Section 1300.67.003 - State Medical Loss Ratio Annual Report(a) Every health care service plan ("health plan") required to submit the Federal Medical Loss Ratio ("MLR") Annual Reporting Form (CMS form-10418) to the federal Department of Health and Human Services ("DHHS") shall also file the MLR Annual Reporting Form with the Department of Managed Health Care ("Department").(b) The MLR Annual Report Form shall be filed with the Department no later than July 31 of the year following the end of the MLR reporting year. The MLR reporting year is the calendar year during which health coverage is provided by a health plan. All terms used in the MLR Annual Reporting Form instructions will have the same meaning as used in 45 CFR Part 158, the Public Health Service Act ( 42 U.S.C. Sec. 300g-18), and Health and Safety Code section 1367.003.(c) If a financial examination pursuant to Health and Safety Code section 1382 and Title 28 California Code of Regulations section 1300.82 is necessary to verify the health plan's representations in the MLR Annual Report, the Department shall give the health plan a 30-day prior notification of the commencement of the financial examination.(d) The health plan shall have 30 days from the date of notification to electronically submit all requested records, books and papers authorized in Health and Safety Code section 1381(a) to the Department.(e) The Director may extend the time for a health plan to comply with subsection (d) upon a finding of good cause.Cal. Code Regs. Tit. 28, § 1300.67.003
1. New section filed 10-7-2013; operative 1-1-2014 (Register 2013, No. 41). Note: Authority cited: Section 1344, Health and Safety Code. Reference: Sections 1367.003 and 1381, Health and Safety Code.
1. New section filed 10-7-2013; operative 1-1-2014 (Register 2013, No. 41).