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Small Group Health Insurance Reforms, were instituted in  1992 with the passage of AB 1672 which provides that  ALL Small Business §10700 (w) Employer  Groups from 2 - 49 employees now have GUARANTEED availability of Medical Insurance coverage from ANY Insurance Company or HMO  that writes business in California under Insurance Code §10702,  as long as  the requirements of §10705 (g) are met, the carrier must accept the Employer's  application.   click here to get the specific details on how to qualify for the GUARANTEED issue coverage that this law provides

To view the rates and benefits, for Small Group Health Insurance, just complete the online form and they will be provided to you immediately 24/7 if you get stuck, call us at (310) 519 1335, fax us a census  or use  Live Chat.

Features

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Guaranteed renewable under §10713.

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An §(f)Eligible employee that can/must be covered, is basically one who works 30 hours/week for full time and 20 hours/part time.

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An employee or dependent can't be excluded for medical reasons§10707.

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Pretty much there are no Pre - X limitations per §10708

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HMO's don't have a Pre - X clause and the clause in PPO's can be waived if the employee has  §(r) credible coverage.

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The rates or premiums for Employers are "leveled," that is they and can't vary more that 20% from the Healthiest to the sickest group that might have the most claims.  This factor is known as the  "Risk adjustment factor" or RAF and is basically determined by the claims experience or expected losses and how many employees are in the group.

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There are  Penalties for non-compliance

Requirements

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Participation requirements and employer contribution requirements   §10706 Generally 75% of employees must be on the plan and the employer must contribute at least 50% of the employee premium.

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Employees should be added on promptly, as soon as the waiting period allows them,  so that they are not considered Late Enrollees

If you have any further questions or would like to obtain coverage for your group, please call or email us.

 

 

Consumer Links

SIMPLE six page explanation from CHCF site.

Benefits of a Group Health Plan Video

Los Angeles Biz Journal 1993 Article

Disability Benefits 101.org  FAQ's

Click here to view discussion on  Can an employer offer an Individual Plan to a couple of employees and everyone else take the Group Plan?

SB 578 Amendments - Allows 1 employee to be on plan - if others have spousal group coverage

Technical & Research Links

Health & Safety Code  §1357-1357.18  Small Employer Group Access to Contracts for Health Care Services

 

 
 
 
 

Is Medical Coverage  tax deductible if you only cover a few employees?  Or offer some their own choice of an individual plan and other the group plan?

 

 

Management Carve Out?
Click here for an explanation and the rules of covering managers and owners only

 

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2 - 50 Employee's Requirements Definitions Types of Biz We Fight for You

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