Section 2699.6175 - Disqualification of Individual Members(a) An individual member shall be disqualified from participation in the program if any of the following occur: (1) If the guaranteed association is disqualified.(2) He or she is found by the program to no longer be a qualified individual member.(3) The individual member fails to pay the monthly individual member premium for the enrolled individual member and enrolled dependents as set forth in Sections 2699.6311 and 2699.6313 of this part.(4) The individual member so requests in writing. Such requests shall be provided to the program at least thirty (30) calendar days prior to the effective date of the requested disqualification.(5) The individual member has committed an act of fraud or misrepresentation to circumvent the statutes or regulations of the program.(b) When a participating individual member is disqualified pursuant to (a) above, the program shall notify the individual member and the qualified guaranteed association of the disqualification. (1) The notice shall be in writing and include the following information:(A) The reason for the disqualification,(B) The effective date of disqualification, and(C) The final day of coverage provided through the program.(2) When an individual member is disqualified pursuant to (a)(3), the notice shall be sent after thirty-one (31) calendar days following the premium due date and also include a statement that the individual member may again be qualified if the individual member meets the requirements of Section 2699.6462 and a statement of the requirements of Section 2699.6319.(c) An individual member which is disqualified pursuant to (a)(2), (a)(4) or (a)(5) above, or is disqualified pursuant to (a)(3) above and does not reinstate pursuant to Section 2699.6319, cannot participate in the program for one (1) year from the date of disqualification.Cal. Code Regs. Tit. 10, § 2699.6175
1. Renumbering and amendment of former section 2699.626.3 to section 2699.6175 filed 5-27-94; operative 5-27-94 (Register 94, No. 21). Note: Authority cited: Section 10731, Insurance Code. Reference: Sections 10731 and 10743, Insurance Code.
1. Renumbering and amendment of former section 2699.626.3 to section 2699.6175 filed 5-27-94; operative 5-27-94 (Register 94, No. 21).