{"data":{"id":"us-ca/hsc-1374.65","jurisdiction":"us-ca","citation":"HSC § 1374.65","heading":"","body":"Point-of-service plan contracts shall:\n(a) Provide incentives, including financial incentives, for enrollees to use in-network coverage or services.\n(b) Only offer coverage or services obtained out-of-network if it also provides coverage or services on an in-network basis.\n(c) Shall not consider the following to be out-of-network coverage or services:\n(1) Health care services received from a provider not affiliated with the health care service plan when the plan arranges for the enrollee to receive services from that provider.\n(2) Out-of-area emergency care provided in accordance with the procedures set by the health care service plan to be followed in securing these services.","path":["Health and Safety Code - HSC","DIVISION 2. LICENSING PROVISIONS [1200. - 1796.88.]","CHAPTER 2.2. Health Care Service Plans [1340. - 1399.874.]","ARTICLE 5.6. Point-of-Service Health Care Service Plan Contracts [1374.60. - 1374.76.]"],"source_url":"https://downloads.leginfo.legislature.ca.gov/pubinfo_2025.zip","current_through":"2026-09-13","vintage":"","retrieved_at":"2026-09-14T05:56:33Z","sha256":"f7c519042ea82dd79319480bc1f3eee118d54171fa3eb356395bddc9c3b49175","source_id":"us-ca","stale":false,"prev":"us-ca/hsc-1374.64","next":"us-ca/hsc-1374.66"},"notice":"GroundRules: Original legal text. Not legal advice."}