Kaiser Announces Relaxed DE9C, Payroll, and Participation Requirements!

Kaiser Announces Latest Small Group Requirements  

Relaxed DE 9C and payroll requirements — New small groups with 6+ enrolling subscribers aren’t required to submit a DE 9C or payroll documentation.*

Reduced payroll requirements for startup businesses — New small groups with fewer than 6 enrolling subscribers that do not yet have a DE 9C for a full quarter can now qualify for coverage by providing 2 weeks of payroll records that show 1 or more eligible employees.*

New Employee Eligibility form – This form documents eligible employees NOT on the DE 9C who were hired in the last 45 days and can’t show 2 weeks of payroll.

Payroll Attestation form – This form is used for new businesses (like a start-up, breakaway, or an existing business that’s establishing payroll) to document eligible employees. Groups are required to submit 30 days of payroll within 45 days of their effective date.*

Reduced participation requirements — Small groups may qualify with only 50% of eligible employees enrolled in a group health plan.

Example: if you have a group of 10 and there are 4 valid waivers (Individual is now a valid waiver in small group), Kaiser Permanente needs only one to enroll.  The 4 valid waivers plus the enrolled subscriber equals 5.  We count the valid waivers as participants, thus, we met the 50% requirement for a group of 10.

Relaxed out-of-state requirement – Out-of-state small groups may qualify with less than 51% of eligible employees in California.

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