Health & Saf. Code, § 1367.001 · Article 5. Standards
Health & Saf. Code, § 1367.001
Text — As published in the Legislative Counsel's database, tables dated October 18, 2026 (pubinfo_2025.zip)
(a) An individual or group health care service plan contract shall not establish either of the following:
(1) Lifetime limits on the dollar value of any covered benefits for an enrollee, whether provided in network or out of network.
(2) Annual limits on the dollar value of any covered benefits for an enrollee, whether provided in network or out of network.
(b) Subdivision (a) does not prevent a group health care service plan contract from placing annual or lifetime per-enrollee limits on specific covered benefits that are not essential health benefits, as defined under Section 1367.005, to the extent that those limits are otherwise permitted under state law.
(c) This section does not apply to a health care service plan contract or insurance policy issued, sold, renewed, or offered for health care services or coverage provided in the Medi-Cal program (Chapter 7 (commencing with Section 14000) of Part 3 of Division 9 of the Welfare and Institutions Code), the Medi-Cal Access Program (Chapter 2 (commencing with Section 15810) of Part 3.3 of Division 9 of the Welfare and Institutions Code), or the California Major Risk Medical Insurance Program (Chapter 4 (commencing with Section 15870) of Part 3.3 of Division 9 of the Welfare and Institutions Code).
(d) This section does not apply to a specialized health care service plan that does not cover an essential health benefit, as defined under Section 1367.005, or a Medicare supplement policy.
Notes and commentary — not statutory text
History
Repealed and added by Stats. 2020, Ch. 302, Sec. 2. (SB 406) Effective September 29, 2020.
Source of truth
- Edition
- As published in the Legislative Counsel's database, tables dated October 18, 2026 (pubinfo_2025.zip)
- Official file
- https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=HSC§ionNum=1367.001.
- Text hash
- sha256 9f2dd52d70c2e9266aad4dcfd757e0fd7552afe906b7f02376d166c1746e6130
- Composed by
- compose_ca.py 2026-10-22: the Legislative Counsel's CAML content files read by a tokenizer (caml_readers.reader_a); an independent xml.etree reading (caml_readers.reader_b) agrees on every section
This section cites
Provisions in this library that the text above cites, as it prints each citation. A range cited as “ss. 61.13-61.16” links its first and last provisions.
Health and Safety Code
Welfare and Institutions Code
- Welf. & Inst. Code, div. 9, pt. 3, ch. 7Basic Health CarePrinted as Chapter 7 (commencing with Section 14000) of Part 3 of Division 9 of the Welfare and Institutions Code
- Welf. & Inst. Code, div. 9, pt. 3.3, ch. 2Medi-Cal Access ProgramPrinted as Chapter 2 (commencing with Section 15810) of Part 3.3 of Division 9 of the Welfare and Institutions Code
- Welf. & Inst. Code, div. 9, pt. 3.3, ch. 4California Major Risk Medical Insurance ProgramPrinted as Chapter 4 (commencing with Section 15870) of Part 3.3 of Division 9 of the Welfare and Institutions Code
Cited by 1 provision
Provisions in this library whose text cites Health & Saf. Code, § 1367.001. Each shows the citation as that text prints it.
Health and Safety Code
Procedural information only. Not legal advice and not a substitute for the advice of an attorney. Confirm the current text with the official publisher before relying on it.