reglab/statecodes huggingface dataset:
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 3 - Competitive Process for Selecting Qualified Health Plans [Repealed] › Section 6422 - Qualified Health Plan (QHP) New Entrant Application for Plan Year 2015. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New section
				  filed 3-6-2014 as an emergency; operative 3-6-2014 (Register 2014, No. 10). A
				  Certificate of Compliance must be transmitted to OAL by 9-2-2014 or emergency
				  language will be repealed by operation of law on the following day. For prior
				  history, see Register 2013, No. 42.
2. New section refiled 9-3-2014
				  as an emergency pursuant to Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 857 (Stats. 2014, c. 31); operative 9-3-2014
				  (Register 2014, No. 36). A Certificate of Compliance must be transmitted to OAL
				  by 3-6-2016 pursuant to Government Code section
				  100504 or
				  emergency language will be repealed by operation of law on the following
				  day.
3. Senate Bill 75 (Stats. 2015, Ch. 18) modified Government
				  Code section
				  100504(a)(6)
				  to change the date upon which a Certificate of Compliance must be transmitted
				  to OAL. Pursuant to Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 75 (Stats. 2015, Ch. 18), a Certificate of
				  Compliance must be transmitted to OAL by 3-6-2017 or the language in the
				  emergency order of 9-3-2014 will be repealed by operation of law on the
				  following day (Register 2015, No. 38).
4. Editorial correction of
				  HISTORIES 2 and 3 (Register 2019, No. 39).
5. Repealed by operation
				  of Government Code section
				  11346.1(g)
				  (Register 2019, No. 39).
Note: Authority cited: Sections
					 100504 and
					 100505,
					 Government Code. Reference: Sections
					 100502,
					 100503,
					 100504 and
					 100505,
					 Government Code.
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 3 - Competitive Process for Selecting Qualified Health Plans [Repealed] › Section 6424 - Standalone Dental Plan (SADP) Issuer 2015 Renewal Application. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New section
				  filed 3-10-2014 as an emergency; operative 3-10-2014 (Register 2014, No. 11). A
				  Certificate of Compliance must be transmitted to OAL by 9-8-2014 or emergency
				  language will be repealed by operation of law on the following day. For prior
				  history, see Register 2013, No. 42.
2. New section refiled 9-2-2014
				  as an emergency pursuant to Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 857 (Stats. 2014, c. 31); operative 9-2-2014
				  (Register 2014, No. 36). A Certificate of Compliance must be transmitted to OAL
				  by 3-10-2016 pursuant to Government Code section
				  100504 or
				  emergency language will be repealed by operation of law on the following
				  day.
3. Editorial correction of HISTORY 2 (Register 2014, No.
				  45).
4. Senate Bill 75 (Stats. 2015, Ch. 18) modified Government
				  Code section
				  100504(a)(6)
				  to change the date upon which a Certificate of Compliance must be transmitted
				  to OAL. Pursuant to Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 75 (Stats. 2015, Ch. 18), a Certificate of
				  Compliance must be transmitted to OAL by 3-10-2017 or the language in the
				  emergency order of 9-2-2014 will be repealed by operation of law on the
				  following day (Register 2015, No. 38).
5. Repealed by operation of
				  Government Code section
				  11346.1(g)
				  (Register 2019, No. 39).
Note: Authority cited: Sections
					 100504 and
					 100505,
					 Government Code. Reference: Sections
					 100502,
					 100503,
					 100504 and
					 100505,
					 Government Code.
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 3 - Competitive Process for Selecting Qualified Health Plans [Repealed] › Section 6426 - 4th Quarter 2015 Shop Exchange Plans. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New section
				  filed 3-29-2013 as a deemed emergency pursuant to Government Code section
				  100504(a)(6);
				  operative 3-29-2013 (Register 2013, No. 13). A Certificate of Compliance must
				  be transmitted to OAL by 9-25-2013 or emergency language will be repealed by
				  operation of law on the following day.
2. Repealed by operation of
				  Government Code section
				  11346.1(g)
				  (Register 2015, No. 12).
3. New section filed 3-16-2015 as an
				  emergency pursuant to Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 857 (Stats. 2014, c. 31); operative 3-16-2015
				  (Register 2015, No. 12). A Certificate of Compliance must be transmitted to OAL
				  by 3-16-2017 pursuant to Government Code section
				  100504 or
				  emergency language will be repealed by operation of law on the following
				  day.
4. Senate Bill 75 (Stats. 2015, Ch. 18) modified Government
				  Code section
				  100504(a)(6)
				  to change the date upon which a Certificate of Compliance must be transmitted
				  to OAL. Pursuant to Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 75 (Stats. 2015, Ch. 18), a Certificate of
				  Compliance must be transmitted to OAL by 3-16-2018 or the language in the
				  emergency order of 3-16-2015 will be repealed by operation of law on the
				  following day (Register 2015, No. 38).
5. Repealed by operation of
				  Government Code section
				  11346.1(g)
				  (Register 2019, No. 39).
Note: Authority cited: Sections
					 100504 and
					 100505,
					 Government Code. Reference: Sections
					 100502,
					 100503,
					 100504 and
					 100505,
					 Government Code.
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 3 - Competitive Process for Selecting Qualified Health Plans [Repealed] › Section 6428 - Qualified Health Plan (QHP) Issuer Recertification Application for Plan Year 2016 Dated January 15, 2015. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New section
				  filed 2-5-2015 as an emergency pursuant to Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 857 (Stats. 2014, c. 31); operative 2-5-2015
				  (Register 2015, No. 6). A Certificate of Compliance must be transmitted to OAL
				  by 2-5-2017, pursuant to Government Code section
				  100504 or
				  emergency language will be repealed by operation of law on the following
				  day.
2. Senate Bill 75 (Stats. 2015, Ch. 18) modified Government
				  Code section
				  100504(a)(6)
				  to change the date upon which a Certificate of Compliance must be transmitted
				  to OAL. Pursuant to Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 75 (Stats. 2015, Ch. 18), a Certificate of
				  Compliance must be transmitted to OAL by 2-4-2018 or the language in the
				  emergency order of 2-5-2015 will be repealed by operation of law on the
				  following day (Register 2015, No. 38).
3. Editorial correction of
				  HISTORIES 1 and 2 (Register 2019, No. 39).
4. Repealed by operation
				  of Government Code section
				  11346.1(g)
				  (Register 2019, No. 39).
Note: Authority: Sections
					 100504 and
					 100505,
					 Government Code. Reference: Sections
					 100502,
					 100503,
					 100504 and
					 100505,
					 Government Code.
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 3 - Competitive Process for Selecting Qualified Health Plans [Repealed] › Section 6430 - Qualified Health Plan (QHP) New Entrant Certification Application for Plan Year 2016 Dated January 15, 2015. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New section
				  filed 2-5-2015 as an emergency pursuant to Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 857 (Stats. 2014, c. 31); operative 2-5-2015
				  (Register 2015, No. 6). A Certificate of Compliance must be transmitted to OAL
				  by 2-5-2017, pursuant to Government Code section
				  100504 or
				  emergency language will be repealed by operation of law on the following
				  day.
2. Senate Bill 75 (Stats. 2015, Ch. 18) modified Government
				  Code section
				  100504(a)(6)
				  to change the date upon which a Certificate of Compliance must be transmitted
				  to OAL. Pursuant to Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 75 (Stats. 2015, Ch. 18), a Certificate of
				  Compliance must be transmitted to OAL by 2-5-2018 or the language in the
				  emergency order of 2-5-2015 will be repealed by operation of law on the
				  following day (Register 2015, No. 38).
3. Editorial correction of
				  HISTORIES 1 and 2 (Register 2019, No. 39).
4. Repealed by operation
				  of Government Code section
				  11346.1(g)
				  (Register 2019, No. 39).
Note: Authority: Sections
					 100504 and
					 100505,
					 Government Code. Reference: Sections
					 100502,
					 100503,
					 100504 and
					 100505,
					 Government Code.
