Section 2220.15 - Basic Hospital Benefits(a) A hospital benefit, other than a benefit described in Sections 2220.17 or 2226.20, shall be deemed not sufficient to be of real economic value to the insured if: (1) The amount of the daily hospital benefit for each covered confined person (provided on either an expense incurred basis or on other than an expense incurred basis) is less than $30.00 per day provided, however, that a policy may provide benefits on an expense incurred basis up to that amount; or(2) The period the benefit is payable is less than 60 days; or(3) The amount of the daily hospital benefit for each covered confined person is less than $40.00 per day for the next 53 days; or(4) The elimination period, if any more than three days for sickness benefits and three days for accident benefits.(b) This section does not prohibit a policy or rider designed and actually programmed to provide hospital benefit for a specified individual to supplement existing in force coverage if (i) such supplemental daily hospital benefit is not less than $10.00 and the benefit period is not less than 60 days, or (ii) the benefit period is equal to the benefit period of existing in force coverage, or (iii) is a rider issued at the same time as the policy by the same insurer to provide full coverage benefits, such as, a rider to either eliminate or reduce a deductible, waiting period or elimination period.(c) This section does not apply to additional daily hospital benefits issued to the insured by the same insurer under guaranteed insurability, future purchase options or other similar policy provisions such as, additional benefits issued by application of a cash dividend.(d) This section does not prohibit a hospital benefit which, in the opinion of the Commissioner, is not less than the actuarial equivalent of one of the benefits specified in Subsection (a) of this section.Cal. Code Regs. Tit. 10, § 2220.15
1. Change without regulatory effect adopting subarticle 4 heading and removing subject heading filed 7-14-2021 pursuant to section 100, title 1, California Code of Regulations (Register 2021, No. 29). Filing deadline specified in Government Code section 11349.3(a) extended 60 calendar days pursuant to Executive Order N-40-20.