Article 1 - GENERAL PROVISIONS

Section 10110 - Insurable interest of every person
Section 10110.1 - Insurable interest defined; unlimited insurable interest; employer's insurance interest; violations of insurable interest laws
Section 10110.2 - Insurer entitled to rely upon statement, declarations and representations by insured
Section 10110.3 - Individual life policy insuring life of applicant's spouse
Section 10110.4 - Corporate-owned life insurance policy
Section 10110.5 - Waiver of premium payments upon involuntary unemployment of insured; waiver of surrender charge benefit upon voluntary or involuntary unemployment of insured
Section 10110.6 - Provision giving insurer or agent discretionary authority void and unenforceable
Section 10110.7 - Coverage without cost sharing for COVID-19 diagnostic and screening testing and health care services by disability insurance policy
Section 10110.75 - Coverage without cost sharing during a public health emergency
Section 10110.8 - Denial or limitations on coverage based solely on organ donor status
Section 10111 - Measure of liability and damage
Section 10111.2 - Payment period under policy of disability income insurance
Section 10111.5 - Payments under life policy dependent upon whether death of insured accident or suicide
Section 10111.7 - Refusal or termination based upon lawful travel destinations
Section 10112 - Contracts made by minors
Section 10112.1 - Prohibition on lifetime or annual limits on dollar value of covered benefits
Section 10112.2 - Minimum coverage; cost sharing requirements
Section 10112.25 - Annual rebate provided health insurers to insureds
Section 10112.26 - Medical Loss Ratio report
Section 10112.27 - Individual or small group health insurance policies providing coverage for essential health benefits
Section 10112.28 - Nongrandfathered individual and small group health insurance policies providing coverage for essential health benefits
Section 10112.281 - Coverage of large group health insurance policies
Section 10112.282 - Discouraging enrollment of individuals with significant health needs or discriminating based on various criteria prohibited
Section 10112.285 - [Repealed]
Section 10112.29 - Deductible under small employer health insurance policy
Section 10112.291 - Deductibles and out-of-pocket expenses
Section 10112.295 - Levels of coverage for nongrandfathered individual market; actuarial value; catastrophic policy
Section 10112.296 - Actuarial value for nongrandfathered bronze level health insurance policy that is a high deductible health plan
Section 10112.297 - Levels of coverage for nongrandfathered small group market ; actuarial value
Section 10112.300 - Renewal of certain small employer health benefit plans
Section 10112.3 - California Health Benefit Exchange (§ 10112.3)
Section 10112.35 - Duties of insurers providing individual coverage in Exchange
Section 10112.4 - Review of Internet portal developed under provisions of Patient Protection and Affordable Care Act
Section 10112.5 - Every policy or certificate of health insurance marketed in state subject to code
Section 10112.6 - License required by sponsor of prescription drug plan authorized by Medicare Prescription Drug, Improvement and Modernization Act
Section 10112.7 - Emergency services coverage
Section 10112.8 - In-network-cost-sharing amount
Section 10112.81 - Establishment of independent dispute resolution process
Section 10112.82 - Reimbursement for services provided by noncontracting individual health professional
Section 10112.9 - Issuance, renewal, etc., of large group plan contract providing minimum value of less than 60 percent prohibited
Section 10112.95 - Insureds displaced by state of emergency
Section 10113 - Policy deemed entire contract between parties
Section 10113.1 - Definitions applicable to act
Section 10113.2 - Licensing persons entering into, brokering or soliciting life settlements
Section 10113.3 - Provider entering into life settlement contract with owner of policy wherein insured terminally ill
Section 10113.35 - Adoption of rules and regulations
Section 10113.4 - Group life certificate holder's coverage contestable on grounds of suicide for period following commencement of coverage
Section 10113.5 - Provision providing that life policy incontestable; contesting policy on account of fraud or misrepresentation upon reinstatement; impostor substituted for named insured
Section 10113.6 - Delivery starting running of statutory period for right of cancellation
Section 10113.7 - Notice required for increase of premium on individual life policy providing for premium changes
Section 10113.70 - Notice of adverse change in the current scale of nonguaranteed elements
