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California Gears Up for Reform Provisions Taking Effect This Year California Healthline

It's been more than a month since President Obama signed health care reform legislation into law. The debate over health care overhaul hasn't stopped since the passage of reform, but the conversation has quickly shifted to implementation.

Many of the most-publicized health reform provisions -- such as the creation of health insurance exchanges and the requirement that most U.S. residents purchase health insurance -- won't take effect for several years. However, there are a slew of provisions slated to go into effect this year that likely will have an immediate impact in California. Here's a rundown.

Effective Immediately -- Small Business Tax Credits : Under the health reform law, small businesses are eligible for tax credits to help offset the cost of providing health insurance to employees. To qualify for the tax credit, a business must have fewer than 25 employees, provide average annual wages of under $50,000 and cover at least 50% of its employees' health insurance premiums. From 2010 through 2013, the tax credit will cover up to 35% of the employer's share of premiums. In 2014, the tax credit will increase to 50%. Not-for-profit, tax-exempt organizations also are eligible for the tax credits -- 25% in 2010 through 2013 and 35% in 2014. According to a March issue brief from UC-Berkeley's Center for Labor Research and Education, California residents who work at small businesses or are self-employed represent a disproportionate 71% of the state's total uninsured population. The center estimates that small California businesses could receive more than $4.4 billion in tax credits over 10 years through the reform provision. California small businesses with fewer than 50 full-time employees are exempt from the reform law's requirement to provide health insurance by 2014, but some analysts say the tax credits and eventually the law's health insurance exchanges could encourage many small businesses to provide insurance. 

Pre-ex with Group when There is IFP Currently?

I'm working with a small company to get them a group health plan (With CalChoice). I need to have 70% participation so it is vital we get the vast majority of the the employees. I got the following last night. I sent it to my GA for an answer but I thought one of you might know. (I've written a lot of small groups, but this has never come up before.)

Quote:
3) One of our employees currently has an individual health plan that she is signed up for and has been on for a while. When she signed up, they denied her coverage for "preexisting" conditions for six month, which she just recently cleared. She is concerned that if she converts over and signs up for our group health plan, she will have to go through a whole new, extended "waiting period" for any "preexisting" conditions.

QUESTION: If an employee who currently has individual
Coverage, and has cleared the waiting period under her existing plan for a preexisting condition, signs up for the proposed compoany plan, will she be penalized (as compared to sticking with her current, individual plan) by having to go through a new waiting period before any "preexisting" condition will be included in her coverage? I'm going to guess that the woman will have to wait six months on pre-ex... which might torpedo the group unless there is a way to get get her to join with double coverage. But why would she want to pay 2 premiums (company is only paying 55% of a low-cost option.) We really need her to make participation ratio. Maybe company could "bonus" her the premium for 6 months... but if it gets out the other are going to be pissed.

According to the CalChoice UW guidelines:

Pre-existing conditions are excluded unless continuously
Insured for six consecutive months. A pre-existing
Condition is an injury or sickness for which the covered...

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