Statute · California Insurance Code

Cal. Ins. Code § 10112.1 — General Provisions

Cal. Ins. Code § 10112.1

Type
Statute
Source
California Insurance Code
Jurisdiction
California
Date
2020-09-29
Current through
Nov 2, 2026 (California Legislative Counsel)

(a) An individual or group health insurance policy shall not establish either of the following:

Citator

Cal. Ins. Code § 10112.1 — General Provisions is in force in the current edition of the Code, and nothing recorded condemns it.

(a) An individual or group health insurance policy shall not establish either of the following:

(1) Lifetime limits on the dollar value of any covered benefits for an insured, whether provided in network or out of network.

(2) Annual limits on the dollar value of any covered benefits for an insured, whether provided in network or out of network.

(b) Subdivision (a) does not prevent a group health insurance policy from placing annual or lifetime per-insured limits on specific covered benefits that are not essential health benefits, as defined under Section 10112.27, to the extent that those limits are otherwise permitted under state law.

(c) This section does not apply to a specialized health insurance policy that does not cover an essential health benefit, as defined under Section 10112.27, or a Medicare supplement policy.