Cal. Code Regs. tit. 10 § 2699.210

Current through Register 2024 Notice Reg. No. 45, November 8, 2024

Section 2699.210 - Transfer of Enrollment

(a) A subscriber shall be transferred from one participating health plan to another if any of the following occurs:

(1) A subscriber so requests, in writing, because the subscriber has moved and no longer resides in an area served by the participating health plan in which the subscriber is enrolled, and there is at least one participating health plan serving the area in which the subscriber now resides that is accepting new enrollees.

(2) The subscriber or the participating health plan so requests, in writing, because of failure to establish a satisfactory subscriber-plan relationship and the Executive Director determines that the transfer is in the best interests of the program, and there is at least one other participating health plan serving the area in which the subscriber resides that is accepting new enrollees.

(3) The program contract with the participating health plan in which the subscriber is enrolled is canceled or not renewed.

(b) The effective date of transfers pursuant to subsection (a)(1) of this section shall be within seventeen (17) calendar days of receipt of the transfer request for the subscriber.

(c) The effective date of transfers pursuant to subsection (a)(2) of this section shall be within fifteen (15) calendar days from approval of the transfer request for the subscriber.

(d) The effective date of transfers pursuant to subsection (a)(3) of this section shall be prior to the end of the contract.

Cal. Code Regs. Tit. 10, § 2699.210

1. New section filed 12-12-91 as an emergency; operative 12-12-91 (Register 92, No. 10). A Certificate of Compliance must be transmitted to OAL 4-10-92 or emergency language will be repealed by operation of law on the following day.
2. Certificate of Compliance as to 12-12-91 order transmitted to OAL 4-8-92 and filed 5-20-92 (Register 92, No. 21).
3. Amendment filed 5-20-2003; operative 5-20-2003 pursuant to Government Code section 11343.4 (Register 2003, No. 21).
4. Amendment of subsections (a), (a)(1), (b) and (c) and repealer of subsections (b)(1)-(2) and (c)(1)-(2) filed 12-27-2013 as an emergency; operative 12-27-2013 (Register 2013, No. 52). A Certificate of Compliance must be transmitted to OAL by 6-25-2014 or emergency language will be repealed by operation of law on the following day. This filing is deemed an emergency and is exempt from review by OAL pursuant to Assembly Bill 82, Chapter 23, Statutes of 2013, section 77.
5. Certificate of Compliance as to 12-27-2013 order transmitted to OAL 5-29-2014 and filed 6-10-2014 (Register 2014, No. 24).

Note: Authority cited: Section 12696.05, Insurance Code. Reference: Sections 12696 and 12697.10, Insurance Code.