follows:
(1) Sole employee or guaranteed association
member only.
(2) Sole employee or
guaranteed association member and spouse.
(3) Sole employee and dependent child or
dependent children, or guaranteed association member and dependent child or
dependent children.
(4) Sole
employee and spouse, and dependent child or dependent children, or guaranteed
association member and spouse and dependent child or dependent
children.
1. Relocation of article heading and renumbering and amendment of former section 2699.640 to section 2699.6300 filed 5-27-94; operative 5-27-94 (Register 94, No. 21).
Note: Authority cited: Section 10731, Insurance Code. Reference: Sections 10731 and 10746, Insurance Code.
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