California Code of Regulations
Title 10 - Investment
Chapter 5 - Insurance Commissioner
Subchapter 2 - Policy Forms and Other Documents
Article 1.5 - Standards for Determining Conformity of Individual Disability Policies with the Provisions of Paragraph (7) of Subdivision (b) of Section 10291.5 of the Insurance Code
Subarticle 4 - Basic Medical Benefits
Section 2220.18 - Basic Private Duty Nurse Benefit
Current through Register 2024 Notice Reg. No. 38, September 20, 2024
A policy which provides a benefit for in hospital or out of hospital private duty nursing by either a licensed registered nurse (R.N.) or a licensed vocational nurse (L.V.N.) shall be deemed not sufficient to be of real economic value to an insured if:
(a) The amount of the daily private duty nursing benefit is less than $18.00 per shift for not less than one shift per day for a licensed registered nurse or $12.00 per shift for not less than one shift per day for a licensed vocational nurse; or
(b) The maximum period of time for which the benefit is payable is less than 10 days.
A policy which provides a nurse benefit for professional nurse home calls-by either a registered nurse or a vocational nurse shall be deemed not to be of real economic value to the insured unless the benefit equals not less than 25 percent of the benefit provided under Subsections (a) and (b) of this section and is not subject to elimination periods of more than the first three home calls for a sickness benefit and not more than the first three home calls for an accident benefit. A "home call" for the purpose of this section means a personal home visit during any one twenty-four hour period.
