Cal. Code Regs. Tit. 10, § 6534 - Coverage Effective Dates for Special Enrollment Periods
(a)
Except as specified in subdivision (b) of this section, coverage effective
dates for special enrollment periods for a QHP selection received by the SHOP
from a qualified employee:
(1) Shall be no
later than the first day of the following month for applications received
between the first and fifteenth day of any month, or
(2) Shall be no later than the first day of
the second following month for applications received between the sixteenth and
last day of any month.
(b) Special coverage effective dates shall
apply to the following situations:
(1) In the
case of birth, adoption, placement for adoption, placement in foster care, and
assumption of a parent-child relationship, coverage is effective for that
enrollee on the date of birth, adoption, placement for adoption, placement in
foster care, or assumption of a parent-child relationship, or on the first day
of the following month if requested by the enrollee;
(2) In the case of marriage, domestic
partnership or where a qualified employee loses Minimum Essential Coverage, as
described in Section
6530(b)(1),
coverage is effective for that qualified employee or dependent on the first day
of the month following the date the request for special enrollment is received;
and
(3) In the case of a qualified
employee or dependent eligible for a special enrollment period as described in
Section 6530(b)(4) and
6530(b)(5), the
coverage is effective on either:
(A) The date
of the event that triggered the special enrollment period under Section
6530(b)(4) or
6530(b)(5),
or
(B) In accordance with
subdivision (a) of this section, whichever is the least financially burdensome
on the enrollee, as determined by the SHOP.
Notes
Note: Authority cited: Section 100504, Government Code. Reference: Sections 100502 and 100503, Government Code; and 45 CFR Sections 155.725 and 156.285.
Note: Authority cited: Section 100504, Government Code. Reference: Sections 100502 and 100503, Government Code; and 45 CFR Sections 155.725 and 156.285.
2. New section refiled 4-1-2014 as a deemed emergency pursuant to Government Code section 100504(a)(6); operative 4-1-2014 (Register 2014, No. 14). A Certificate of Compliance must be transmitted to OAL by 6-30-2014 or emergency language will be repealed by operation of law on the following day.
3. New section refiled 6-30-2014 as a deemed emergency pursuant to Government Code section 100504(a)(6); operative 6-30-2014 (Register 2014, No. 27). A Certificate of Compliance must be transmitted to OAL by 9-29-2014 or emergency language will be repealed by operation of law on the following day.
4. New section, including amendment of subsections (a)(1)-(2) and (b)(1)-(2), refiled 10-2-2014 as an emergency pursuant to Government Code section 100504(a)(6), as modified by Senate Bill 857 (Stats.
5. Editorial correction of History 3 and History 4 (Register 2014, No. 45).
6. 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 10-2-2014 will be repealed by operation of law on the following day (Register 2015, No. 38).
7. 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 10-2-2014 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.
8. Refiling of 9-30-2016 order, including further amendment of section, on 11-28-2016 as a deemed emergency pursuant to Government Code section 100504(a)(6), as modified by Senate Bill 833 (Stats. 2016, c. 30); operative 11-28-2016 (Register 2016, No. 49). A Certificate of Compliance must be transmitted to OAL by 10-1-2018 pursuant to Government Code section 100504 or emergency language will be repealed by operation of law on the following day.
9. Refiling of 11-28-2016 order, including further amendment of section, filed 4-20-2018 as a deemed emergency pursuant to Government Code section 100504(a)(6), as modified by Senate Bill 833 (Stats. 2016, c.30); operative 4-20-2018 (Register 2018, No. 16). A Certificate of Compliance must be transmitted to OAL by 10-1-2018 pursuant to Government Code section 100504 or emergency language will be repealed by operation of law on the following day.
10. Certificate of Compliance as to 4-20-2018 order, including amendment of Note, transmitted to OAL 8-3-2018 and filed
11. Amendment of subsection (a) filed 9-7-2021 as an emergency; operative
12. Certificate of Compliance as to 9-7-2021 order, including further amendment of subsections (a), (b)(3) and (b)(3)(B), transmitted to OAL 8-22-2024 and filed 9-23-2024; amendments effective
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