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 3 - Competitive Process for Selecting Qualified Health Plans [Repealed] › Section 6432 - 2016 Standard Benefit Plan Designs. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New section
				  filed 2-19-2015 as an emergency pursuant to Government Code section
				  100504(a)(6);
				  operative 2-19-2015 (Register 2015, No. 8). A Certificate of Compliance must be
				  transmitted to OAL by 2-19-2017 pursuant to Government Code section
				  100504(a)(6)
				  or emergency language will be repealed by operation of law on the following
				  day.
2. Editorial Correction of HISTORY 1 (Register 2015, No.
				  12).
3. New section refiled with amendments to 2016 Standard Benefit
				  Plan Designs, 3-18-2015 as an emergency pursuant to Government Code section
				  100504,
				  subdivision (a)(6), as modified by Senate Bill 857 (Stats. 2014, c. 31);
				  operative 3-18-2015 (Register 2015, No. 12). A Certificate of Compliance must
				  be transmitted to OAL by 2-19-2017 pursuant to Government Code section
				  100504 or
				  emergency language will be repealed by operation of law on the following
				  day.
4. New section refiled 6-15-2015, with further amendments to
				  2016 Standard Benefit Plan Designs, as an emergency pursuant to Government Code
				  section
				  100504(a)(6),
				  as modified by Senate Bill 857 (Stats. 2014, c. 31); operative 6-15-2015
				  (Register 2015, No. 25). A Certificate of Compliance must be transmitted to OAL
				  by 2-19-2017 pursuant to Government Code section
				  100504 or
				  emergency language will be repealed by operation of law on the following
				  day.
5. Senate Bill 75 (Stats. 2015, Ch. 18) modified Government
				  Code section
				  100504(a)(6)
				  to change the date upon which a Certificate of Compliance must be transmitted
				  to OAL. Pursuant to Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 75 (Stats. 2015, Ch. 18), a Certificate of
				  Compliance must be transmitted to OAL by 2-19-2018 or the language in the
				  emergency order of 6-15-2015 will be repealed by operation of law on the
				  following day (Register 2015, No. 38).
6. Editorial correction of
				  HISTORIES 1, 3, 4 and 5 (Register 2019, No. 39).
7. Repealed by
				  operation of Government Code section
				  11346.1(g)
				  (Register 2019, No. 39).
Note: Authority cited: Section
					 100504,
					 Government Code. Reference: Sections
					 100503 and
					 100504(c),
					 Government Code; Section
					 1366.6(e),
					 Health and Safety Code; and Section
					 10112.3(e),
					 Insurance Code.
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 3 - Competitive Process for Selecting Qualified Health Plans [Repealed] › Section 6434 - Qualified Dental Plan (QDP) Issuer Recertification Application for Plan Year 2016 Dated March 5, 2015. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New section
				  filed 3-16-2015 as an emergency pursuant to Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 857 (Stats. 2014, c. 31); operative 3-16-2015
				  (Register 2015, No. 12). A Certificate of Compliance must be transmitted to OAL
				  by 3-16-2017 pursuant to Government Code section
				  100504 or
				  emergency language will be repealed by operation of law on the following
				  day.
2. Senate Bill 75 (Stats. 2015, Ch. 18) modified Government
				  Code section
				  100504(a)(6)
				  to change the date upon which a Certificate of Compliance must be transmitted
				  to OAL. Pursuant to Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 75 (Stats. 2015, Ch. 18), a Certificate of
				  Compliance must be transmitted to OAL by 3-16-2018 or the language in the
				  emergency order of 3-16-2015 will be repealed by operation of law on the
				  following day (Register 2015, No. 38).
3. Repealed by operation of
				  Government Code section
				  11346.1(g)
				  (Register 2019, No. 39).
Note: Authority cited: Sections
					 100504 and
					 100505,
					 Government Code. Reference: Sections
					 100502,
					 100503,
					 100504 and
					 100505,
					 Government Code.
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 3 - Competitive Process for Selecting Qualified Health Plans [Repealed] › Section 6440 - Dental Plan New Entrant Application for Plan Year 2015. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New section
				  filed 3-10-2014 as an emergency; operative 3-10-2014 (Register 2014, No. 11). A
				  Certificate of Compliance must be transmitted to OAL by 9-8-2014 or emergency
				  language will be repealed by operation of law on the following day. For prior
				  history, see Register 2013, No. 42.
2. New section refiled 9-2-2014
				  as an emergency pursuant to Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 857 (Stats. 2014, c. 31); operative 9-2-2014
				  (Register 2014, No. 36). A Certificate of Compliance must be transmitted to OAL
				  by 3-10-2016 pursuant to Government Code section
				  100504 or
				  emergency language will be repealed by operation of law on the following
				  day.
3. Editorial correction of HISTORY 2 (Register 2014, No.
				  45).
4. Senate Bill 75 (Stats. 2015, Ch. 18) modified Government
				  Code section
				  100504(a)(6)
				  to change the date upon which a Certificate of Compliance must be transmitted
				  to OAL. Pursuant to Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 75 (Stats. 2015, Ch. 18), a Certificate of
				  Compliance must be transmitted to OAL by 3-10-2017 or the language in the
				  emergency order of 9-2-2014 will be repealed by operation of law on the
				  following day (Register 2015, No. 38).
5. Repealed by operation of
				  Government Code section
				  11346.1(g)
				  (Register 2019, No. 39).
Note: Authority cited: Sections
					 100504 and
					 100505,
					 Government Code. Reference: Sections
					 100502,
					 100503,
					 100504 and
					 100505,
					 Government Code.
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 3 - Competitive Process for Selecting Qualified Health Plans [Repealed] › Section 6442 - QHP Certification. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New section
				  filed 1-17-2013 as an emergency; operative 1-17-2013 (Register 2013, No. 3). A
				  Certificate of Compliance must be transmitted to OAL by 7-16-2013 or emergency
				  language will be repealed by operation of law on the following
				  day.
2. New section refiled 7-10-2013 as an emergency; operative
				  7-10-2013 (Register 2013, No. 28). A Certificate of Compliance must be
				  transmitted to OAL by 10-8-2013 or emergency language will be repealed by
				  operation of law on the following day.
3. Repealed by operation of
				  Government Code section
				  11346.1(g)
				  (Register 2013, No. 42).
Note: Authority cited: Sections
					 100502 and
					 100504,
					 Government Code. Reference: Sections
					 100502 and
					 100503,
					 Government Code; 42 U.S.C.
					 Section 18031;
					 45 C.F.R.
					 156.200.
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 3 - Competitive Process for Selecting Qualified Health Plans [Repealed] › Section 6444 - Protest Process. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New section
				  filed 1-17-2013 as an emergency; operative 1-17-2013 (Register 2013, No. 3). A
				  Certificate of Compliance must be transmitted to OAL by 7-16-2013 or emergency
				  language will be repealed by operation of law on the following
				  day.
2. New section refiled 7-10-2013 as an emergency; operative
				  7-10-2013 (Register 2013, No. 28). A Certificate of Compliance must be
				  transmitted to OAL by 10-8-2013 or emergency language will be repealed by
				  operation of law on the following day.
3. Repealed by operation of
				  Government Code section
				  11346.1(g)
				  (Register 2013, No. 42).
Note: Authority cited: Sections
					 100502,
					 100504 and
					 100505,
					 Government Code. Reference: Sections
					 100502 and
					 100505,
					 Government Code.
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 3 - Competitive Process for Selecting Qualified Health Plans [Repealed] › Section 6446 - Pediatric Dental Health Plan Solicitation. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New section
				  filed 3-29-2013 as an emergency; operative 3-29-2013 (Register 2013, No. 13). A
				  Certificate of Compliance must be transmitted to OAL by 9-25-2013 or emergency
				  language will be repealed by operation of law on the following
				  day.
2. Repealed by operation of Government Code section
				  11346.1(g)
				  (Register 2015, No. 39).
Note: Authority cited: Section
					 100504,
					 Government Code. Reference: Sections
					 100502,
					 100503,
					 100504,
					 100505 and
					 100507,
					 Government Code.
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 4 - General Provisions › Section 6452 - Accessibility and Readability Standards

