Life and Disability Insurance: General Provisions, second half

What this document is

California Insurance Code Div. 2, Pt. 2, Ch. 1, Art. 1 - Life and Disability Insurance: General Provisions, second half (Secs. 10123.31 through 10127.20) is a state statute published by California Legislative Counsel (leginfo.legislature.ca.gov). It is one of the California documents that insurance license exam questions are written from, including california life & health practice questions. This page summarizes it and points to the official version, which is the text to rely on.

Sections cited in practice questions

Each practice answer shows the exact passage it comes from. These are sections of this document that questions cite, with a short excerpt from the source text.

• Cal. Ins. Code § 10126 (Group Conversion Rights for a Dependent Spouse)

  “which contains provisions granting the employee or member the right to convert the insurance coverage in the event of termination of employment or membership, shall include in such conversion provisions the same conversion rights and conditions to a covered dependent spouse of the employee or...”

• Cal. Ins. Code § 10126.6 (Emergency Medical Transportation Coverage)

  “shall include coverage for emergency medical transportation services, as defined in subdivision (b). This coverage shall be provided without regard to whether the emergency provider has a contractual arrangement with the insurer or whether there was prior authorization, subject to the terms and...”

• Cal. Ins. Code § 10127.9(a)(1) (Cancellation Notice on Individual Life and Annuity Contracts)

  “Every individual life insurance policy and every individual annuity contract that is initially delivered or issued for delivery in this state on and after January 1, 1990, shall have printed on the front of the policy jacket or on the cover page a notice stating that, after receipt of the policy by...”

• Cal. Ins. Code § 10125.1 (Reimbursement for Services Performed by a Licensed Pharmacist)

  “Every insurer issuing disability insurance that covers hospital, medical, or surgical expenses that offers coverage for a service that is within the scope of practice of a duly licensed pharmacist shall pay or reimburse the cost of the service performed by a pharmacist at an in-network pharmacy or...”

• Cal. Ins. Code § 10123.65(a) (Point-of-Sale Prescription Drug Payment Cap)

  “(a) The maximum amount a health insurer may require an insured to pay at the point of sale for a covered prescription drug is the lesser of the following: (1) The applicable cost-sharing amount for the prescription drug. (2) The retail price.”

• Cal. Ins. Code § 10123.68(d) (Second Medical Opinion: Insured Cost Sharing)

  “(d) If an insurer approves a request by an insured for a second opinion, the insured shall be responsible only for the costs of applicable copayments that the insurer requires for similar referrals.”

• Cal. Ins. Code § 10127.12 (Annual Statement Values for Senior Citizen Policyowners)

  “Whenever an insurer provides an annual statement to a senior citizen policyowner of an individual life insurance policy or an individual annuity contract issued after January 1, 1995, the insurer shall also provide the current accumulation value and the current cash surrender value.”

• Cal. Ins. Code § 10123.61(a) (Short-Term Limited Duration Health Insurance Prohibited)

  “(a) Commencing January 1, 2019, a health insurer shall not issue, amend, sell, renew, or offer a policy of short-term limited duration health insurance in this state.”

• Cal. Ins. Code § 10123.8 (Breast Cancer Screening, Diagnosis, and Treatment Coverage)

  “No policy of disability insurance that provides coverage for hospital, medical, or surgical expenses shall deny enrollment or coverage to an individual solely due to a family history of breast cancer, or who has had one or more diagnostic procedures for breast disease but has not developed or been...”

• Cal. Ins. Code § 10123.16 (Coverage for Insureds With Loss of Brain Function)

  “Except for a preexisting condition, every disability insurer issuing policies of individual or group disability insurance in this state that offers group or individual coverage for long-term care facility services or home-based care shall not exclude persons covered by the plan from receiving these...”

• Cal. Ins. Code § 10124(a) (continuation of coverage for an incapacitated dependent child)

  “(a) A self-insured employee welfare benefit plan delivered or issued for delivery in this state more than 120 days after the effective date of this section, which provides that coverage of a dependent child of an employee shall terminate upon attainment of the limiting age for dependent children...”

• Cal. Ins. Code § 10124.7 (extended care facility benefits)

  “Each self-insured employee benefit plan issued or renewed on or after the effective date of this section shall provide, where feasible, that benefits for confinement in an extended care facility, as defined in subsection (j) of Section 1395x of Title 42 of the United States Code, may be provided...”

Practice this material

Questions about this source

More California sources

• California Accident and Health Agent Examination Educational ObjectivesCandidate handbook or exam outline
• California Casualty License Examination ObjectivesCandidate handbook or exam outline
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• California Personal Lines License Examination ObjectivesCandidate handbook or exam outline
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• Cal. Ins. Code s. 790.03: Unfair methods of competition and unfair or deceptive acts definedState statute
• Cal. Ins. Code s. 1668: Grounds for license denial, suspension, or revocationState statute
• Cal. Ins. Code ss. 10350.2-10350.3: Individual disability policy required provisionsState statute