Insurance Code section 10123.5
(a)
On or after January 1, 1993, every insurer issuing group disability insurance that covers hospital, medical, or surgical expenses shall provide benefits for the comprehensive preventive care of children 16 years of age or younger under those terms and conditions as may be agreed upon between the group policyholder and the insurer. Every insurer shall communicate the availability of these benefits to all group policyholders and to all prospective group policyholders with whom they are negotiating.(b)
For purposes of this section, benefits for the comprehensive preventive care of children shall comply with both of the following:(1)
Be consistent with both of the following:(A)
The most recent Recommendations for Preventive Pediatric Health Care, as adopted by the American Academy of Pediatrics.(B)
The Recommended Childhood Immunization Schedule/United States, jointly adopted as of January 1, 2025, by the American Academy of Pediatrics, the Advisory Committee on Immunization Practices, and the American Academy of Family Physicians. Immunizations subject to this subparagraph may be modified or supplemented by the State Department of Public Health pursuant to Section 120164.(2)
Provide for the following:(A)
Periodic health evaluations.(B)
Immunizations.(C)
Laboratory services in connection with periodic health evaluations.(D)
Screening for blood lead levels in children who are at risk for lead poisoning, as determined by a health care provider in accordance with the applicable California regulations.(c)
For purposes of this section, a health care provider is any of the following:(1)
A person licensed to practice medicine pursuant to Article 3 (commencing with Section 2050) of Chapter 5 of Division 2 of the Business and Professions Code.(2)
A nurse practitioner licensed to practice pursuant to Article 8 (commencing with Section 2834) of Chapter 6 of Division 2 of the Business and Professions Code.(3)
A physician assistant licensed to practice pursuant to Article 3 (commencing with Section 3513) of Chapter 7.7 of Division 2 of the Business and Professions Code.
Source:
Section 10123.5, https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=INS§ionNum=10123.5. (updated Sep. 17, 2025; accessed Nov. 10, 2025).
