California · Insurance Code
INS §10112.1: (a) An individual or group health insurance policy shall not establish either of the following: (1) Lifetime limits on the dollar value of any covered benefits for an insured, whether provided in netw
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(a) An individual or group health insurance policy shall not establish either of the following: (1) Lifetime limits on the dollar value of any covered benefits for an insured, whether provided in network or out of network. (2) Annual limits on the dollar value of any covered benefits for an insured, whether provided in network or out of network. (b) Subdivision (a) does not prevent a group health insurance policy from placing annual or lifetime per-insured limits on specific covered benefits that are not essential health benefits, as defined under Section 10112.27, to the extent that those limits are otherwise permitted under state law. (c) This section does not apply to a specialized health insurance policy that does not cover an essential health benefit, as defined under Section 10112.27, or a Medicare supplement policy.
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