While there may no longer be a Federal Penalty and there are issues with Constitutionality Texas vs USA for not having health insurance, we are showing you this page, as we expect California’s mandate to have the same or very similar rules as the Feds did. We are waiting to hear from the FTB Franchise Tax Board on the details.
(a)Qualified health plan In this title: [1]
(C)is offered by a health insurance issuer that—
(i) is licensed and in good standing to offer health insurance coverage in each State in which such issuer offers health insurance coverage under this title;
(2)Inclusion of CO–OP plans and multi-State qualified health plans
Any reference in this title 1 to a qualified health plan shall be deemed to include a qualified health plan offered through the CO–OP program under section 18042 of this title, and a multi-State plan under section 18054 of this title, unless specifically provided for otherwise.
(3)Treatment of qualified direct primary care medical home plans
The Secretary of Health and Human Services shall permit a qualified health plan to provide coverage through a qualified direct primary care medical home plan that meets criteria established by the Secretary, so long as the qualified health plan meets all requirements that are otherwise applicable and the services covered by the medical home plan are coordinated with the entity offering the qualified health plan.
(b)Terms relating to health plansIn this title:
(B)Exception for self-insured plans and MEWAs
Except to the extent specifically provided by this title,
the term “health plan” shall not include a group health plan or multiple employer welfare arrangement to the extent the plan or arrangement is not subject to State insurance regulation under section 1144 of title 29.
Subpart C—Qualified Health Plan Minimum Certification Standards
§156.200 QHP issuer participation standards.
§156.210 QHP rate and benefit information.
§156.215 Advance payments of the premium tax credit and cost-sharing reduction standards.
§156.220 Transparency in coverage.
§156.225 Marketing and Benefit Design of QHPs.
§156.230 Network adequacy standards.
§156.235 Essential community providers.
§156.245 Treatment of direct primary care medical homes.
§156.250 Meaningful access to qualified health plan information.
§156.255 Rating variations.
§156.260 Enrollment periods for qualified individuals.
§156.265 Enrollment process for qualified individuals.
§156.270 Termination of coverage or enrollment for qualified individuals.
§156.275 Accreditation of QHP issuers.
§156.280 Segregation of funds for abortion services.
§156.285 Additional standards specific to SHOP.
§156.290 Non-renewal and decertification of QHPs.
§156.295 Prescription drug distribution and cost reporting.
§156.298 Meaningful difference standard for Qualified Health Plans in the Federally-facilitated Exchanges.