Section 6907 - Conflict of Interest(a) Certified Medi-Cal Managed Care Plans and Certified Medi-Cal Managed Care Plan Enrollers shall:(1) Comply with applicable State law related to the sale, solicitation, and negotiation of insurance products, including applicable State law related to agent, broker, and producer licensure;(2) Create a written plan to remain free of conflicts of interest while carrying out functions under this Article;(3) Provide information to consumers about the full range of QHP options and insurance affordability programs for which they are eligible;(4) Disclose to each consumer who receives application assistance from the entity or individual: (A) Any lines of insurance business which the entity or individual intents to sell while carrying out the Consumer Assistance functions;(B) Any existing employment relationships, or any former employment relationships within the last five years, with any health insurance issuers or issuers of stop loss insurance, or subsidiaries of health insurance issuers or issuers of stop loss insurance, including any existing employment relationships between a spouse or domestic partner and any health insurance issuers or issuers of stop loss insurance, or subsidiaries of health insurance issuers or issuers of stop loss insurance; and(C) Any existing or anticipated financial, business, or contractual relationship with one or more health insurance issuers or issuers of stop loss insurance, or subsidiaries of health insurance issuers or issuers of stop loss insurance.(b) Medi-Cal Managed Care Plan Enrollers who are licensed insurance agents with the California Department of Insurance shall:(1) Comply with 45 C.F.R. section 155.220, (December 22, 2016), hereby incorporate by reference;(2) Execute an agreement with the Exchange that complies with 45 C.F.R. section 155.220;(3) While a Certified Medi-Cal Managed Care Plan Enroller, not receive any direct or indirect consideration from any health insurance issuer or stop loss insurance issuer, other than compensation on a salary or contractual basis from the Certified Medi-Cal Managed Care Plan, in connection with the enrollment of any individuals in a QHP or non-QHP;(4) Not be concurrently certified as a certified insurance agent by the Exchange.Cal. Code Regs. Tit. 10, § 6907
1. New section filed 3-12-2020; operative 3-12-2020 pursuant to Government Code section 11343.4(b)(3) (Register 2020, No. 11). Note: Authority cited: Sections 100502 and 100504, Government Code. Reference: Sections 100502 and 100503, Government Code; and 45 C.F.R. § 155.220.
1. New section filed 3-12-2020; operative 3/12/2020 pursuant to Government Code section 11343.4(b)(3) (Register 2020, No. 11). For prior history, see Register 2019, No. 39.