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UNDERSTAND
CALIFORNIA SMALL BUSINESS
 
INDIVIDUAL FAMILY

Specific information for individual family coverage

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SMALL BUSINESS

Specific information Small Group coverage for 2-50 employees
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SENIOR

Specific information for Seniors eligible for Medicare Supplement


Guide provided by http://www.dmhc.ca.gov/ 

Group Health Insurance in California

Group health insurance is insurance you may get through your job or union, or as a retiree. It usually costs less than individual health insurance, which you buy on your own.

Sign Up for California Group Health Insurance

  • When you start a new job, ask how to sign up for health insurance, when your health insurance starts, and what your share of the cost is.
  • Compare plans. Look at all the plans your employer offers to find the one that offers the most benefits you need.
  • You can add new dependents to your health plan when you marry, have a baby, or adopt a child. You may also be able to add a domestic partner. When you add someone to your health plan, your monthly premium may go up.
  • Most employers have Open Enrollment in the fall of each year. Open Enrollment is when you can change your benefit choices. For example, you can change health plans if your employer offers more than one plan.

Waiting Periods and Pre-Existing Conditions

The California group health plan at your new job cannot refuse to cover you if you have a pre-existing condition (an injury or illness that started before you joined the plan). However, some plans have a waiting period before the pre-existing condition is covered. The waiting period cannot be more than 6 months.

  • There is no waiting period if you have not had diagnosis or care for your injury or illness in the last 6 months.
  • There is no waiting period if you had previous health insurance for 6 months with no gaps of more than 62 days before your last insurance ended and the new insurance starts. This is called having creditable coverage.
  • There is a shortened waiting period if you had health insurance for less than 6 months with no gaps of more than 62 days before your last insurance ended and the new insurance starts.

Keep Your Group Health Insurance

Federal COBRA and Cal-COBRA are laws that help you keep your California group health insurance for a certain amount of time if your job ends, your hours are cut, or you change jobs and there is a waiting period before your new health insurance starts. You will have to pay the premiums yourself. But it may cost less than CA individual health insurance, which is insurance that you buy on your own. And the benefits may be better.

These laws also help your spouse, former spouse, or child keep health insurance after your job ends, or after divorce or your death.

Before Your California Health Insurance Ends

 


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