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) All applications, including the single,
				streamlined application described in Section
				6470 of Article 5 of this chapter,
				forms, notices, and correspondence provided to the applicants and enrollees by
				the Exchange and QHP issuers shall conform to the standards outlined in
				subdivisions (b), (c), and (d) of this section. This section shall not be
				interpreted as limiting the application of existing State laws and regulations
				regarding accessibility and readability standards, if any, that apply to the
				QHP issuers.
(b) Information shall
				be provided to applicants and enrollees in plain language, as defined in
				Section 6410 of Article 2 of this chapter,
				and to the extent administratively feasible, all written correspondence shall
				also:
(1) Be formatted and written in such a
				way that it can be understood at the ninth-grade level and, if possible, at the
				sixth-grade level;
(2) Be in print
				no smaller than 12 point-equivalent font; and
(3) Contain no language that minimizes or
				contradicts the information being provided.
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 4 - General Provisions › Section 6454 - General Standards for Exchange Notices

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Any notice of action required to be sent
				by the Exchange to individuals or employers shall be written and include:
(1) An explanation of the action reflected in
				the notice, including the effective date of the action;
(2) Any factual bases upon which the decision
				was made;
(3) Citations to, or
				identification of, the relevant regulations supporting the action;
(4) Contact information for available
				customer service resources, including local legal aid and welfare rights
				offices; and
(5) An explanation of
				appeal rights, as specified in Section
				6604(b) of
				Article 7 of this chapter.
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 4 - General Provisions › Section 6456 - Fingerprinting and Criminal Record Checks

