California · Insurance Code
INS §10716: In connection with the offering for sale of any benefit plan design to small employers: Each carrier shall make a reasonable disclosure, as part of its solicitation and sales materials, of the followi
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In connection with the offering for sale of any benefit plan design to small employers: Each carrier shall make a reasonable disclosure, as part of its solicitation and sales materials, of the following: (a) The extent to which the premium rates for a specified small employer are established or adjusted in part based upon the actual or expected variation in claims costs or actual or expected variation in health conditions of the employees and dependents of the small employer. (b) The provisions concerning the carrier’s ability to change premium rates and the factors other than claim experience which affect changes in premium rates. (c) Provisions relating to the guaranteed issue of policies and contracts. (d) Provisions relating to the effect of any preexisting condition provision. (e) Provisions relating to the small employer’s right to apply for any benefit plan design written, issued, or administered by the carrier at the time of application for a new health benefit plan, or at the time of renewal of a health benefit plan. (f) The availability, upon request, of a listing of all the carrier’s benefit plan designs, including the rates for each benefit plan design.
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