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The Act limits the Association to pay benefits as follows:

Life & Annuity Benefits

  • Eighty percent of what the life insurance company would owe under a life policy or annuity contract up to $100,000 in cash surrender values, $100,000 in present value of annuities, or $250,000 in life insurance death benefits.
  • A maximum of $250,000 for any one insured life no matter how many policies and contracts there were with the same company, even if the policies provided different types of coverages.

Health Benefits

  • A maximum of $200,000 of the contractual obligations that the health insurance company would owe were it not insolvent. The maximum may increase or decrease annually based upon changes in the health care cost component of the consumer price index.

Premium Surcharge

  • Member insurers are required to recoup assessments paid to the Association through a surcharge on premiums charged for health insurance policies.

Source: California Department of Insurance Bulletin 96-2


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