(a)CA 保险 Code § 10128.55(a) Every group benefit plan contract between a disability insurer and an employer subject to this article that is issued, amended, or renewed on or after July 1, 1998, shall require the employer to notify the insurer in writing of any employee who has had a qualifying event, as defined in paragraph (2) of subdivision (d) of Section 10128.51, within 30 days of the qualifying event. The group contract shall also require the employer to notify the insurer, in writing, within 30 days of the date when the employer becomes subject to Section 4980B of the United States Internal Revenue Code or Chapter 18 of the Employee Retirement Income Security Act, 29 U.S.C. Sec. 1161 et seq.
(b)CA 保险 Code § 10128.55(b) Every group benefit plan contract between a disability insurer and an employer subject to this article that is issued, amended, or renewed after July 1, 1998, shall require the employer to notify qualified beneficiaries currently receiving continuation coverage, whose continuation coverage will terminate under one group benefit plan prior to the end of the period the qualified beneficiary would have remained covered, as specified in Section 10128.57, of the qualified beneficiary’s ability to continue coverage under a new group benefit plan for the balance of the period the qualified beneficiary would have remained covered under the prior group benefit plan. This notice shall be provided either 30 days prior to the termination or when all enrolled employees are notified, whichever is later.
Every disability insurer shall provide to the employer replacing a group benefit plan policy issued by the insurer, or to the employer’s agent or broker
representative, within 15 days of any written request, information in possession of the insurer reasonably required to administer the notification requirements of this subdivision and subdivision (c).
(c)CA 保险 Code § 10128.55(c) Notwithstanding subdivision (a), the group benefit plan contract between the insurer and the employer shall require the employer to notify the successor plan in writing of the qualified beneficiaries currently receiving continuation coverage so that the successor plan, or contracting employer or administrator, may provide those qualified beneficiaries with the necessary premium information, enrollment forms, and instructions consistent with the disclosure required by subdivision (c) of Section 10128.54 and subdivision (e) of this section to allow the qualified beneficiary to continue coverage. This information shall be sent to all qualified beneficiaries who are enrolled in the group benefit plan and those qualified beneficiaries who have been
notified, pursuant to Section 10128.54 of their ability to continue their coverage and may still elect coverage within the specified 60-day period. This information shall be sent to the qualified beneficiary’s last known address, as provided to the employer by the health care service plan or, disability insurer currently providing continuation coverage to the qualified beneficiary. The successor insurer shall not be obligated to provide this information to qualified beneficiaries if the employer or prior insurer or health care service plan fails to comply with this section.
(d)CA 保险 Code § 10128.55(d) A disability insurer may contract with an employer, or an administrator, to perform the administrative obligations of the plan as required by this article, including required notifications and collecting and forwarding premiums to the insurer. Except for the requirements of subdivisions (a), (b), and (c), this subdivision shall not be construed to permit an insurer to
require an employer to perform the administrative obligations of the insurer as required by this article as a condition of the issuance or renewal of coverage.
(e)CA 保险 Code § 10128.55(e) Every insurer, or employer or administrator that contracts to perform the notice and administrative services pursuant to this section, shall, within 14 days of receiving a notice of a qualifying event, provide to the qualified beneficiary the necessary premium information, enrollment forms, and disclosures consistent with the notice requirements contained in subdivisions (b) and (c) of Section 10128.54 to allow the qualified beneficiary to formally elect continuation coverage. This information shall be sent to the qualified beneficiary’s last known address.
