Will owner-only groups be eligible small employer groups outside of Covered California?

No.

Can an existing small group enroll in Covered California?

Yes, if the small business meets the eligibility criteria. See pages 4-5 in the Eligibility and Enrollment for the Covered California for Small Business participant guide.

Are small employers who do not meet the 9.5% affordability requirement penalized/taxed?

The Affordable Care Act only requires employers that employed an average of at least 50 full-time (FT) and full-time equivalent (FTE) employees in the prior calendar year to offer Minimum Essential Coverage, that is Minimum Value and affordable, to substantially all of its FT employees and their dependents (does not include spouses).  Employers with less than 50 FT plus FTE employees will not be assessed a penalty for not meeting the affordability requirement.

Can an employer choose more than 1 tier?

Starting with coverage effective October 1st, employers may offer Covered California for Small Business plans from two adjacent metal tiers. The two tiers will not be available for existing groups until they come up for renewal. No exceptions for mid-year contract plan changes.

If a group grows to more than 100 employees mid-year, when do they lose eligibility for Covered California for Small Business?

By Federal Regulation, groups cannot be terminated or not allowed to re-enroll based upon the group growing to a size bigger than what was allowed at initial eligibility.

What is the participation requirement for Covered California for Small Business?

70%

If an employer covers only employees, how does an employee get coverage for the remainder of the family?

There are a number of coverage options for the remainder of the family, which includes, but is not limited to the following:

1. They can purchase coverage through Covered California’s individual and family market and possibly be eligible for premium assistance and cost-sharing reductions.
2. They may be eligible for Medi-Cal.
3. They can shop in the private individual and family market.

How does an employer/agent provide supporting documents (ex. DE-9C, etc.) with an online application?

Documents may be submitted by fax, U.S. mail, or scanned and attached using secure email.

Are employees with individual subsidized coverage counted towards the Covered California for Small Business 70% participation requirement?

Enrollment in the Individual Marketplace is not a valid waiver

Will Covered California for Small Business be administrating Cal Cobra coverage?

Yes, but it will be billed separately.