California Code of Regulations
Title 10 - Investment
Chapter 5.7 - Voluntary Alliance Uniting Employers Purchasing Pool (the Health Insurance Plan of California)
Article 4 - Employer Premiums
Section 2699.6307 - Program Participation Fee

Universal Citation: 10 CA Code of Regs 2699.6307

Current through Register 2024 Notice Reg. No. 38, September 20, 2024

(a) This subsection applies to sole employers and guaranteed associations with effective dates of coverage prior to September 1, 1998 who have not made an election pursuant to Section 2699.6116.

(1) The program shall establish a program participation fee to be paid as part of the employer premium or individual member premium. The program shall include an amount to be paid for participation for dental coverage if the employer or individual member participates in the dental benefits option. The amount of the fee shall be sufficient to cover necessary administrative costs in connection with the program. Small employers enrolling after July 1, 1996 and before July 1, 1997 who do not utilize the services of an agent or broker shall pay, as an additional part of their program participation fee, a monthly amount equal to the monthly amounts specified in subsections 2699.6194(a)(4) and 2699.6196(a)(1)(D) for the first year and subsections 2699.6194(a)(5)(B) and 2699.6196(a)(1)(E)2. for the second year to compensate for the program's application, open enrollment and requalification assistance. Small employers enrolling on or after July 1, 1997 who do not utilize the services of an agent or a broker shall pay, as an additional part of their program participation fee, a monthly amount equal to the monthly amount specified in subsections 2699.6194(a)(4) and 2699.6196(a)(1)(D) for the first year and subsections 2699.6194(a)(5)(C) and 2699.6195(a)(1)(E)3. for the second year to compensate for these services.

(b) This section applies to sole employers and guaranteed associations with effective dates of coverage on or after September 1, 1998 or who have made an election pursuant to Section 2699.6116.

(1) The program shall establish a program participation fee that is a percentage of the comprehensive individual medical premium and the comprehensive individual dental premium.

(2) For sole employers and member employers the program participation fee shall be an amount equal to three and one half percent of the comprehensive individual medical premium and the comprehensive individual dental premium.

(3) For individual members the program participation fee shall be an amount equal to ten percent of the comprehensive individual medical premium and the comprehensive individual dental premium.

(4) The program participation fee shall also include all amounts so designated pursuant to Sections 2699.6194(b), 2699.6195(b), 2699.6196(b) and 2699.6197(b).

1. Renumbering and amendment of former section 2699.643 to new section 2699.6307 filed 5-23-94 as an emergency; operative 5-23-94 (Register 94, No. 21). A Certificate of Compliance must be transmitted to OAL by 9-20-94 or emergency language will be repealed by operation of law on the following day.
2. Certificate of Compliance as to 5-23-94 order transmitted to OAL 9-16-94 and filed 10-27-94 (Register 94, No. 43).
3. Editorial correction of HISTORY 1 (Register 94, No. 43).
4. Amendment filed 4-25-96; operative 5-25-96 (Register 96, No. 17).
5. Amendment filed 6-3-97; operative 7-1-97 pursuant to Government Code section 11343.4(d) (Register 97, No. 23).
6. Amendment filed 7-3-98 as an emergency; operative 7-3-98 (Register 98, No. 27). A Certificate of Compliance must be transmitted to OAL by 11-2-98 or emergency language will be repealed by operation of law on the following day.
7. Certificate of Compliance as to 7-3-98 order, including amendment of subsection (a)(1), transmitted to OAL 10-2-98 and filed 11-16-98 (Register 98, No. 47).

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

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