Section 10113.71 - Provision providing for grace period from premium due date; notice of pending lapse or termination of life policy
Section 10113.72 - Applicant given right to designate person to receive notice of lapse or termination
Section 10113.8 - Comparative benefit matrix
Section 10113.9 - Notice necessary to effectuate change in premium rate for individual health insurance policy
Section 10113.95 - [First of two versions] Guidelines, policies or procedures for providing or denying coverage required of insurer issuing individual health policies
Section 10113.95 - [Second of two versions] Criteria, policies, procedures and guidelines for providing or denying coverage required of insurer renewing individual grandfathered health policies
Section 10114 - Payment of proceeds to undertaker or funeral director for funeral services
Section 10115 - Death of applicant before policy issued and delivered
Section 10116 - Providing for continuation of policy in event of cessation of work by employees covered by policy
Section 10116.5 - Continuation of benefits beyond date coverage under COBRA or Cal-COBRA
Section 10117 - Plan providing exception for other coverage where other coverage entitlement to Medi-Cal benefits or medicaid benefits
Section 10117.5 - Provision restricting health facilities compliance with section 1262.5, Health and Safety Code requirements
Section 10117.52 - Disclosure of claims data provided policyholder, insured or beneficiaries of self-insured health coverage arrangement
Section 10118 - When attainment of limiting age not to operate as termination of dependent child coverage
Section 10119 - Coverage or insurability of newborn infants of insured
Section 10119.1 - Transfer without medical underwriting to other individual health benefit plan offered by same insurer
Section 10119.2 - [First of two versions] Coverage when individual health benefit plan rescinded (§ 10119.2)
Section 10119.3 - Duties of agent or broker assisting applicant in submitting application
Section 10119.5 - Maternity coverage
Section 10119.6 - Infertility treatment
Section 10119.7 - Conditions attributable to diethylstilbestrol
Section 10119.8 - Screening for blood lead levels for covered children
Section 10119.9 - General anesthesia and associated facility charges for dental procedures rendered in hospital or surgery center
Section 10120 - Sterilization operation or procedure
Section 10120.2 - Dental insurance policy coordinating benefits
Section 10120.3 - Charges for dental services not covered services under policy
Section 10120.35 - Health care provider reimbursements
Section 10120.4 - Third party access to dental services provider network contract, or a provider's dental services or contractual discounts
Section 10120.41 - Imposition of dental waiting period provision or preexisting condition provision prohibited
Section 10120.42 - Dental coverage disclosures
Section 10120.5 - Disability insurer violating sections 510, 2056 or 2056.1, Business and Professions Code
Section 10121 - Coverage for sterilization, newborn infants and maternity benefits under self-insured employee welfare benefit plan
Section 10121.5 - Spouses claiming combined maximum contractual benefits
Section 10121.6 - Dependent child not residing with employee, insured or policyholder
Section 10121.7 - Coverage under group health insurance policy for registered domestic partner of employee, insured or policyholder
Section 10122 - Group policy providing for extension of coverage following termination of employment of employee applicable to dependents
Section 10122.1 - Coverage to physically handicapped individual members of group
Section 10122.2 - Coverage under conditions less favorable
Section 10123 - Self-insured plan providing extension of coverage after termination of employment applicable to dependents
Section 10123.1 - Self-insured plan to comply with Article 1.5
Section 10123.2 - Coverage under self-insured plan for physically handicapped persons
Section 10123.3 - Refusal of self-insured plan to enroll person based in genetic characteristics
Section 10123.31 - Penalties assessed against self-insured plans
Section 10123.35 - Disclosure of genetic test results contained applicant's or enrollee's medical records by self-insured plan
Section 10123.36 - Filing of description of policies and procedures related to economic profiling utilized by insurer
Section 10123.4 - Self-insured plan providing for coverage under conditions less favorable for employees
Section 10123.5 - Comprehensive preventive care of children 16 years of age or younger
Section 10123.51 - Adverse childhood experiences screenings
