(A) Health insurer, or any health care entity licensed through the Department of Insurance.
(B) Self-insured plan.
(C) Group health plan, as defined in Section 607(1) of the Employee Retirement Income Security Act of 1974.
(D) Service benefit plan.
(E) Managed care organization, including a health care service
plan as defined in subdivision (f) of Section 1345 of the Health and Safety Code, licensed pursuant to 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).
(F) Pharmacy benefit manager.
(G) Third-party administrator.
(H) Union trust.
(I) Other party that is, by statute, contract, or agreement, legally responsible for payment of a claim for a health care item or service.
pertaining to an individual or group health insurance policy or plan issued by such insurer or plan against, or pertaining to the medical or dental benefits paid by or claims made against such insurer or plan under a policy or plan, make the requested records or information available upon a certification by the department that the individual is an applicant for or recipient of services under this chapter or is a person who is legally responsible for such an applicant or recipient.
department, within 90 days of the department’s request.
used only for the purpose of identifying the records or information requested in such manner so as not to violate the confidentiality of an applicant or recipient.
Cite this section
Other sections in Article 3.5 - Third Party Liability