(f)CA 保险 Code § 10128.55(f) 每一保险公司，或根据本条规定签订合同提供通知和行政服务的雇主或管理人，应当在根据第10128.57条(a)款的(1)、(3)和(5)项终止持续承保之日前的180天期间内，通知根据本条选择持续承保的合格受益人其承保终止的日期，并通知该合格受益人可获得的任何转换承保。当持续承保因保险公司与雇主之间的团体合同终止而终止时，本要求不适用。
(g)Copy CA 保险 Code § 10128.55(g)
(1)Copy CA 保险 Code § 10128.55(g)(1) 保险公司应当向在ARRA第3001条(a)款(3)项(A)分项规定的期间内发生合格事件的合格受益人提供一份书面通知，其中包含有关ARRA项下保费援助可用性的信息。该通知应寄送至合格受益人最后所知的地址。该通知应包含清晰易懂的语言，告知合格受益人联邦法律的变更提供了选择持续承保并获得65%保费补贴的新机会，并应包括以下所有内容：
(A)CA 保险 Code § 10128.55(g)(1)(A) 该人将支付的保费金额。对于在2008年9月1日至2009年5月12日（含）期间发生合格事件的合格受益人，如果保险公司无法在通知中提供正确的保费金额，通知可以包含最后所知的保费金额，并为合格受益人提供通过免费电话号码请求适用于该受益人的正确保费的机会。
(B)CA 保险 Code § 10128.55(g)(1)(B) 注册表格以及根据(e)款要求包含的任何其他信息，以允许合格受益人选择持续承保。此信息不应包含在发送给目前已注册持续承保的合格受益人的通知中。
(C)CA 保险 Code § 10128.55(g)(1)(C) ARRA第3001条(a)款(1)项(B)分项中规定的选择注册不同承保的选项的描述。该描述应建议合格受益人联系被承保雇员的前雇主以获得选择此选项的事先批准。
(D)CA 保险 Code § 10128.55(g)(1)(D) 根据ARRA第3001条获得65%保费援助的资格要求。
(E)CA 保险 Code § 10128.55(g)(1)(E) 根据ARRA可获得的保费援助的持续时间。
(F)CA 保险 Code § 10128.55(g)(1)(F) 一份声明，说明根据ARRA有资格获得保费援助的合格受益人可在通知日期起60天内选择持续承保。
(G)CA 保险 Code § 10128.55(g)(1)(G) 一份声明，说明根据ARRA有资格获得保费援助的合格受益人，如果在收到本款要求的通知之前拒绝或中止了持续承保，有权撤回该拒绝并选择带有保费援助的持续承保。
(H)CA 保险 Code § 10128.55(g)(1)(H) 一份声明，内容如下：
“如果您在阅读或理解本通知时遇到任何困难，请联系[保险公司名称]，电话[插入适当的电话号码]。”
(2)CA 保险 Code § 10128.55(2) 对于在2008年9月1日至2009年5月12日（含）期间发生合格事件的合格受益人，本款所述的通知应在2009年5月26日或保险公司收到合格事件通知之日起七个工作日内（以较晚者为准）提供。
(3)CA 保险 Code § 10128.55(3) 对于在2009年5月13日至ARRA第3001条(a)款(3)项(A)分项中规定的较晚日期（含）之间发生或将发生合格事件的合格受益人，本款所述的通知应在(e)款规定的时间内提供。
(4)CA 保险 Code § 10128.55(4) 本条中的任何内容均不应解释为要求保险公司将其承保凭证作为本款要求的通知的一部分提供，本条中的任何内容均不应解释为要求保险公司修改其现有承保凭证以符合2009-10年度常会第23号议会法案的颁布或在2009-10年度常会第二年修订本条的法案所作的变更。
(2)CA 保险 Code § 10128.55(2) 根据第 (1) 款直接向受保雇员的前雇主请求核实的保险公司，应当通过向雇主提供书面通知来完成。该书面通知应在保险公司根据 (h) 款收到合格受益人的选择通知之日起七个工作日内，通过邮件或传真发送给受保雇员的前雇主。在收到本款要求的书面通知后十个日历日内，前雇主应向保险公司提供书面核实，说明受保雇员的雇佣关系是否属于非自愿终止。
(3)CA 保险 Code § 10128.55(3) 根据《美国复苏与再投资法案》(ARRA) 请求保费援助的合格受益人，可以向保险公司提供一份来自受保雇员前雇主的书面文件或其他信息，表明该受保雇员的雇佣关系属于非自愿终止。除非保险公司合理且及时地认定合格受益人提供的文件或信息在法律上不足以证明雇佣关系的非自愿终止，否则该文件或信息应被保险公司视为足以证明受保雇员的雇佣关系为非自愿终止，以满足《美国复苏与再投资法案》(ARRA) 的目的。
(4)CA 保险 Code § 10128.55(4) 如果保险公司根据本款请求核实，并且在雇主收到核实请求之日或保险公司根据第 (3) 款收到合格受益人提供的文件或其他信息之日起十四个工作日内无法核实雇佣关系的非自愿终止，则保险公司应向合格受益人提供附带联邦保费援助的持续承保，或向合格受益人发送一份拒绝信，其中应包含其根据《美国复苏与再投资法案》(ARRA) 对该决定提出上诉的权利通知。
(5)CA 保险 Code § 10128.55(5) 任何人不得故意拖延根据本款进行的雇佣关系非自愿终止的核实。
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