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Definitions. For purposes of this
				section, the following terms shall have the following associated meanings:
(1) Federal Tax Information or FTI: return or
				return information as defined in
				26 U.S.C. §
											6103(b)(1)-(2).
(2) Personal Identifying Information or PII:
				information which can be used to distinguish or trace an individual's identity
				such as their name, social security number, biometric records, etc. alone, or
				when combined with other personal or identifying information which is linked or
				linkable to a specific individual, such as date and place of birth, mother's
				maiden name, etc., consistent with the definition in Office of Management and
				Budget, Memorandum for the Heads of Executive Departments and Agencies, M-07-16
				(May 22, 2007).
(3) Personal Health
				Information or PHI: protected health information or individually identifiable
				health information as defined in
				45 C.F.R.
				160.103.
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 4 - General Provisions › Section 6458 - 2014 Standard Benefit Plan Designs. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New section
				  filed 9-19-2013 as an emergency; operative 9-19-2013 (Register 2013, No. 38). A
				  Certificate of Compliance must be transmitted to OAL by 3-18-2014 or emergency
				  language will be repealed by operation of law on the following
				  day.
2. New section refiled 3-17-2014 as an emergency; operative
				  3-17-2014 (Register 2014, No. 12). A Certificate of Compliance must be
				  transmitted to OAL by 6-16-2014 or emergency language will be repealed by
				  operation of law on the following day.
3. New section refiled
				  6-16-2014 as an emergency; operative 6-16-2014 (Register 2014, No. 25). A
				  Certificate of Compliance must be transmitted to OAL by 9-15-2014 or emergency
				  language will be repealed by operation of law on the following
				  day.
4. Repealed by operation of Government Code section
				  11346.1(g)
				  (Register 2015, No. 9).
Note: Authority cited: Section
					 100504,
					 Government Code. Reference: Sections
					 100503 and
					 100504(c),
					 Government Code; Section
					 1366.6(e),
					 Health and Safety Code; and Section
					 10112.3(e),
					 Insurance Code.
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 4 - General Provisions › Section 6460 - 2015 Standard Benefit Plan Designs. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New section
				  filed 5-21-2014 as an emergency; operative 5-21-2014 (Register 2014, No. 21). A
				  Certificate of Compliance must be transmitted to OAL by 11-17-2014 or emergency
				  language will be repealed by operation of law on the following
				  day.
2. New section refiled 11-17-2014 as an emergency pursuant to
				  Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 857 (Stats. 2014, c. 31); operative 11-17-2014
				  (Register 2014, No. 47). A Certificate of Compliance must be transmitted to OAL
				  by 5-21-2016 pursuant to Government Code section
				  100504 or
				  emergency language will be repealed by operation of law on the following
				  day.
3. Senate Bill 75 (Stats. 2015, Ch. 18) modified Government
				  Code section
				  100504(a)(6)
				  to change the date upon which a Certificate of Compliance must be transmitted
				  to OAL. Pursuant to Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 75 (Stats. 2015, Ch. 18), a Certificate of
				  Compliance must be transmitted to OAL by 5-21-2017 or the language in the
				  emergency order of 11-17-2014 will be repealed by operation of law on the
				  following day (Register 2015, No. 38).
4. Editorial correction of
				  HISTORY 1 (Register 2019, No. 39).
5. Repealed by operation of
				  Government Code section
				  11346.1(g)
				  (Register 2019, No. 39).
Note: Authority cited: Section
					 100504,
					 Government Code. Reference: Sections
					 100503 and
					 100504(c),
					 Government Code; Section
					 1366.6(e),
					 Health and Safety Code; and Section
					 10112.3(e),
					 Insurance Code.
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 4 - General Provisions › Section 6462 - Voter Registration. [Repealed]

