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HomeHealth and Safety CodeDiv. 2Ch. 2.2Art. 1§ 1342 Health Plan Consumer Protections

§ 1342 Health Plan Consumer Protections

Health and Safety Code·California
AI Summary·Official Text·Key Terms·Related Statutes·References
AI SummaryVerified

§ 1342 Health Plan Consumer Protections

Key Takeaways

  • •Doctors decide what care you need, not insurance companies.
  • •You should know exactly what your health plan covers so you can pick the best one.
  • •If someone lies or tricks you about a health plan, they can get in trouble.
  • •Your health plan must help you if you have a problem or complaint.

Example

You sign up for a health plan, but later find out they didn’t tell you about important benefits.

The law says the health plan must clearly explain what they offer so you can choose wisely. If they hide info, they can get in trouble.

AI-generated — May contain errors. Not legal advice. Always verify source.

Official Source
View on CA.gov

§ 1342 Health Plan Consumer Protections

It is the intent and purpose of the Legislature to promote the delivery and the quality of health and medical care to the people of the State of California who enroll in, or subscribe for the services rendered by, a health care service plan or specialized health care service plan by accomplishing all of the following: (a)  Ensuring the continued role of the professional as the determiner of the patient’s health needs which fosters the traditional relationship of trust and confidence between the patient and the professional. (b)  Ensuring that subscribers and enrollees are educated and informed of the benefits and services available in order to enable a rational consumer choice in the marketplace. (c)  Prosecuting malefactors who make fraudulent solicitations or who use deceptive methods, misrepresentations, or practices which are inimical to the general purpose of enabling a rational choice for the consumer public. (d)  Helping to ensure the best possible health care for the public at the lowest possible cost by transferring the financial risk of health care from patients to providers. (e)  Promoting effective representation of the interests of subscribers and enrollees. (f)  Ensuring the financial stability thereof by means of proper regulatory procedures. (g)  Ensuring that subscribers and enrollees receive available and accessible health and medical services rendered in a manner providing continuity of care. (h)  Ensuring that subscribers and enrollees have their grievances expeditiously and thoroughly reviewed by the department. (Amended by Stats. 2002, Ch. 797, Sec. 2. Effective January 1, 2003.)

Last verified: January 23, 2026

Key Terms

healthbenefitsmedicalfraudmisrepresentationlegislaturepatientquality

Related Statutes

  • § 1342.2 Covid-19 Testing Coverage Mandate
  • § 1342.6 Health Care Contract Promotion
  • § 1342.7 Prescription Drug Benefit Regulation
  • § 1345.5 Minimum Essential Health Coverage
  • § 1363.5 Health Care Authorization Disclosure

References

  • Official text at leginfo.legislature.ca.gov
  • California Legislature. Health and Safety Code. Section 1342.
View Official Source