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Cal. Code Regs. Tit. 10, § 2562.3 Prohibited Limitations On Coverage
Library | California Code of Regulations |
Edition | 2023 |
Currency | Current through Register 2023 Notice Reg. No. 52, December 29, 2023 |
Citation | Cal. Code Regs. Tit. 10, § 2562.3 |
Year | 2023 |
For purposes of Insurance Code section California Insurance Codeundefined10144.5,
(a) If treatment or services are
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(1) Medically necessary,
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(2) Rendered to an individual diagnosed with
a health condition indicated in subdivision (d)(7) of Insurance Code section
California Insurance Codeundefined10144.5
and
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(3) Rendered for the purpose of
treating that condition;
(b) Then an insurer shall not impose
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(1) An annual visit limit, or
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(2) An annual dollar limit, a copayment, a
deductible, or any other financial term, when the same term or limit is not
equally applicable to all benefits under the policy.
(c) For purposes of subdivision (a) of this section 10undefined2562.3, "treatment or services" includes but is not limited to speech therapy, occupational therapy and behavioral health treatment.
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