28 CA ADC § 1300.52.1
28 CCR s 1300.52.1
Cal. Admin. Code tit. 28, s 1300.52.1
CALIFORNIA CODE OF REGULATIONS
TITLE 28. MANAGED HEALTH CARE
DIVISION 1. THE DEPARTMENT OF MANAGED HEALTH CARE
CHAPTER 2. HEALTH CARE SERVICE PLANS
ARTICLE 3. PLAN APPLICATIONS AND AMENDMENTS
This database is current through 06/09/06, Register 2006, No. 23.
s 1300.52.1. Notice of Material Modification.
A notice of material modification of its operations or of any plan
contract pursuant to subdivision (b) of Section 1352 of the Act shall be
filed as an amendment to the application as provided in Section 1300.52,
and there shall be attached to such amendment, preceding the Execution
Page, the following form:
DEPARTMENT OF MANAGED HEALTH CARE STATE OF CALIFORNIA NOTICE OF MATERIAL
MODIFICATION Pursuant to Health and Safety Code Sec. 1352(b) 1. Name of
applicant: __________ 2. Department of Managed HealthCare File Number:
__________ 3. The fee for filing this application will be forwarded upon
receipt of the billing therefore from the Director of the Department of
Managed Health Care, pursuant to Health and Safety Code Section 1352(d) or
pursuant to Section 1399.73 if this application involves a conversion or
restructuring.
4. Pursuant to Subdivision (b) of Section 1352 of the Health and Safety
Code, applicant requests approval of the material modification of its plan
and/or operations, within the time specified below:
(Check appropriate box)
( ) Within the 20 business-day period provided in Section 1352(b).
( ) Applicant extends the time for action upon this notice by the Director
until __________.
( ) Applicant requests accelerated approval by the Director for the
following reasons:
__________ __________ __________ __________ __________ __________ 5.
Conversion or Restructuring. If this application involves a conversion or
restructuring, the applicant shall fully disclose information which
describes the proposed transaction and demonstrates how the charitable
trust requirements of Section 1399.72(c) of the Act will be satisfied. In
addition, the applicant shall submit a copy of all of its original and
amended articles of incorporation and bylaws, and a report as described in
Section 1399.70(a) of the Act. If this application involves a
restructuring, the applicant shall also submit a public benefit program as
described in Section 1399.71(b) of the Act. 6. Exempt Restructuring
Transaction. If this application involves a transaction or transactions
described in Section 1399.71(e) of the Act, the applicant shall fully
disclose information which describes the transaction or transactions and
demonstrates how the applicable conditions of exemption of Section
1399.71(e) of the Act will be satisfied. 7. Nonprofit Mutual Benefit
Health Care Service Plans. a. Assets subject to a charitable trust
obligation. If this application involves a conversion or restructuring of
a nonprofit mutual benefit health care service plan with any or all of its
assets subject to a charitable trust obligation, the applicant shall
submit information pursuant to Item 5 or Item 6 above and, if applicant
believes that partial assets are subject to a charitable trust obligation,
the applicant shall fully disclose information which: (i) describes why
less than all of its assets are not subject to any charitable trust
obligation, (ii) explains whether any charitable trust obligation
terminated for any assets previously held subject to a charitable trust
obligation, and (iii) demonstrates how every noncharitable trust
obligation will be satisfied. b. Assets not subject to a charitable trust
obligation. An applicant that is a nonprofit mutual benefit health care
service plan must comply with Item 7. a. above unless it has established
that none of its assets are subject to a charitable trust obligation. If
the applicant believes that this application involves a conversion or
restructuring of a nonprofit mutual benefit health care service plan with
no assets subject to any charitable trust obligation, the applicant shall
submit a copy of all its original and amended articles of incorporation
and bylaws and fully disclose information which: (i) describes the
proposed transaction, (ii) describes why all its assets are not subject to
any charitable trust obligation, (iii) explains whether any charitable
trust obligation terminated for any assets previously held subject to a
charitable trust obligation, and (iv) demonstrates how every noncharitable
trust obligation will be satisfied.
Date: __________ __________ Signature of Authorized Officer __________
Title
Note: Authority cited: Sections 1344 and 1399.74, Health and Safety Code.
Reference: Sections 1352, 1399.70, 1399.71, 1399.72, 1399.73, 1399.74 and
1399.75, Health and Safety Code.
HISTORY
1. Amendment of form paragraph 3, new form paragraphs 5 and 6 and new Note
filed 6-20-96 as an emergency; operative 6-20-96 (Register 96, No. 25). A
Certificate of Compliance must be transmitted to OAL by 10-18-96 or
emergency
language will be repealed by operation of law on the following day.
2. Amendment of form paragraph 3, new form paragraphs 5 and 6 and new Note
refiled 10-15-96 as an emergency; operative 10-18-96 (Register 96, No.
42).
A Certificate of Compliance must be transmitted to OAL by 2-12-97 or
emergency
language will be repealed by operation of law on the following day.
3. Certificate of Compliance as to 10-15-96 order, including new form
paragraphs 7.-7.b., transmitted to OAL 2-3-97 and filed 2-24-97 (Register
97,
No. 9).
4. Change without regulatory effect amending section filed 7-18-2000
pursuant
to section 100, title 1, California Code of Regulations (Register 2000,
No. 29).
5. Change without regulatory effect amending section filed 11-21-2002
pursuant
to section 100, title 1, California Code of Regulations (Register 2002,
No. 47).
28 CA ADC s 1300.52.1
END OF DOCUMENT
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