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Chapter 4.5. Division of Workers' Compensation
Subchapter 1.7

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§10180. Employee Choice Of Plans.

(a) An employee participating in a proposal approved by the administrative director must be offered a choice between the following:

(1) Receiving medical benefits under an exclusive provider of care option for both occupational and non occupational injuries and illness;

(2) Receiving medical benefits for non occupational injuries and illness from a traditional health benefit plan and receiving medical treatment for occupational injuries and illness from a traditional workers' compensation provider.

(b) Employees may be permitted to choose between the two options specified in subdivision (a) in the following ways:

(1) The employee selects an option only once, either (i) before the plan begins in the case of current employees, or (ii) at the time of employment in the case of persons employed after the initial selection period for current employees.

(2) After the initial election, the employee is permitted to change options annually, during an open enrollment period made available to all participating employees.

(c) Nothing in this section shall be construed to preclude an employee from changing plans at any time for good cause, as specified in the approved pilot project proposal or in the rules of the health care service plan.

NOTE: Authority cited: Sections 133, 4612, and 5307.3, Labor Code. Reference: Section 4612, Labor Code.

HISTORY

1. New section filed 8-31-93; operative 8-31-93. Submitted to OAL for printing only pursuant to Government Code section 11351 (Register 93, No. 36).

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