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
1. New section
				  filed 10-2-2014 as an emergency pursuant to Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 857 (Stats. 2014, c. 31); operative 10-2-2014
				  (Register 2014, No. 40). A Certificate of Compliance must be transmitted to OAL
				  by 10-2-2016 pursuant to Government Code section
				  100504 or
				  emergency language will be repealed by operation of law on the following
				  day.
2. Senate Bill 75 (Stats. 2015, Ch. 18) modified Government
				  Code section
				  100504(a)(6)
				  to change the date upon which a Certificate of Compliance must be transmitted
				  to OAL. Pursuant to Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 75 (Stats. 2015, Ch. 18), a Certificate of
				  Compliance must be transmitted to OAL by 10-2-2017 or the language in the
				  emergency order of 10-2-2014 will be repealed by operation of law on the
				  following day (Register 2015, No. 38).
3. Repealed by operation of
				  Government Code section
				  11346.1(g)
				  (Register 2019, No. 39).
Note: Authority: Section
					 100504,
					 Government Code. Reference: Sections
					 2400,
					 2401,
					 2403,
					 2406 and
					 2408,
					 Elections Code; and 42
					 U.S.C. §
												1973gg-5.
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 4 - General Provisions › Section 6464 - Identity Verification Requirement

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Definitions. For purposes of this
				section, the following terms shall have the following meanings:
(1) RIDP: Remote Identity Proofing
				service;
(2) FDSH: Federal Data
				Service Hub;
(3) Certified
				Representative:
(A) Service Center
				Representative: an Exchange employee operating in a call center as set forth in
				45 C.F.R. section
				155.205(a);
(B) Certified Enrollment Counselor as defined
				in section
				6650;
(C) Certified Application Counselor as
				defined in 45 C.F.R. section
				155.225;
(D) Certified Insurance Agent as defined in
				section 6800;
(E) Certified Plan-Based Enroller as defined
				in section
				6410.
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 4 - General Provisions › Section 6466 - Average Statewide Monthly Premium

