Article 8.8 - Long-Term Care Group Insurance

California Government Code — §§ 31696.1-31696.5

Sections (5)

Amended by Stats. 2000, Ch. 857, Sec. 15. Effective January 1, 2001.

(a)The board of retirement may provide a long-term care insurance program for retired members and their spouses, their parents, and their spouses’ parents.

(b)Subject to Section 31696.5, the board may permit active members and their spouses, their parents, and their spouses’ parents to enroll in the long-term care insurance program.

(c)The long-term care insurance plan shall be made available periodically during open enrollment periods determined by the board.

(d)The board shall award contracts to carriers who are qualified to provide long-term care benefits.

(e)The long-term care insurance plan shall include home, community, and institutional care and shall provide substantially equivalent coverage to that required under Chapter 2.6 (commencing with Section 10230) of Part 2 of Division 2 of the Insurance Code and shall meet those requirements set forth in the Knox-Keene Health Care Service Plan Act of 1975 (Chapter 2.2 (commencing with Section 1340) of Division 2 of the Health and Safety Code). However, the Department of Managed Health Care shall have no jurisdiction over the insurance plan authorized by this article.

(f)Notwithstanding subdivision (a), no person shall be enrolled unless he or she meets the eligibility and underwriting criteria approved by the board.

(g)The board shall approve eligibility criteria for enrollment, approve appropriate underwriting criteria for potential enrollees, approve the scope of covered benefits, approve the criteria to receive benefits, and approve any other standards as needed.

§ 31696.2

Added by Stats. 1997, Ch. 491, Sec. 2. Effective January 1, 1998.

(a)The full cost of enrollment in a long-term care insurance plan shall be paid by the enrollees.

(b)The long-term care insurance plan shall not become part of, or subject to, the retirement or health benefits programs administered by the system.

§ 31696.3

Amended by Stats. 2014, Ch. 740, Sec. 14. (AB 2473) Effective January 1, 2015.

(a)The board shall establish a trust fund designated as the Long-Term Care Fund for the purpose of the payment of the costs and administration of the long-term care plan. The Long-Term Care Fund shall be held for the exclusive benefit of enrollees and the payment of the costs and administration of the program.

(b)The board shall have exclusive control of the administration and investment of the Long-Term Care Fund, except that in a county having a board of investments, the board of investments shall have exclusive control of the investment of the fund. Funds in the Long-Term Care Fund shall be invested pursuant to the law governing the

investment of the retirement fund.

(c)Income, of whatever nature, earned on the Long-Term Care Fund shall be credited to the fund.

(d)If the Long-Term Care Fund is intended to be a part of the retirement system trust fund, then the operation of the Long-Term Care Fund, including, but not limited to, its funding, governance, investment of assets, allocation of income, and payment of benefits, shall comply with the requirements of Section 401(h) of Title 26 of the United States Code, to the extent required by that title and related federal regulations. If the Long-Term Care Fund is intended to be separate from and not a part of the retirement system, then

no assets attributable to that fund shall be commingled for investment or any other purpose, with the assets of the retirement system and shall constitute a separate fund with a trust that is separate from the funds and trust of the retirement system to the extent commingling of assets for investment purposes satisfies the requirements of the federal tax laws. The board shall indicate, as a part of establishment of the Long-Term Care Fund, whether the separate fund is intended to be a part of, or separate from, the retirement system.

§ 31696.4

Added by Stats. 1997, Ch. 491, Sec. 2. Effective January 1, 1998.

The board is authorized to recover the administrative costs of the long-term care insurance program from insurance carriers and premiums paid by enrollees.

§ 31696.5

Added by Stats. 1997, Ch. 491, Sec. 2. Effective January 1, 1998.

Subdivision (b) of Section 31696.1 shall not be operative in any county until the board of supervisors shall, by resolution adopted by a majority vote, make that subdivision applicable in the county.