In 2020, California residents who do not have creditable health insurance or an exemption will be subject to a California individual mandate penalty. Under California legislation SB 78, employees of small groups who had previously waived coverage will have a Special Enrollment Period to sign up for health insurance through their employer for 2020.
SB 78 Enrollment Period Rules
Rules from Blue Shield of California that may or may not apply to other carriers.
- The SB 78 enrollment period is from December 2, 2019 through January 31, 2020
- The effective date of coverage is January 1, 2020, as long as the eligible employee’s waiting period has been met
- Only an eligible employee who refused coverage in 2019 can enroll, and can enroll their dependent(s), during the SB 78 enrollment period
- Currently enrolled employees may enroll their dependent(s) during the SB 78 enrollment period
- Eligible employees may only choose from a variety health plans.
- Currently enrolled employees are not allowed to make plan changes
- Member materials, including the Summary of Benefits and Coverage (SBC), Evidence of Coverage (EOC) and any required notices, should be distributed to new enrollees consistent with the Group Health Service Contract
- Groups electing to offer coverage to their employees during the SB 78 enrollment period agree to waive provisions in the Group Health Service Contract, the Evidence of Coverage and any other plan documents that limit enrollment of eligible employees to the open enrollment period, the annual enrollment period or a special enrollment period triggered by specified qualifying events
California Senate Bill 78 was signed by Governor Gavin Newsom on June 27, 2019. The law mandates California residents to enroll and maintain minimum essential health coverage for themselves and their dependents every month throughout the year beginning January 1, 2020. Those who fail to maintain qualifying health insurance coverage could face a financial penalty unless they qualify for an exemption.
Generally, a taxpayer who fails to secure coverage will be subject to a penalty of $695 or more when they file their 2020 state income tax return in 2021. The penalty for a dependent child is half of what it would be for an adult.
To the financial penalty, California residents must have minimum essential health coverage for themselves and their dependents for each month of the year beginning on January 1, 2020.
Contact your current small group health administrator to learn more on how to sign up during the Special Enrollment Period.
Special Enrollment For New Small Groups
For small employers who do not offer a small group plan, Covered California has designated a special group enrollment period where groups do not have to minimum participation requirements. From November 15 through December 15 period and will accept submissions all the way through December 31, 2019. During this period, new small groups do not need to meet the minimum participation and contribution requirements; however, eligibility requirements still.
If you are interested in getting a quote for your small group, please use my Contact Page to start the process.