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Summary:

A group health insurance policy that provides coverage of a dependent child of an employee or other member of the covered group will not terminate upon attainment of the limiting age for dependent children if the child is (1) incapable of self-sustaining employment by reason of a physical or mental injury, illness, or condition; and (2) chiefly dependent upon the employee or member for support and maintenance. The employee or member must submit proof of the physical or mental condition before the child attains the limiting age. The insurer may subsequently request information about a dependent child whose coverage is continued beyond the limiting age, but not more frequently than annually after the two-year period following the child's attainment of the limiting age. If the employee or member changes carriers to another insurer or to a health care service plan, the new insurer or plan shall continue to provide coverage for the dependent child. The new plan or insurer may request information about the dependen

Summary:

With respect to a group health insurance policy that provides coverage for a dependent child over 18 years of age and enrolled as a full-time student at a secondary or postsecondary educational institution, if the dependent child takes a medical leave of absence from school but the nature of the dependent child's injury, illness, or condition would render the dependent child incapable of self-sustaining employment, then the child still qualifies for coverage if he/she is chiefly dependent on the policyholder for support and maintenance. If the child is capable of self-sustaining employment, then the his/her coverage will terminate after a period not to exceed 12 months or until the date on which the coverage is scheduled to terminate pursuant to the terms and conditions of the policy, whichever comes first. Documentation or certification of the medical necessity for a leave of absence from school shall be submitted to the insurer at least 30 days prior to the medical leave of absence from the school, if the m

Summary:

An individual health insurance policy that provides coverage of a dependent child will not terminate upon attainment of the limiting age for dependent children if the child is (1) incapable of self-sustaining employment by reason of a physical or mental injury, illness, or condition; and (2) chiefly dependent upon the employee or member for support and maintenance. The subscriber/policyholder must submit proof of the physical or mental condition before the child attains the limiting age. The insurer may subsequently request information about a dependent child whose coverage is continued beyond the limiting age, but not more frequently than annually after the two-year period following the child's attainment of the limiting age. If the subscriber/policyholder changes carriers to another insurer or to a health care service plan, the new insurer or plan shall continue to provide coverage for the dependent child. The new plan or insurer may request information about the dependent child initially and not more frequ

Summary:

With respect to an individual health insurance policy that provides coverage for a dependent child over 18 years of age and enrolled as a full-time student at a secondary or postsecondary educational institution, if the dependent child takes a medical leave of absence from school but the nature of the dependent child's injury, illness, or condition would render the dependent child incapable of self-sustaining employment, then the child still qualifies for coverage if he/she is chiefly dependent on the policyholder for support and maintenance. If the child is capable of self-sustaining employment, then the his/her coverage will terminate after a period not to exceed 12 months or until the date on which the coverage is scheduled to terminate pursuant to the terms and conditions of the policy, whichever comes first. Documentation or certification of the medical necessity for a leave of absence from school shall be submitted to the insurer at least 30 days prior to the medical leave of absence from the school, if

Summary:

Every disability insurer that provides group or individual policies of disability that provides telephone medical advice services to its insureds shall require that the in-state or out-of-state telephone medical advice service makes and maintains records for a period of five years after the telephone medical advice services are provided, including, but not limited to, oral or written transcripts of all medical advice conversations with the disability insurer's insureds in California and copies of all complaints. If the records of telephone medical advice services are kept out of state, the insurer shall, upon the request of the director, provide the records to the director within 10 days of the request.

Summary:

To be approved by the commissioner, all applications for disability insurance must contain clear and unambiguous questions designed to ascertain the health condition or history of the applicant. Those questions must be based on medical information that is reasonable and necessary for medical underwriting purposes. The application must also display the notice: “California law prohibits an HIV test from being required or used by health insurance companies as a condition of obtaining health insurance coverage.”

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