Section 10123.55 - Comprehensive preventive care of children 17 and 18 years of age
Section 10123.6 - Treatment for alcoholism
Section 10123.61 - Issuance, amendment, sale, renewal, or offer of policy of short-term limited duration health insurance prohibited
Section 10123.65 - Maximum amount paid for covered prescription drugs
Section 10123.67 - Filing policy describing manner of determining if second medical opinion medically necessary or appropriate
Section 10123.68 - Second opinion by appropriately qualified health care professional
Section 10123.7 - Orthotic and prosthetic devices and services
Section 10123.8 - Breast cancer
Section 10123.81 - Coverage for mammography for screening or diagnostic purposes
Section 10123.82 - Laryngectomy
Section 10123.83 - Obstetrician-gynecologists eligible primary care physicians
Section 10123.835 - Prostate cancer screening and diagnosis
Section 10123.84 - Direct access to obstetricians and gynecologists
Section 10123.85 - Services provided through telehealth
Section 10123.855 - Reimbursement for telehealth services
Section 10123.856 - Telehealth service through third-party telehealth provider
Section 10123.857 - Telehealth dental care; report; disclosure of impact of telehealth visits on benefits
Section 10123.86 - Mastectomies and lymph node dissections
Section 10123.865 - Maternity services covered under individual policies
Section 10123.866 - Maternity services covered under group policies
Section 10123.867 - Development of maternal mental health programs
Section 10123.868 - Maternal and infant health equity program; doula coverage
Section 10123.87 - Restrictions on maternity coverage prohibited
Section 10123.88 - Reconstructive surgery
Section 10123.89 - Phenylketonuria (PKU)
Section 10123.9 - Prenatal diagnosis of genetic disorders of fetus in cases of high-risk pregnancy
Section 10123.91 - Human immunodeficiency virus (HIV) testing
Section 10123.10 - Home health care
Section 10123.11 - Denial of claim because individual served confined in jail or juvenile detention
Section 10123.12 - Statement describing how participation may effect choice of physician, hospital or other health care providers
Section 10123.13 - Time for payment of claims; notice claim contested
Section 10123.131 - Payment to provider for duplicating information with contested claim and for patient records
Section 10123.132 - Indication on insured's identification card whether separate telephone number called to verify eligibility
Section 10123.135 - Contracts for services that include utilization review or utilization management functions; employment or designation of medical director
Section 10123.137 - Dispute resolution of disputes between providers and insurers
Section 10123.14 - Self-insured plans providing coverage for treatment of alcoholism, chemical dependency or nicotine use
Section 10123.141 - Special footwear for person suffering from foot disfigurement
Section 10123.145 - Reimbursement by provider to insurer for overpayment
Section 10123.147 - Time for reimbursement after receipt of claim; notice claim contested
Section 10123.15 - Treatment of biologically based severe mental disorders
Section 10123.16 - Exclusion of persons from individual or group plan diagnosed as having significant destruction of brain tissue with resultant loss of brain function
Section 10123.17 - Exclusion of persons from self-insured plan diagnosed as having significant destruction of brain tissue with resultant loss of brain function
Section 10123.18 - Annual cervical cancer screening test
Section 10123.184 - Coverage for participation in California Prenatal Screening Program
Section 10123.185 - Osteoporosis
Section 10123.19 - Disclosure in policy requiring binding arbitration to settle disputes
Section 10123.191 - Prior authorization for prescription drug benefits
Section 10123.192 - Health insurer; Department of Managed Health Care; commissioner
Section 10123.193 - Coverage for medically necessary prescription drugs
Section 10123.1931 - Medically necessary treatments for AIDS/HIV
Section 10123.1932 - Maximum amount of cost for covered outpatient prescription drug; drug formulary tiers
Section 10123.1933 - Prohibition on subjecting antiretroviral drugs to prior authorization or step therapy
Section 10123.194 - Uniform prescription drug information card
Section 10123.1945 - Disability insurance policies after January 1, 2024; vasectomy services; religious employers and contraception coverage
Section 10123.195 - Drug prescribed for use different from use to which drug approved for marketing by FDA
Section 10123.196 - Outpatient prescription drug coverage