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) On or before each September 1, Covered
				California shall publish the average statewide monthly premium for an
				individual for the following calendar year for a Covered California bronze
				health insurance plan on its public website.
(b) For purposes of this section, the
				"average statewide monthly premium" published pursuant to subdivision (a) for
				the calendar year subsequent to each September 1, means the average statewide
				bronze premium calculated when determining California's Individual Shared
				Responsibility Penalty pursuant to section
				61015, subdivision (a)(2) of the
				Revenue and Taxation Code multiplied by the average age rating factor for
				individuals enrolled in Covered California in the prior calendar
				year.
(c) For purposes of this
				section, "average age rating factor" means the age rating curve established by
				the federal Centers for Medicare and Medicaid Services pursuant to Section
				2701(a)(3) of the
				federal Public Health Service Act (42 U.S.C. Sec.
				300gg(a)(3)), weighted by
				the average age of all enrollees in Covered California qualified health plans
				in the individual market.
1. New section
				  filed 4-8-2021 as an emergency; operative 4-8-2021 (Register 2021, No. 15).
				  Pursuant to Business and Professions Code section
				  7466(b),
				  a Certificate of Compliance must be transmitted to OAL by 4-7-2023 or emergency
				  language will be repealed by operation of law on the following
				  day.
2. Certificate of Compliance as to 4-8-2022 order, including
				  amendment of Note, transmitted to OAL 1-26-2023 and filed 2-23-2023; amendments
				  operative 2-23-2022 pursuant to Government Code section
				  11343.4(b)
				  (Register 2023, No. 8).
Note: Authority cited: Section
					 100504,
					 Government Code; and Section
					 7454,
					 Business and Professions Code. Reference: Section
					 7454,
					 Business and Professions Code; and Section
					 61015,
					 Revenue and Taxation Code.
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 5 - Application, Eligibility, and Enrollment Process for the Individual Exchange › Section 6470 - Application

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) A single,
				streamlined application shall be used to determine eligibility and to collect
				information necessary for:
(1) Enrollment in a
				QHP,
(2) Medi-Cal,
(3) CHIP,
(4) APTC, and
(5) CSR.
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 5 - Application, Eligibility, and Enrollment Process for the Individual Exchange › Section 6472 - Eligibility Requirements for Enrollment in a QHP Through the Exchange

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) An applicant
				who is seeking enrollment in a QHP that is not a catastrophic plan shall meet
				the requirements of this section, except for the requirements specified in
				subdivision (f) of this section, regardless of the applicant's eligibility for
				APTC or CSR. For purposes of this section, an applicant includes all
				individuals listed on the application who are seeking enrollment in a QHP
				through the Exchange. An applicant who is seeking enrollment in a catastrophic
				QHP shall also meet the requirements specified in subdivision (f) of this
				section. An applicant who is seeking enrollment in a QDP shall also meet the
				requirements specified in subdivision (g) of this section.
(b) An applicant who has a SSN shall provide
				his or her SSN to the Exchange.
(c)
				An applicant shall be a citizen or national of the United States, or a
				non-citizen who is lawfully present in the United States, and is reasonably
				expected to be a citizen, national, or a non-citizen who is lawfully present
				for the entire period for which enrollment is sought.
(d) An applicant shall not be incarcerated,
				other than incarceration pending the disposition (judgment) of
				charges.
(e) An applicant shall
				meet one of the following applicable residency standards:
(1) For an individual who is age 21 and over,
				is not living in an institution as defined in
				42 CFR Section
				435.403(b) (March 23, 2012),
				hereby incorporated by reference, is capable of indicating intent, and is not
				receiving Supplemental Security Income/State Supplemental Program payments as
				defined in Title 22, Division 3, Section
				50095 of CCR, the service area of
				the Exchange of the individual is the service areas of the Exchange in which he
				or she is living and:
(A) Intends to reside,
				including without a fixed address; or
(B) Has entered with a job commitment or is
				seeking employment (whether or not currently employed).
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 5 - Application, Eligibility, and Enrollment Process for the Individual Exchange › Section 6474 - Eligibility Requirements for APTC and CSR

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Those individuals who apply to receive
				APTC and CSR shall meet the eligibility requirements of this section in
				addition to the requirements of Section
				6472, except for the requirements
				specified in Section
				6472(f) relating
				to enrollment in a catastrophic QHP.
(b) For purposes of this section, household
				income has the meaning given the term in Section
				36 B(d)(2) of IRC (26 USC §
										36B(d)(2)) and in
				26 CFR Section
				1.36B-1(e).
(c) Eligibility for APTC.
(1) A tax filer shall be eligible for APTC
				if:
(A) Tax filer is an "applicable taxpayer"
				as defined in section
				36 B(c)(1) of IRC (26 USC §
												36B(c)(1)) and
				26 CFR Section
				1.36B-2(b) for the benefit
				year for which coverage is requested; and
(B) One or more applicants for whom the tax
				filer expects to claim a personal exemption deduction on their tax return for
				the benefit year, including the tax filer and their spouse:
1. Meets the requirements for eligibility for
				enrollment in a QHP that is not a catastrophic plan through the Exchange, as
				specified in subdivisions (a) through (e) of Section
				6472;
2. Is not eligible for MEC for the full
				calendar month for which APTC would be paid, with the exception of coverage in
				the individual market, in accordance with section
				36 B(c)(2)(B) and (C) of IRC
				(26 USC §
													36B(c)(2)(B), (C)) and
				26 CFR Section
				1.36B-2(a)(2) and (c);
				and
3. Is enrolled in a QHP that is
				neither a catastrophic plan nor a QDP through the Exchange.
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 5 - Application, Eligibility, and Enrollment Process for the Individual Exchange › Section 6476 - Eligibility Determination Process

