Statute · California Health and Safety Code
Cal. Health & Safety Code § 1374.65 — Point-of-Service Health Care Service Plan Contracts
Cal. Health & Safety Code § 1374.65
- Type
- Statute
- Source
- California Health and Safety Code
- Jurisdiction
- California
- Date
- 1994-01-01
- Current through
- Nov 2, 2026 (California Legislative Counsel)
Point-of-service plan contracts shall:
Citator
Cal. Health & Safety Code § 1374.65 — Point-of-Service Health Care Service Plan Contracts is in force in the current edition of the Code, and nothing recorded condemns it.
Point-of-service plan contracts shall:
(a) Provide incentives, including financial incentives, for enrollees to use in-network coverage or services.
(b) Only offer coverage or services obtained out-of-network if it also provides coverage or services on an in-network basis.
(c) Shall not consider the following to be out-of-network coverage or services:
(1) Health care services received from a provider not affiliated with the health care service plan when the plan arranges for the enrollee to receive services from that provider.
(2) Out-of-area emergency care provided in accordance with the procedures set by the health care service plan to be followed in securing these services.