Section 10123.1961 - Deductible, coinsurance, copayment, or any other cost-sharing requirement on coverage for all abortion and abortion-related services prohibited
Section 10123.197 - Request for exception to step therapy process
Section 10123.198 - Identification card issued by insurer providing coverage for professional mental health services
Section 10123.199 - Internet Web site established by insurer providing coverage for professional mental health services
Section 10123.1991 - [Effective 1/1/2025] Notice regarding benefits of behavioral health and wellness screening for children and adolescents
Section 10123.20 - Cancer screening tests; no prior authorization for biomarker testing
Section 10123.201 - Coverage for medically necessary drugs; pharmacy and therapeutics committee
Section 10123.202 - Requirement for referral to receive coverage or services for reproductive and sexual health care prohibited
Section 10123.203 - Prorating cost for partial fill
Section 10123.204 - Prescription drug coverage
Section 10123.205 - Reporting drug data to department
Section 10123.206 - Coverage for prescribed orally administered anticancer medications
Section 10123.207 - Colorectal cancer coverage
Section 10123.208 - Health care policies to provide coverage for home test kits for sexually transmitted diseases (STD)
Section 10123.209 - Coverage for medically necessary biomarker testing
Section 10123.210 - Information to be provided by health plan to employees of a religious employer that does not include coverage and benefits for both abortion and contraception
Section 10123.21 - Surgical procedures directly affecting upper or lower jawbone or associated bone joints
Section 10123.22 - Organ or other tissue transplantation services
Section 10124 - Self-insured employee welfare benefit plan
Section 10124.7 - Benefits for confinement in extended care facility provided for in self-insured employee benefit plan
Section 10125 - Coverage for expenses incurred as result of mental or nervous disorder under group insurance
Section 10125.1 - Reimbursement or payment for services performed by pharmacist for insurer under group insurance
Section 10126 - Conversion of group insurance coverage in event of termination of employment
Section 10126.5 - Policy provision requiring provider accept lowest possible payment rate charged by provider
Section 10126.6 - Coverage for emergency medical transportation services
Section 10126.65 - Covered services from noncontracting air ambulance provider; in-network cost-sharing amount
Section 10126.66 - In-network cost-sharing amount; noncontracting ground ambulance providers
Section 10127 - Coverage for expenses incurred as result of mental or nervous disorders provided in self-insured employee welfare benefit plan
Section 10127.09 - Disability insurance policies after January 1, 2024 to comply with sections 10123.1945 and 10123.196
Section 10127.1 - Insurance or plan providing for loss of time benefits
Section 10127.2 - Policy providing benefits that accrue after certain time of confinement in health care facility
Section 10127.3 - Expenses incurred as result of treatment by holders of certificates under section 4938
Section 10127.4 - Advertising by health care providers
Section 10127.5 - Preexisting health condition may render coverage void
Section 10127.7 - Return of life policy for cancelation
Section 10127.8 - Advertisements for term life insurance
Section 10127.9 - Return of individual life insurance policy for cancellation
Section 10127.10 - Return of individual life insurance policy or annuity contract for cancellation
Section 10127.11 - Disclosure in nonpreprinted illustrations of nonguaranteed values in life insurance policy or annuity contract
Section 10127.12 - Current accumulation value and current cash surrender value provided senior citizen policyholder
Section 10127.13 - Disclosure in senior citizen life insurance policies and annuity contracts containing surrender charge upon surrender, partial surrender, excess withdrawal or penalties
Section 10127.14 - Comparative benefit matrices
Section 10127.15 - Reduction in loss of time benefits because of Social Security Act benefits increase
Section 10127.16 - Continued coverage after termination of pilot program under section 10127.15
Section 10127.17 - Life and Annuity Consumer Protection Fund
Section 10127.18 - Health insurer ceasing to offer individual health policies in state
Section 10127.19 - Report by insurers on number of covered lives by product type; MEWA information
Section 10127.20 - California Health Benefit Exchange annual report
Section 10127.21 - Submission of data for purposes of risk adjustment program described in section 1343, Patient Protection and Affordable Care Act