Health & Saf. Code, § 1374.65 · Article 5.6. Point-of-Service Health Care Service Plan Contracts
Health & Saf. Code, § 1374.65
Text — As published in the Legislative Counsel's database, tables dated October 18, 2026 (pubinfo_2025.zip)
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.
Notes and commentary — not statutory text
History
Added by Stats. 1993, Ch. 987, Sec. 3. Effective January 1, 1994.
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=1374.65.
- Text hash
- sha256 f7c519042ea82dd79319480bc1f3eee118d54171fa3eb356395bddc9c3b49175
- 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
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.