AB 1083, which would implement the federal Patient Protection and Affordable Care Act provisions for small business. California law requires health insurers to sell coverage or “guarantee issue” of coverage to small businesses with 2-50 employees. Rates may vary by 10% depending on the health status of the employees, age, geographic region, and family size. The bill eliminate pricing of premiums based on health status:
- Limits the range of premiums based on age to no more than 3:1 for age rated plans.
- Add the self-employed to those eligible for guaranteed issue of coverage.
- Expand the rules to employers with up to 100 employees.
In addition AB 1083 requires the waiting period for eligibility for non-grandfathered plans to be no greater than 60 days of employment for employers with less than 50 employees.
In 2014, California defines small group as an employer with “at least one, but no more than 50” employees (California Health and Safety Code § 1357.500(k)(1)(A)). Since ACA applies to groups with more than 50 employees, there really is no conflict in 2014 or 2015. The policies for the most part must meet the essential health benefit (EHB) requirements found in the Patient Protection and Affordable Care Act (ACA) and must be available on or after October 1, 2013.