III.C · Patient Protection and Affordable Care Act (PPACA)
Covered California, CCSB and agent certification
California runs its own Health Benefit Exchange, Covered California, with two parts: the Individual Exchange and Covered California for Small Business (CCSB).
Why it matters for the client: consumers must buy a QHP through Covered California to receive premium tax credits. CCSB is likewise where a small employer must buy coverage to claim the federal small business health care tax credit.
CCSB size: the CDI outline says the CCSB program serves small businesses with up to 50 employees. Covered California's current Eligibility Guidelines say 100 or fewer full-time-equivalent employees; on the exam, answer 50. Do not confuse it with 25, the size limit for the small business tax credit.
Agents: a California license with accident and health authority is necessary but not enough. Before writing applications for QHPs through Covered California, an agent must first complete all Covered California agent agreements and certification requirements. Federal rules also require registration with the Exchange and training in QHP options and affordability programs.
Remember
· Premium tax credits: QHP bought through Covered California only.
· CCSB: up to 50 employees (outline).
· Agents: complete Covered California agreements and certification first.
CA
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