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 2220.21 - Basic Scheduled Surgical Benefits

A basic surgical benefit in which surgical operations are listed by name or description with a limiting amount on each item shall be deemed not sufficient to be of real economic value to the insured if the amount provided for the most severe operation is less than $300.00 and the amounts provided for other operations are not reasonably related to such maximum amount and if it fails to contain a proviso that any operation not named and not otherwise excluded will be paid for in an amount which shall be objectively determined by the company on the basis of the gravity and severity of the unnamed operation as compared to analogously named operations.