Amendments Made to California State-Based SHOP Regulations

On April 17, 2017, the California Office of Administrative Law approved emergency amendments to three sections of Title 10 of the California Code of Regulations (Sections 6520, 6522 and 6528). These regulations establish standards and processes for small employers to qualify for and enroll in the state-based Small Business Health Options Program (SHOP). These amendments were made as a result of updates to state and federal law, and also to streamline processes and improve language clarity.

The first amendment includes a new requirement that employers disclose any contributions to employees’ group dental premiums when applying for SHOP coverage. The second adds criteria specifically for SHOP group dental plan eligibility. The third clarifies that a new employee’s waiting period is calculated as of the eligibility date, regardless of when the employer actually notifies the SHOP.

Thus, employers wishing to enroll in California SHOP coverage should make note of these changes and include any newly applicable information. These amendments are effective as of April 17, 2017, and will expire on Oct. 1, 2018.

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