28 CA ADC § 1300.43.6


      28 CCR s 1300.43.6

      Cal. Admin. Code tit. 28, s 1300.43.6


      CALIFORNIA CODE OF REGULATIONS
      TITLE 28. MANAGED HEALTH CARE
      DIVISION 1. THE DEPARTMENT OF MANAGED HEALTH CARE
      CHAPTER 2. HEALTH CARE SERVICE PLANS
      ARTICLE 1. EXEMPTIONS
      This database is current through 06/09/06, Register 2006, No. 23.

      s 1300.43.6. Moribund Plans.

      A health care service plan which is a general acute care hospital whose 
      business as a plan is limited to providing, administering, or otherwise 
      arranging for the provision of health care services to members of one 
      moribund group of not more than 250 members is exempted from the 
      provisions of the Knox-Keene Health Care Service Plan Act of 1975, subject 
      to each of the following conditions:

      (a) That such plan is licensed as a health facility pursuant to Chapter 2 
      (commencing with Section 1250) of the Health and Safety Code, and is not 
      insolvent.

      (b) That such plan has not accepted any new members for the last twenty 
      years and does not accept any new members for the duration of this 
      exemption.

      (c) That such plan receives prepaid or periodic charges, if any, from 
      members of such group in an amount not exceeding $5 per member per month 
      and has received no substantial payment or transfer of property from or on 
      behalf of such contracting group during the last twenty years.

      (d) That such plan derives not more than one-half of one percent of its 
      annual income from prepaid or periodic charges paid by or on behalf of 
      members of such group, and has a minimum net worth of $15,000,000 based 
      upon its most recent certified financial statements (prepared as of a date 
      within the preceding 15 months).

      (e) That such plan establish and maintain a grievance procedure 
      substantially complying with Section 1300.68.

      (f) That such plan deliver to each subscriber and enrollee within 60 days 
      of the adoption of this section, and thereafter to any subscriber or 
      enrollee upon request, the following written notice:

      "(Name of plan) IS A HEALTH CARE SERVICE PLAN OPERATING PURSUANT TO AN 
      EXEMPTION FROM THE KNOX-KEENE HEALTH CARE SERVICE PLAN ACT OF 1975 
      PROVIDED BY RULE OF THE DIRECTOR OF THE DEPARTMENT OF MANAGED HEALTH CARE 
      OF THE STATE OF CALIFORNIA."


      


      Note: Authority cited: Sections 1343 and 1344, Health and Safety Code. 
      Reference: Section 1343, Health and Safety Code. 


       HISTORY 
         
      1. New section filed 6-13-78 as an emergency; effective upon filing 
      (Register
      78, No. 24).

      2. Certificate of Compliance filed 8-18-78 (Register 78, No. 33).

      3. Editorial correction of subsection (f) (Register 95, No. 12).

      4. Change without regulatory effect amending subsection (f) filed 
7-18-2000
      pursuant to section 100, title 1, California Code of Regulations (Register
      2000, No. 29).

      5. Change without regulatory effect amending subsection (f) filed 
      11-21-2002
      pursuant to section 100, title 1, California Code of Regulations (Register
      2002, No. 47).
      28 CA ADC s 1300.43.6

      END OF DOCUMENT

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