Did You Know Covered California for Small Business has Solutions for Difficult to Cover Employer Groups?
Majority of Employees Out of State:
CCSB allows groups that have a majority of their eligible employees Out of State. The group must be domiciled in California with at least one eligible and enrolling employee/officer.
CCSB also accepts Out of State groups providing
they are part of a controlled group; have at least one controlled group in California and total group size is 100 or less FTEs. A letter from the group CPA is required to write controlled groups with CCSB. The owner/officer in a control group must have at least 50% ownership/shares in each group.
Blue Shield PPO with the Blue Card provider network is available for Out of State employees.
Professional Employer Organization (PEO) Subgroups:
PEO subgroups are eligible to enroll in CCSB. The most recent PEO payroll invoice is required in lieu of a DE9c or payroll register.
Groups Wishing to Offer Employee Only Coverage:
Groups with 1-49 FTEs may offer Employee Only Coverage. This allows dependents (spouse and children) to apply for a subsidy in the Individual Exchange.
Groups of 50-100 FTEs are required to offer coverage to dependent children. If the employer does not offer coverage to spouses, spouses are eligible to apply for a subsidy in the Individual Exchange.
CCSB allows employer groups who wish to cover their domestic staff. These groups must provide their most recently filed DE9c or most recent 30 days of payroll and must meet all applicable eligibility guidelines. CCSB requires a copy of the group’s filed IRS Schedule H and a copy of their IRS Letter with their Employer ID.
Alternatively, if the group is less than 3 months old and has not filed their taxes, CCSB will accept a Fictitious Business Name (FBN) filing in lieu of the Schedule H. The group name on the FBN must match the company name on the submitted DE9c or payroll records.
Your RBG Team is prepared with answers for your group placement needs.