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) An applicant may request an eligibility
				determination only for enrollment in a QHP through the Exchange.
(b) An applicant's request for an eligibility
				determination for an IAP shall be deemed a request for all IAPs.
(c) The Exchange shall determine an applicant
				eligible for an enrollment period if they meet the criteria for an enrollment
				period, as specified in Sections
				6502 and
				6504.
(d) The following special rules relate to
				APTC.
(1) An enrollee may accept less than
				the full amount of APTC for which they are determined eligible.
(2) To be determined eligible for APTC, a tax
				filer shall make the following attestations as applicable:
(A) They will file an income tax return for
				the benefit year, in accordance with Sections
				6011 and
				6012
				of IRC (26 USC §§
												6011,
				6012) and the implementing
				regulations;
(B) If married (within
				the meaning of 26 CFR
				Section 1.77031), they will file a joint tax
				return for the benefit year, unless they satisfy one of the exceptions
				specified in 26 CFR Section
				1.36B-2(b)(2)(ii)-(v);
(C) No other taxpayer will be able to claim
				them as a tax dependent for the benefit year; and
(D) They will claim a personal exemption
				deduction on their tax return for the applicants identified as members of their
				family, including the tax filer and their spouse, in accordance with Section
				6482(d).
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 5 - Application, Eligibility, and Enrollment Process for the Individual Exchange › Section 6478 - Verification Process Related to Eligibility Requirements for Enrollment in a QHP Through the Exchange

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The
				Exchange shall verify or obtain information as provided in this section to
				determine whether an applicant meets the eligibility requirements specified in
				Section 6472 relating to the eligibility
				requirements for enrollment in a QHP through the Exchange.
(b) Verification of SSN.
(1) For any individual who provides their SSN
				to the Exchange, the Exchange shall transmit the SSN and other identifying
				information to HHS, which will submit it to the SSA.
(2) If the Exchange is unable to verify an
				individual's SSN through the SSA, or the SSA indicates that the individual is
				deceased, the Exchange shall follow the procedures specified in Section
				6492, except that the Exchange
				shall provide the individual with a period of 95 days from the date of the
				notice described in Section
				6492(a)(2)(A) for
				the applicant to provide satisfactory documentary evidence or resolve the
				inconsistency with the SSA. If the Exchange determines on a case-by-case basis
				that the individual has demonstrated that they did not receive the notice
				within five days from the date of the notice, the individual shall have 90 days
				from the date on which they received the notice to provide satisfactory
				documentary evidence to the Exchange or resolve the inconsistency with the
				SSA.
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 5 - Application, Eligibility, and Enrollment Process for the Individual Exchange › Section 6482 - Verification of Family Size and Household Income Related to Eligibility Determination for APTC and CSR

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) For
				purposes of this section, "family size" and "household income" have the
				meanings given the terms in Section
				36 B(d)(1) and (2) of IRC
				(26 USC §
										36B(d)(1), (2)) and in
				26 CFR Section
				1.36B-1(d), (e).
(b) For all individuals whose income is
				counted in calculating a tax filer's household income, in accordance with
				Section 36 B(d)(2) of IRC (26 USC §
										36B(d)(2)) and
				26 CFR Section
				1.36B-1(e), or an
				applicant's household income, calculated in accordance with
				42 CFR Section
				435.603(d), and for whom the
				Exchange has a SSN, the Exchange shall:
(1)
				Request tax return data regarding MAGI and family size from the Secretary of
				the Treasury and data regarding Social Security benefits described in
				26 CFR Section
				1.36B-1(e)(2)(iii) from the
				Commissioner of Social Security by transmitting identifying information
				specified by HHS to HHS; and
(2)
				Proceed in accordance with the procedures specified in Section
				6492(a)(1) if the
				identifying information for one or more individuals does not match a tax record
				on file with the IRS that may be disclosed in accordance with Section
				6103(l)(21) of
				IRC (26 USC §
											6103(l)(21)) and its
				accompanying regulations.
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 5 - Application, Eligibility, and Enrollment Process for the Individual Exchange › Section 6484 - Verification Process for Changes in Household Income Related to Eligibility Determination for APTC and CSR

