2009 California Insurance Code - Section 10860-10861 :: Article 7. Contracts With Employers, Small Employers, And Participating Carriers

INSURANCE CODE
SECTION 10860-10861

10860.  Contracts between the purchasing alliance and participating
carriers shall specify how all premiums will be transmitted, and
penalties and grace periods for payments.

10861.  Contracts between purchasing alliances and participating
employers shall provide all of the following:
   (a) For administrative purposes, the purchasing alliance shall be
the policyholder or contractholder of the health benefit plan or
ancillary benefit plan on behalf of participating employers, their
eligible employees, and dependents.
   (b) That the participating carrier will issue a certificate of
coverage, or equivalent document, specifying the essential features
of the health benefit plan's or ancillary benefit plan's coverage to
each enrolled eligible employee.
   (c) The following notice shall be provided to employers, small
employers, and eligible employees who obtain coverage from a
purchasing alliance at the time of enrollment:
                                      NOTICE
   (1) THE PURCHASING ALLIANCE IS NOT AN INSURANCE COMPANY AND DOES
NOT PAY BENEFITS OR CLAIMS. IT COLLECTS AND DISTRIBUTES PREMIUMS IN
YOUR EMPLOYER'S BEHALF TO INSURERS WHO MAY PARTICIPATE IN A GUARANTEE
FUND CREATED BY CALIFORNIA LAW. THE ALLIANCE ITSELF DOES NOT
PARTICIPATE IN A GUARANTEE FUND CREATED BY CALIFORNIA LAW.
   (2) THE PURCHASING ALLIANCE WHICH YOUR EMPLOYER HAS JOINED IS
REGISTERED BY THE CALIFORNIA DEPARTMENT OF INSURANCE TO PROVIDE
SPECIFIC ADMINISTRATIVE SERVICES AND MAY NOT ASSUME ANY RISK FOR
CLAIM AND BENEFIT PAYMENTS.
   (3) FOR ADDITIONAL INFORMATION ABOUT THE PURCHASING ALLIANCE YOU
SHOULD ASK QUESTIONS OF YOUR BENEFITS ADMINISTRATOR OR YOU MAY
CONTACT THE CALIFORNIA DEPARTMENT OF INSURANCE AT 1-800-927-4356.


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