2019 California Code
Health and Safety Code - HSC
DIVISION 2 - LICENSING PROVISIONS
CHAPTER 2.2 - Health Care Service Plans
ARTICLE 4 - Solicitation and Enrollment
Section 1366.2.
(a) A full health care service plan shall make available to a group subscriber, upon request, the termination date of all major health care provider contracts that are for services in the geographic area for which the group subscriber has secured coverage and that include a specified termination date.
(b) For purposes of this section, the following terms have the following meanings:
(1) “Enrollee” means a person who is enrolled in a health care service plan and who is a recipient of services from the plan.
(2) “Full health care service plan” means a plan that meets the definition set forth in subdivision (f) of Section 1345, and that has a total enrolled membership exceeding 499,999 enrollees.
(3) “Hospital” means a general acute care hospital.
(4) “Major health care provider contract” means a contract between a full service plan and provider group or hospital covering more than 25,000 of that plan’s enrollees. “Major health care provider contract” does not mean a provider contract between a specialized health care service plan and a provider group or hospital.
(5) “Provider group” means a medical group, independent practice association, or other similar group of providers with a total enrolled membership exceeding 99,999 enrollees.
(Added by Stats. 2004, Ch. 411, Sec. 1. Effective September 9, 2004.)
