Current through Register 2024 Notice Reg. No. 38, September 20, 2024
(a) For
purposes of this article, the following terms shall have the following meanings:
(1) "Applicant" means an individual who is seeking
an exemption from the Minimum Essential Coverage Individual Mandate established in
Title 24 of the Government Code or from the requirement to maintain minimum
essential coverage under Section 5000A of the Internal
Revenue Code (26 USC §
5000A) for the purpose of enrollment in a
catastrophic plan through an application submitted to the Exchange.
(2) "Application filer" means an applicant, an
individual who is liable for the Individual Shared Responsibility Penalty under Part
32 of Division 2 of the Revenue and Taxation Code or the shared responsibility
payment under Section 5000A(b) of the Internal
Revenue Code (26 USC §
5000A(b)) for an applicant, an
authorized representative, or if the applicant is a minor or incapacitated, someone
acting responsibly for an applicant.
(3)
"Certificate of exemption" is a certification attesting that the individual is
exempt from the Minimum Essential Coverage Individual Mandate established in Title
24 of the Government Code or from the requirement to maintain minimum essential
coverage under Section 5000A of the Internal Revenue Code
(26 USC §
5000A) and the Individual Shared Responsibility
Penalty imposed under Section
61010
of the Revenue and Taxation Code.
(4)
"Exemption" means an exemption from the Minimum Essential Coverage Individual
Mandate established in Title 24 of the Government Code and the Individual Shared
Responsibility Penalty imposed under Section
61010
of the Revenue and Taxation Code or from the requirement to maintain minimum
essential coverage under Section 5000A of the Internal
Revenue Code (26 USC §
5000A) for the purpose of enrollment in a
catastrophic plan through an application submitted to the Exchange.
(5) "Household income" has the same meaning given
the term in Section 5000A(c)(4)(B) of the Internal
Revenue Code (26 USC §
5000A(c)(4)(B)) and in
26 CFR Section
1.5000A-1(d)(10) (December 26,
2013), hereby incorporated by reference.
(6) "Incarcerated" has the same meaning given the
term in Section
6410.
(7) "Indian tribe" has the same meaning given the
term in Section
6410.
(8) "Individual Shared Responsibility Penalty" has
the same meaning given the term in Section
61010
of the Revenue and Taxation Code.
(9)
"Projected household income" means the household income that the applicant
reasonably expects for the calendar year.
(10) "Qualified individual" means an individual
who meets the eligibility standards for exemption through the Exchange, as specified
in Section 6914.
(11) "Required contribution" has the same meaning
given the term in Section 5000A(e)(1)(B) of the Internal
Revenue Code (26 USC §
5000A(e)(1)(B)).
(12) "Tax filer" has the same meaning given the
term in Section
6410. "Tax filer" also includes an
individual who is required to make a return to the Franchise Tax Board in accordance
with Section
18501
of the Revenue and Taxation Code.
(b) For purposes of this article, any attestation
that an applicant is to provide under this article may be made by the application
filer on behalf of the applicant.
(c)
For purposes of this article, information obtained through electronic data sources,
information provided by the applicant, or other information in the records of the
Exchange shall be considered to be reasonably compatible with an applicant's
attestation if the difference or discrepancy does not impact the applicant's
eligibility for the exemption or exemptions for which the applicant
applied.
(d) Information, including
notices, forms, and applications, shall be provided to applicants in accordance with
the accessibility and readability standards specified in Section
6452.
Note: Authority cited: Sections
100504 and
100725,
Government Code. Reference: Sections
100502,
100705 and
100715,
Government Code; Section
61010,
Revenue and Taxation Code; 26 USC
Section 5000A; and
45 CFR Section
155.600.
Note: Authority cited: Sections
100504 and
100725,
Government Code. Reference: Sections
100502,
100705 and
100715,
Government Code; Section
61010,
Revenue and Taxation Code; 26 USC
Section 5000A; and
45 CFR Section
155.600.
