Section 1357.502 Of Article 3.16. Nongrandfathered Small Employer Plans From California Health And Safety Code >> Division 2. >> Chapter 2.2. >> Article 3.16.
1357.502
. (a) A health care service plan providing or arranging for
the provision of essential health benefits, as defined by the state
pursuant to Section 1302 of PPACA, to small employers shall be
subject to this article if either of the following conditions is met:
(1) Any portion of the premium is paid by a small employer, or any
covered individual is reimbursed, whether through wage adjustments
or otherwise, by a small employer for any portion of the premium.
(2) The plan contract is treated by the small employer or any of
the covered individuals as part of a plan or program for the purposes
of Section 106 or 162 of the Internal Revenue Code.
(b) This article shall not apply to health care service plan
contracts for coverage of Medicare services pursuant to contracts
with the United States government, Medicare supplement, Medi-Cal
contracts with the State Department of Health Care Services,
long-term care coverage, or specialized health care service plan
contracts.