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Except as provided in subdivisions (b)
				and (c) of this section, the Exchange shall accept the applicant's attestation
				regarding the tax filer's annual household income without further verification
				if:
(1) An applicant attests, in accordance
				with Section
				6482(e)(2), that
				a tax filer's annual household income has increased, or is reasonably expected
				to increase, from the income described in Section
				6482(e)(1) for
				the benefit year for which the applicant(s) in the tax filer's family are
				requesting coverage; and
(2) The
				Exchange has not verified the applicant's MAGI-based income to be within the
				applicable Medi-Cal or CHIP MAGI-based income standard, in accordance with the
				process specified in Medicaid regulations at
				42 CFR Sections
				435.945 (November 30, 2016), hereby
				incorporated by reference, 435.948 (March 23, 2012), hereby incorporated by
				reference, and 435.952 (November 30, 2016), hereby incorporated by reference,
				and CHIP regulations at 42
				CFR Section 457.380 (November 30, 2016),
				hereby incorporated by reference.
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 5 - Application, Eligibility, and Enrollment Process for the Individual Exchange › Section 6486 - Alternate Verification Process for APTC and CSR Eligibility Determination for Decreases in Annual Household Income or if Tax Return Data is Unavailable

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) A tax filer's
				annual household income shall be determined based on the alternate verification
				procedures described in subdivisions (b) and (c) of this section if:
(1) An applicant attests to projected annual
				household income in accordance with Section
				6482(e)(2);
(2) The tax filer does not meet the criteria
				specified in Section
				6484;
(3) The Exchange has not verified the
				applicant's MAGI-based income to be within the applicable Medi-Cal or CHIP
				MAGI-based income standard, in accordance with the process specified in
				Medicaid regulations at 42
				CFR Sections 435.945,
				435.948, and
				435.952 and CHIP regulations at
				42 CFR Section
				457.380; and
(4) One of the following conditions is met:
(A) The IRS does not have tax return data
				that may be disclosed under Section
				6103 (
l
)(21) of
				IRC (26 USC §
												6103 (
l
)(21)) for the tax
				filer that is at least as recent as the calendar year two years prior to the
				calendar year for which APTC and CSR would be effective;
(B) The applicant attests that the tax
				filer's applicable family size has changed, or is reasonably expected to change
				(or the members of the tax filer's family have changed, or are reasonably
				expected to change), for the benefit year for which the applicants in the tax
				filer's family are requesting coverage;
(C) The applicant attests that a change in
				circumstances has occurred, or is reasonably expected to occur, and so the tax
				filer's annual household income has decreased, or is reasonably expected to
				decrease, from the income obtained from the data sources described in Section
				6482(b)(1) for
				the benefit year for which the applicants in the tax filer's family are
				requesting coverage;
(D) The
				applicant attests that the tax filer's filing status has changed, or is
				reasonably expected to change, for the benefit year for which the applicants in
				the tax filer's family are requesting coverage; or
(E) An applicant in the tax filer's family
				has filed an application for unemployment benefits.
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 5 - Application, Eligibility, and Enrollment Process for the Individual Exchange › Section 6490 - Verifications of Enrollment in an Eligible Employer-Sponsored Plan and Eligibility for Qualifying Coverage in an Eligible Employer-Sponsored Plan Related to Eligibility Determination for APTC and CSR

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The Exchange shall verify whether an
				applicant reasonably expects to be enrolled in an eligible employer-sponsored
				plan or is eligible for qualifying coverage in an eligible employer-sponsored
				plan for the benefit year for which coverage is requested.
(b) The Exchange shall obtain:
(1) Data about enrollment in and eligibility
				for an eligible employer-sponsored plan from any HHS-approved electronic data
				sources that are available to the Exchange;
(2) Any available data regarding enrollment
				in employer-sponsored coverage or eligibility for qualifying coverage in an
				eligible employer-sponsored plan based on federal employment by transmitting to
				HHS identifying information specified by HHS to provide the necessary
				verification using data obtained by HHS; and
(3) Any available data from
				SHOP.
California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 5 - Application, Eligibility, and Enrollment Process for the Individual Exchange › Section 6494 - Special Eligibility Standards and Verification Process for Indians

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) An Indian
				applicant's eligibility for CSR shall be determined based on the following
				procedures.
(1) An Indian applicant shall be
				eligible for CSR if the applicant:
(A) Meets
				the eligibility requirements specified in Sections
				6472 and
				6474(c);
(B) Is expected to have a household income,
				as defined in section
				36 B(d)(2) of IRC (26 USC §
												36B(d)(2)) and in
				26 CFR Section
				1.36B-1(e), that does not
				exceed 300 percent of the FPL for the benefit year for which coverage is
				requested; and
(C) Is enrolled in a
				QHP through the Exchange.