The board shall use due diligence in the creation of participation standards for the program that minimize the incentive for employers or applicants to drop or reduce dependent health coverage.
Healthy FamiliesProtection Against Substitution of Benefits
Section § 12693.80
This law requires the board to carefully create rules for a program to prevent employers or applicants from being tempted to stop or cut down on health coverage for dependents. The idea is to maintain existing health coverage options while still offering program benefits.
participation standards dependent health coverage program rules
Section § 12693.81
This law makes it unfair competition for insurance companies, agents, brokers, or administrators to try to move an employee or their dependents from group health insurance to another program simply to separate them from the employee's job health coverage. Employees impacted by this practice have the right to take legal action against these efforts.
(a)CA Insurance Code § 12693.81(a) It shall constitute unfair competition for purposes of Chapter 5 (commencing with Section 17200) of Part 2 of Division 7 of the Business and Professions Code for an insurer, an insurance agent or broker, or an administrator, as defined in Section 1759, to refer an individual employee or employee’s dependent to the program, or arrange for an individual employee or employee’s dependent to apply for the program, for the purpose of separating that employee or employee’s dependent from group health coverage in connection with the employee’s employment.
(b)CA Insurance Code § 12693.81(b) Any employee applicant in subdivision (a) shall have personal right of action to enforce subdivision (a).
unfair competition insurance agents insurance brokers
Section § 12693.82
This law makes it illegal for employers to push employees or their dependents towards a government health program to remove them from the company's health coverage. It's considered an unfair labor practice and goes against public policy.
It shall constitute an unfair labor practice contrary to public policy, and enforceable under Section 95 of the Labor Code, for any employer to refer an individual employee or employee’s dependent to the program, or to arrange for an individual employee or employee’s dependent to apply to the program, for the purpose of separating that employee or employee’s dependent from group health coverage provided in connection with the employee’s employment.
unfair labor practice employer misconduct employee health coverage
Section § 12693.83
This law says it is considered an unfair labor practice for employers to change how much employees have to pay for health costs based on how much they earn or their job type. It's also unfair to change health coverage options to push employees or their families to join a specific health program.
(a)CA Insurance Code § 12693.83(a) It shall constitute an unfair labor practice contrary to public policy and enforceable under Section 95 of the Labor Code for any employer to change the employee-employer share-of-cost ratio based upon the employee’s wage base or job classification or to make any modification of coverage for employees and employee’s dependents in order that the employees or employee’s dependents enroll in the program established pursuant to this part.
unfair labor practice employee-employer cost ratio wage base
Section § 12693.84
This law defines "group health coverage" as including various types of insurance plans that cover hospital, medical, or surgical expenses. Specifically, it covers group disability insurance policies, group health care service plans, and self-insured employee welfare benefit plans.
For purposes of Sections 12693.82 and 12693.83, group health coverage includes any group disability insurance policy covering hospital, medical, or surgical expenses, group health care service plan contract, or self-insured employee welfare benefit plan.
group health coverage group disability insurance hospital expenses
