California Code of Regulations › Title 10 - Investment › Chapter 12 - California Health Benefit Exchange › Article 7 - Appeals Process for the Individual Exchange › Section 6622 - Employer Appeals Process

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The
				provisions of this section apply to employer appeals processes through which an
				employer may, in response to a notice under Section
				6476(i) of
				Article 5 of this chapter, appeal a determination that the employer does not
				provide MEC through an employer-sponsored plan or that the employer does
				provide such coverage but it is not affordable coverage with respect to an
				employee or employee's dependent who is an enrollee receiving APTC through the
				Exchange.
(b) An employer who seeks
				an appeal pursuant to paragraph (a) of this section shall request such an
				appeal directly to HHS in accordance with the process specified in
				45 CFR Section
				155.555 (December 22, 2016), hereby
				incorporated by reference, and the process established by HHS.
(c) After receiving an appeal decision that
				affects the enrollee's eligibility, the Exchange shall, within 30 days from the
				date on which the Exchange receives the decision, notify the enrollee of the
				requirement to report changes in eligibility, as described in Section
				6496(b) of
				Article 5 of this chapter.
1. New section
				  filed 5-11-2015 as an emergency pursuant to Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 857 (Stats. 2014, c. 31); operative 5-11-2015
				  (Register 2015, No. 20). A Certificate of Compliance must be transmitted to OAL
				  by 9-30-2015 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				  emergency language will be repealed by operation of law on the following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 9-30-2016 or the language in the
				  emergency order of 5-11-2015 will be repealed by operation of law on the
				  following day (Register 2015, No. 38).
3. New section refiled
				  9-17-2015 as an emergency pursuant to Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 857 (Stats. 2014, c. 31) and Senate Bill 75 (Stats.
				  2015, Ch. 18); operative 9-17-2015 (Register 2015, No. 38). A Certificate of
				  Compliance must be transmitted to OAL by 9-30-2016 pursuant to Government Code
				  section
				  100504 or
				  the language in the emergency order of 9-17-2015 will be repealed by operation
				  of law on the following day.
4. New section refiled 12-14-2015 as an
				  emergency pursuant to Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 857 (Stats. 2014, c. 31) and Senate Bill 75 (Stats.
				  2015, Ch. 18); operative 12-14-2015 (Register 2015, No. 51). A Certificate of
				  Compliance must be transmitted to OAL by 9-30-2016 pursuant to Government Code
				  section
				  100504 or
				  the language in the emergency order of 12-14-2015 will be repealed by operation
				  of law on the following day.
5. New section refiled 6-6-2016 as an
				  emergency pursuant to Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 857 (Stats. 2014, c. 31) and Senate Bill 75 (Stats.
				  2015, Ch. 18); operative 6-6-2016 (Register 2016, No. 24). A Certificate of
				  Compliance must be transmitted to OAL by 9-30-2016 pursuant to Government Code
				  section
				  100504 or
				  the language in the emergency order of 6-6-2016 will be repealed by operation
				  of law on the following day.
6. Senate Bill 833 (Stats. 2016, c. 30)
				  modified Government Code section
				  100504(a)(6)
				  to extend the date upon which a Certificate of Compliance must be transmitted
				  to OAL. Refiling of 6-6-2016 order on 9-30-2016 as a deemed emergency pursuant
				  to Government Code section
				  100504(a)(6);
				  operative 9-30-2016 (Register 2016, No. 40). A Certificate of Compliance must
				  be transmitted to OAL by 10-1-2018 pursuant to Government Code section
				  100504(a)(6)
				  or emergency language will be repealed by operation of law on the following
				  day.
7. New section refiled 2-16-2017 as an emergency pursuant to
				  Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 833 (Stats. 2016, c. 30), Senate Bill 75 (Stats.
				  2015, c. 18) and Senate Bill 857 (Stats. 2014, c. 31); operative 2-16-2017
				  (Register 2017, No. 7). A Certificate of Compliance must be transmitted to OAL
				  by 10-1-2018 pursuant to Government Code section
				  100504(a)(6)
				  or the language in the emergency order of 2-16-2017 will be repealed by
				  operation of law on the following day.
8. New section refiled,
				  including amendment of subsection (a) and new subsection (c) 10-26-2017 as an
				  emergency pursuant to Government Code section
				  100504(a)(6),
				  as modified by Senate Bill 833 (Stats. 2016, c. 30), Senate Bill 75 (Stats.
				  2015, c. 18) and Senate Bill 857 (Stats. 2014, c. 31); operative 10-26-2017
				  (Register 2017, No. 43). A Certificate of Compliance must be transmitted to OAL
				  by 10-1-2018 pursuant to Government Code section
				  100504(a)(6)
				  or the language in the emergency order of 10-26-2017 will be repealed by
				  operation of law on the following day.
9. Certificate of Compliance
				  as to 10-26-2017 order, including further amendment of section, transmitted to
				  OAL 8-10-2018 and filed 9-24-2018; amendments effective 9-24-2018 pursuant to
				  Government Code section
				  11343.4(b)(3)
				  (Register 2018, No. 39).
Note: Authority cited: Section
					 100504,
					 Government Code. Reference: Sections
					 100503 and
					 100506,
					 Government Code; and 45 CFR
					 Section
					 155.555.