1. For the purposes of determining rates charged for health benefit plans, a health
benefit plan that contains a provision for a restricted network is not similar coverage
to a health benefit plan that does not contain such a provision if the restriction
of benefits results in material differences in cost of claims.
2. As used in this section, “provision for a restricted network” means any provision of a group health benefit plan that conditions the payment of
benefits, in whole or in part, on the use of providers of health care who have entered
into a contractual arrangement with the carrier to provide health care to persons
covered by the plan.
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature or via Westlaw before relying on it for your legal needs.
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