Cal. Code Regs. tit. 10 § 2274.50

Current through Register 2024 Notice Reg. No. 40, October 4, 2024
Section 2274.50 - Notice of the Right to Request Review by the Commissioner
(a) Each insurer who cancels, rescinds or non-renews, or sends a notice of intent to cancel, rescind or non-renew, a policy of health insurance shall provide to the policyholder, certificate holder or other insured a notice of the right to request a review by the commissioner.
(b) The notice of the right to request a review by the commissioner shall be part of, accompany, or be sent simultaneously with any notice of intent to cancel, rescind or non-renew, including but not limited to the notice required by subdivision (b) of Section 2274.53, the notice required by subdivision (h) of Section 2274.78 when the insurer's determination is to cancel the policy, and the notice required by subdivision (b) of Insurance Code section 10384.17. In the event the insurer does not send a notice of intent to cancel, rescind or non-renew, the notice of the right to request a review by the commissioner shall be part of, accompany, or be sent simultaneously with any notice of cancellation, nonrenewal or rescission the insurer sends to the policyholder, certificate holder or other insured.
(c) The form of notice specified in subdivision (d) of this Section 2274.50 shall satisfy the notice requirement stated in subdivision (a) of this section, provided the notice is printed in bold, 12-point or larger type. The insurer shall send the notice via first-class mail to the policyholder's, certificate holder's or other insured's most recent address known to the insurer.
(d) NOTICE OF RIGHT TO REQUEST REVIEW BY THE CALIFORNIA INSURANCE COMMISSIONER

You may request a review by the California Insurance Commissioner if you believe your health insurance policy or coverage has been or will be wrongly canceled, rescinded or not renewed. To do so, you must, as soon as possible, submit your request for review in writing to: California Department of Insurance, Consumer Communications Bureau, 300 S. Spring Street, South Tower, Los Angeles, California, 90013 or through the website: http://www.insurance.ca.gov. You may contact the California Insurance Commissioner's Consumer Communications Bureau at 1-800-927-HELP (4357) or TDD 1-800-482-4833 for information about how to request a review in writing. Please provide the Department with your health insurance policy number, copies of any letters you have received from us or a copy of your health insurance card.

You have 30 days from the date we sent this notice to you to request a review by the commissioner in order to ensure that we are required to provide you health insurance coverage while your request for review is being evaluated. To ensure that your coverage is continued without interruption, however, you must request a review by the commissioner before your coverage ends. Even if more than 30 days have passed since we sent this notice, we must continue your coverage while your request is being evaluated, as long as you request the review by the commissioner at a time when your coverage is still in effect.

Regardless of whether or not we are required to provide you health insurance coverage while your request for review is being evaluated, the commissioner will order us to reinstate your coverage, retroactive to the time of cancellation, rescission or nonrenewal, if the commissioner determines that your request for review is a proper complaint and, ultimately, that the cancellation, rescission, or nonrenewal was unlawful.

WARNING: You must continue to pay your insurance premiums on time in order to maintain coverage, and if your coverage is reinstated retroactively you will be responsible for paying insurance premiums corresponding to any gap in coverage between the time your coverage was terminated and the time it was continued or reinstated.

Cal. Code Regs. Tit. 10, § 2274.50

1. New article 10 (sections 2274.50-2274.60) and section filed 11-20-2013; operative 1-1-2014 (Register 2013, No. 47).

Note: Authority cited: Sections 10273.7 and 12926, Insurance Code; CalFarm Ins. Co. v. Deukmejian, 48 Cal.3d 805 (1989) and 20th Century Ins. Co. v. Garamendi, 8 Cal. 4th 216 (1994). Reference: Sections 10273.4, 10273.6, 10273.7, 10384, 10384.17 and 10713, Insurance Code.

1. New article 10 (sections 2274.50-2274.60) and section filed 11-20-2013; operative 1-1-2014 (Register 2013, No. 47).