Section 2699.6167 - Participating Sole Employer Disqualification(a) A sole employer shall be disqualified from participation in the program if any of the following occur: (1) It is found by the program pursuant to Section 2699.6117 to no longer be a qualified sole employer. However, an employer shall not be determined to be no longer eligible to participate in the program solely because the employer employs more than 50 eligible employees, provided the employer employs no more than 100 eligible employees.(2) It is found by the program to no longer be in compliance with the participation requirements as set forth in Section 2699.6107.(3) It fails to pay the monthly employer premium for the enrolled sole employees and enrolled dependents as set forth in Section 2699.6311 and 2699.6313 of this chapter.(4) It so requests in writing. Such requests shall be provided to the program at least thirty (30) calendar days prior to the effective date of the requested disqualification.(5) It has committed an act of fraud or misrepresentation to circumvent the statutes or regulations of the program.(b) When a participating employer is disqualified pursuant to (a)(1), (a)(2), (a)(3), or (a)(5) above, the program shall notify the employer and each enrolled sole employee of the disqualification. Notices sent to enrolled sole employees shall be sent to their addresses of record.(1) The notice shall be in writing and include the following information: (A) The reason for the disqualification,(B) The effective date of disqualification, and(C) The final day of coverage provided through the program.(2) When an employer is disqualified pursuant to (a)(2), the notice shall be sent after thirty-one (31) calendar days following the premium due date and also include a statement that the employer may again be qualified if the employer meets the requirements of Section 2699.6319 and a statement of the requirements of Section 2699.6319.(c) An employer which is disqualified pursuant to (a)(1) above may reapply to the program whenever it again meets the requirements to be a qualified sole employer.(d) An employer which is disqualified pursuant to (a)(2), (a)(4) or (a)(5) above, or an employer disqualified pursuant to (a)(3) above which does not reinstate pursuant to Section 2699.6319, cannot participate in the program for one (1) year from the date of disqualification.Cal. Code Regs. Tit. 10, § 2699.6167
1. Renumbering and amendment of former section 2699.626 to section 2699.6167 filed 5-27-94; operative 5-27-94 (Register 94, No. 21).
2. Amendment of subsections (a)(1), (a)(2), (b), and NOTE filed 12-29-94 as an emergency; operative 12-29-94 (Register 94, No. 52). A Certificate of Compliance must be transmitted to OAL 4-28-95 or emergency language will be repealed by operation of law on the following day.
3. Certificate of Compliance as to 12-29-94 order including amendment of subsection (a)(1) transmitted to OAL 4-12-95 and filed 5-22-95 (Register 95, No. 21).
4. Amendment of subsection (a)(1), new subsection (a)(2) and subsection renumbering, and amendment of subsections (b) and (d) filed 5-5-97; operative 7-1-97 (Register 97, No. 19). Note: Authority cited: Section 10731, Insurance Code. Reference: Sections 10731, 10733.5 and 10743, Insurance Code.
1. Renumbering and amendment of former section 2699.626 to section 2699.6167 filed 5-27-94; operative 5-27-94 (Register 94, No. 21).
2. Amendment of subsections (a)(1), (a)(2), (b), and Note filed 12-29-94 as an emergency; operative 12-29-94 (Register 94, No. 52). A Certificate of Compliance must be transmitted to OAL 4-28-95 or emergency language will be repealed by operation of law on the following day.
3. Certificate of Compliance as to 12-29-94 order including amendment of subsection (a)(1) transmitted to OAL 4-12-95 and filed 5-22-95 (Register 95, No. 21).