State Regulators definition
Examples of State Regulators in a sentence
If instructions provided by Covered California include inaccurate information which necessitates an additional round of validation, or an additional round of validation is necessary due to required changes by Covered California or Contractor’s State Regulators, those rounds of validation will not be counted in the two rounds of validations.
Contractor shall not initiate collection activities if they have knowledge of a pending appeal, including notice from the consumer, Covered California, or Contractor’s State Regulators.
Such materials shall be available in languages as required by Federal and State law and receive any necessary regulatory approvals from the relevant State Regulators, be provided to Covered California as directed by Covered California, and shall include information brochures, a summary of the Plan that accurately reflects the coverage available under the Plan (a Summary of Benefits and Coverage), and related communication materials.
Contractor shall maintain a utilization management program that complies with applicable laws, rules and regulations, including Health and Safety Code § 1367.01 and other requirements established by the applicable State Regulators responsible for oversight of Contractor.
Covered California, in its sole discretion and in consultation with the appropriate State Regulators determines what constitutes a material violation for this purpose.
Contractor’s QHPs shall comply with the network adequacy standards established by the applicable State Regulators responsible for oversight of Contractor, including, those set forth at Health and Safety Code § 1367.03 and 28 CCR § 1300.67.2 (if Contractor is a licensed health care service plan) or Insurance Code § 10133.5 and 10 CCR § 2240 et seq.
Contractor shall perform, or may delegate activities related to, credentialing and re-credentialing Participating Providers in accordance with a process reviewed and approved by State Regulators.
Covered California, in its sole discretion and in consultation with the appropriate State Regulators, determines what constitutes a material violation for this purpose.
Contractor may vary premiums by geographic area, family size, and age band (within 3:1 range requirement) as permitted by State law, including the requirements of State Regulators regarding rate setting and rate variation set forth at Health and Safety Code §§ 1357.512 and 1399.855, Insurance Code §§ 10753.14 and 10965.9, 10 CCR § 2222.12 and, as applicable, other laws, rules and regulations, including, 45 C.F.R. § 156.255(b).
Contractor shall comply with rate filing requirements imposed by State Regulators, including, those set forth under Insurance Code § 10181 et seq.