Cal. Code Regs. Tit. 10, § 6910 - Definitions and General Requirements

Current through Register 2021 Notice, Register No. 40, October 1, 2021

(a) For purposes of this article, the following terms shall have the following meanings:
(1) "Applicant" means an individual who is seeking an exemption from the Minimum Essential Coverage Individual Mandate established in Title 24 of the Government Code or from the requirement to maintain minimum essential coverage under Section 5000 A of the Internal Revenue Code ( 26 USC § 5000A ) for the purpose of enrollment in a catastrophic plan through an application submitted to the Exchange.
(2) "Application filer" means an applicant, an individual who is liable for the Individual Shared Responsibility Penalty under Part 32 of Division 2 of the Revenue and Taxation Code or the shared responsibility payment under Section 5000 A(b) of the Internal Revenue Code ( 26 USC § 5000A(b) ) for an applicant, an authorized representative, or if the applicant is a minor or incapacitated, someone acting responsibly for an applicant.
(3) "Certificate of exemption" is a certification attesting that the individual is exempt from the Minimum Essential Coverage Individual Mandate established in Title 24 of the Government Code or from the requirement to maintain minimum essential coverage under section 5000 A of the Internal Revenue Code ( 26 USC § 5000A ) and the Individual Shared Responsibility Penalty imposed under Section 61010 of the Revenue and Taxation Code.
(4) "Exemption" means an exemption from the Minimum Essential Coverage Individual Mandate established in Title 24 of the Government Code and the Individual Shared Responsibility Penalty imposed under Section 61010 of the Revenue and Taxation Code or from the requirement to maintain minimum essential coverage under section 5000 A of the Internal Revenue Code ( 26 USC § 5000A ) for the purpose of enrollment in a catastrophic plan through an application submitted to the Exchange.
(5) "Household income" has the same meaning given the term in Section 5000 A(c)(4)(B) of the Internal Revenue Code ( 26 USC § 5000A(c)(4)(B) ) and in 26 CFR Section 1.5000A-1(d)(10) (December 26, 2013), hereby incorporated by reference.
(6) "Incarcerated" has the same meaning given the term in Section 6410 of Article 2 of this chapter.
(7) "Indian tribe" has the same meaning given the term in Section 6410 of Article 2 of this chapter.
(8) "Individual Shared Responsibility Penalty" has the same meaning given the term in Section 61010 of the Revenue and Taxation Code.
(9) "Projected household income" means the household income that the applicant reasonably expects for the calendar year.
(10) "Qualified Individual" means an individual who meets the eligibility standards for exemption through the Exchange, as specified in Section 6914.
(11) "Required contribution" has the same meaning given the term in Section 5000 A(e)(1)(B) of the Internal Revenue Code ( 26 USC § 5000A(e)(1)(B) ).
(12) "Tax filer" has the same meaning given the term in Section 6410 of Article 2 of this chapter. "Tax filer" also includes an individual who is required to make a return to the Franchise Tax Board in accordance with Section 18501 of the Revenue and Taxation Code.
(b) For purposes of this article, any attestation that an applicant is to provide under this article may be made by the application filer on behalf of the applicant.
(c) For purposes of this article, information obtained through electronic data sources, information provided by the applicant, or other information in the records of the Exchange shall be considered to be reasonably compatible with an applicant's attestation if the difference or discrepancy does not impact the applicant's eligibility for the exemption or exemptions for which the applicant applied.
(d) Information, including notices, forms, and applications, shall be provided to applicants in accordance with the accessibility and readability standards specified in Section 6452.

Notes

Cal. Code Regs. Tit. 10, § 6910

Note: Authority cited: Sections 100504 and 100725, Government Code. Reference: Sections 100502, 100705 and 100715, Government Code; Section 61010, Revenue and Taxation Code; 26 USC Section 5000A; and 45 CFR Section 155.600.

1. New article 13 (sections 6910-6922 ) and section filed 10-7-2019 as a deemed emergency pursuant to Government Code section 100725(c); operative 1-1-2020 (Register 2019, No. 41). A Certificate of Compliance must be transmitted to OAL by 1-1-2025 pursuant to Government Code section 100725or emergency language will be repealed by operation of law on the following day.
2. New article 13 (section 6910-6922 ) and section refiled 5-11-2020 as a deemed emergency pursuant to Government Code section 100725(c), including new subsection (a)(10) and subsection renumbering; operative 5-11-2020 (Register 2020, No. 20). A Certificate of Compliance must be transmitted to OAL by 1-1-2025 pursuant to Government Code section 100725 or emergency language will be repealed by operation of law on the following day.

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