Cal. Code Regs. tit. 10 § 2699.6139

Current through Register 2024 Notice Reg. No. 45, November 8, 2024

Section 2699.6139 - Open Enrollment Period for Sole Employers

(a) The program shall provide for an annual open enrollment period which shall last for at least thirty (30) consecutive days. During this period, enrolled sole employees may transfer from one health benefits plan to another, sole employees may choose to enroll themselves and their dependents in the program and enrolled sole employees may choose to enroll their dependents.

(b) Late applicants may enroll during this period.

(c) If a sole employee of a qualified sole employer is determined not to be a sole employee by the program, or if a person for whom coverage as a dependent has been requested is determined not to be a dependent, the sole employer shall be notified of the determination and the sole employer shall notify the sole employee. The notice shall include the reason for the determination of ineligibility and an explanation of the appeal process. The portion of the sole employer's premium covering amounts owed for coverage to persons found either to be ineligible or not a dependent shall be refunded.

(d) For sole employees applying during an open enrollment period, the sole employer shall provide the following:

(1) For sole employees transferring to a new health benefits plan:

(A) Name.

(B) Address.

(C) Social Security Number, as defined in Section 2699.6000.

(D) Current Health Benefits Plan.

(E) New Health Benefits Plan.

(F) Name and social security number, as defined in Section 2699.6000, and, if available, for enrolled dependents.

(2) For sole employees or dependents who have not previously been enrolled:

(A) The information required by Section 2699.6121(d)(2) of this part,

(3) The sole employer's most recent state EDD Form DE-6 (entitled "Quarterly Wage Report") or Form DE3B (entitled "Report of Wages") or DE3DP (entitled "Quarterly Contribution Report") as submitted to the EDD and a copy of the Federal W-4 form or employer payroll records for any employee not listed on the EDD forms submitted to the program.

Cal. Code Regs. Tit. 10, § 2699.6139

1. Renumbering and amendment of former section 2699.6242 to section 2699.6139 filed 5-27-94; operative 5-27-94 (Register 94, No. 21).
2. Amendment of subsection (d)(2)(A)(3) filed 10-18-95; operative 10-18-95 pursuant to Government Code section 11343.4(d) (Register 95, No. 42).

Note: Authority cited: Section 10731, Insurance Code. Reference: Section 10731, Insurance Code.