Section 2274.76 - Agent Attestation and Notification Requirements when Health Insurance Applications Are Submitted to Insurers(a) Any agent, as defined in Section 1622 or 1626 of the Insurance Code assisting an applicant in submitting an application for health insurance as that phrase is defined in Subdivision (c) of this Section 2274.76 shall notify the insurer that the agent has provided such assistance.(b) For purposes of Insurance Code Section 10119.3, an application includes an application for health insurance submitted electronically using an Internet web site provided by the insurer or any other Internet web site, such as an agent's or broker's web site, which is intended to be used for submission of health insurance applications to insurers.(c) For purposes of Insurance Code section 10119.3, assisting an applicant in submitting an application for health insurance to a health insurer includes: (1) providing information or advice or answering the applicant's questions about any aspect of the application or its submission(2) providing information or advice or answering the applicant's questions about the medical underwriting of the application(3) providing information or advice or answering any of the applicant's questions about the health insurance coverage sought by the applicant or(4) entering information directly into or onto the application.(d) If the agent provides assistance to the applicant as described in Subdivision (c) of this Section 2274.76 at any time prior to the date of issuance of the policy sought by the applicant, the agent is required to comply with all provisions of Insurance Code section 10119.3 and any regulation promulgated thereunder, including but not limited to Subdivision (a) of this Section 2274.76.(e) In order to complete medical underwriting, insurers are required to obtain the written attestation of any agent who assists an applicant in submitting an application for health insurance. If the agent provided no assistance to an applicant in submitting an application for health insurance as defined in Subdivision (c), the insurer must obtain and maintain written notification from the agent of this fact, unless no agent has been involved in completing or submitting the application. Insurers may not complete medical underwriting and issue a health insurance policy without receiving an agent attestation as required by Section 10119.3 of the Insurance Code unless the insurer is processing the application without the involvement of any agent.(f) When an insurer receives an electronically submitted application for health insurance through an agent's web site, the insurer is required to promptly provide to the agent (1) a copy of the application and (2) notification of its receipt.(g) When an agent is notified by either the insurer or by the agent's web site that an application for health insurance has been electronically submitted to the insurer through the agent's Web Site, the agent must promptly deliver to the insurer a notification stating whether or not the agent provided assistance to the applicant. If the agent did not assist the applicant in submitting an application for health insurance within the meaning of Subdivision (c) of Section 2274.76 prior to the receipt of the application by the insurance company, but provides such assistance to the applicant thereafter and prior to the issuance of the policy, the agent must provide an attestation in order to comply with all provisions of Insurance Code section 10119.3 and any regulation promulgated thereunder, including but not limited to Subdivision (a) of this Section 2274.76.Cal. Code Regs. Tit. 10, § 2274.76
1. New section filed 7-19-2010; operative 8-18-2010 (Register 2010, No. 30).
2. Change without regulatory effect amending NOTE filed 9-23-2010 pursuant to section 100, title 1, California Code of Regulations (Register 2010, No. 39). Note: Authority cited: Sections 790.10, 10119.3, 10291.5, 10384, 12921 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 106, 380, 730, 733, 734, 790.03, 796.04, 10113, 10119.3, 10291.5, 10380, 10381.5 and 10384, Insurance Code.
1. New section filed 7-19-2010; operative 8-18-2010 (Register 2010, No. 30).
2. Change without regulatory effect amending Note filed 9-23-2010 pursuant to section 100, title 1, California Code of Regulations (Register 2010, No. 39).