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California Health Insurance Facts

  2. Coverage – If your plan is eligible for the group health plan, the plan has to give you coverage, however if there are eligibility requirements that must be maintained, any slip below these may cause the plan to be void, such as full time status or a certain length of time spent within the company. Once eligible, it is California law for the employee to be allowed to join the plan.
  3. Current Health – Your current health status will not prevent you from receiving coverage. This is usually defined by your employee’s medical history, genetic information or current medical health. Under anti-discrimination laws an employee cannot be denied coverage because of these factors.
  4. Increased Charge – Just as with the coverage, it is illegal, under anti-discrimination laws for the insurance company to charge more for health insurance premiums of employees with health conditions than employees without health conditions.
  5. Waiting Period - Many health care plans have a waiting period before coverage will start which the employer can institute. However, this waiting period must be standard for all employees regardless of their current health.
  6. Enrollment - Special opportunities may arise for employees to enroll in your group health plan if they have not already done so. These special events would be defined as the birth or adoption of a child, marriage and even retirement. These opportunities only last for 30 days from the day of the event.
  7. Disabled Dependent – Under California law, a disabled dependent, such as a child will be covered under the health policy until they reach adulthood. There are limitations, such as the dependent must be considered previously disabled before the health coverage started, was already covered by the plan or has not reached the age limit for dependent coverage.
  8. Coverage Limit – There are federal and state laws currently in place that limit insurance companies from denying coverage for pre-existing conditions. Many insurance companies can limit coverage for a specific amount of time or require that the condition occurred within a certain time frame before joining the group health policy.
  9. Continuous Coverage – A break of not longer than 63 days in a row, is the standard measure for continuous coverage. An employee may transfer to a new job, a new policy or change jobs and as long as the time between coverage periods is less than 63 days, the employee will remain covered.


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