2007 California Insurance Code Chapter 7. Vision Benefits And Copayments

CA Codes (ins:12693.65-12693.66)

12693.65.  (a) Vision benefits shall be provided to subscribers and
shall meet the federal coverage requirements in Section 2103 of Title
XXI of the Social Security Act.
   (b) The covered benefits shall be equivalent to those provided to
state employees through the Department of Personnel Administration on
July 1, 1997, except for tinted lenses and also photochromatic
lenses, unless otherwise deemed medically necessary.
   (c) The board shall establish the required subscriber copayment
levels for vision benefits consistent with the limitations of Section
2103 of Title XXI of the Social Security Act. The copayment levels
established by the board shall, to the extent possible, reflect the
copayment levels provided to state employees through the Department
of Personnel Administration on July 1, 1997.
   (d) The board may adopt, and may only one-time readopt,
regulations to implement subdivision (b). The adoption and one-time
readoption of a regulation authorized by this subdivision is deemed
to address an emergency, for purposes of Sections 11346.1 and 11349.6
of the Government Code, and the board is hereby exempted for this
purpose from the requirements of subdivision (b) of Section 11346.1
of the Government Code.



12693.66.  Notwithstanding any other provision of law, for a
subscriber who is determined by the California Children's Services
Program to be eligible for benefits under the program pursuant to
Article 5 (commencing with Section 123800) of Chapter 3 of Part 2 of
Division 106 of the Health and Safety Code, a participating plan
shall not be responsible for the provision of, or payment for, the
particular services authorized by the California Children's Services
Program for the particular subscriber for the treatment of a
California Children's Services Program eligible medical condition.
All other services provided under the participating plan shall be
available to the subscriber.