Small Group Health Care Reform
ACA Obamacare
AB 1083

California passed AB 1083 (California AB 1083 Small Group Health Plans  pdf  HTML ) so that California law complies with Health Care Reform.  AB 1083 replaces Insurance Code §10753 and so forth, the  rules for Non Grandfathered Plans which we had previously under  AB 1672…Insurance Code 10700-10752.8  Here’s a summy from * CHFC 6 page pdf summary *

LEGISLATIVE COUNSEL’S DIGEST

AB 1083, Monning. (our PDF with bookmarks & annotations)
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The federal Patient Protection and Affordable Care Act (PPACA) (Obamacare), did various health care coverage market reforms that take effect with respect to plan years on or after January 1, 2014.   PPACA requires each health insurance issuer that offers health insurance coverage in the individual or group market in a state to accept every employer and individual
 
***That’s why group plans have participation requirements and Individual Plans have Open & Special Enrollment
 
in the state that applies for that coverage and to renew that coverage at the option of the plan sponsor or the individual. PPACA prohibits a group health plan and a health insurance issuer offering group or individual health insurance coverage from imposing any preexisting condition exclusion with respect to that plan or coverage. PPACA allows the premium rate charged by a health insurance issuer offering small group or individual coverage to vary only by family composition, rating area, age, and tobacco use [not in CA] and prohibits discrimination against individuals based on health status, as specified. PPACA specifies that certain of these provisions do not apply to grandfathered health plans.
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Existing law AB 1672.. requires a plan or insurer to offer, market, and sell all of its small employer health benefit plans to all small employers in each service area in which the plan provides or arranges for the provisions of health care services and provides certain limits on the rates for these plans. Existing law prohibits a group health benefit plan from excluding coverage for an individual on the basis of a preexisting condition provision for a period greater than 6 months, except as specified..

Self employed

18) Permits a self-employed individual with specified income to, at his or her discretion, enroll in the Exchange as an individual rather than a small employer.   Husband & Wife groups are no longer allowed…  Must have a bonafide employee.

Self Employed – Group Health Insurance

Resources & Links

Hutton & Williams LLP Checklist TimeLine  4.2015

Federal CFR PART 146—REQUIREMENTS FOR THE GROUP HEALTH INSURANCE MARKET

One comment on “AB 1083 – PPACA – CA law to comply with Federal Law

  1. Both my wife and I have S-Corps, my wife has been operating for over 10 years. I recently became an S-Corp. (We both work a psychotherapists). My wife’s S-Corp has three employee currently. I am an employee as well as as our daughter. We are all paid thru the S-corp. Can we qualify for health insurance as a small business? We were able two year ago. Has the law changed? Thank You
    ***We will answer your question in detail on this page.

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