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What are the consequences of California residents not having health insurance coverage?


Photo by Natasha Spencer


Health Care and Health Insurance laws are constantly changing. Art Young Insurance is here to keep you informed, protected, and in compliance with the latest Health Care laws affecting California residents.


This article covers:

  • California Health Insurance Coverage

  • California Senate Bill 78 (CA SB 78)

  • Affordable Care Act (ACA)

  • Open Enrollment

  • Health Insurance Requirements


Many people have heard that the Affordable Care Act (ACA) requirement that people have health insurance has been eliminated. If you are in California, that is not correct. In 2019, you do not have to pay a federal penalty fee or tax if you do not have coverage, regardless of whether or not you qualify for an individual mandate exemption. However, there are a few states that still enforce the individual mandate - California is one of those states. While Congress did in fact eliminate the federal tax penalty for not having health insurance, effective January 1, 2019 - California residents have a new State law that requires Health Insurance coverage.


California Senate Bill 78 (CA SB 78) requires all California residents, including children, to maintain minimum essential coverage or be subject to a state tax penalty (unless they qualify for an exemption).


The California law is similar to ACA penalties implemented with the Affordable Care Act. Under California SB 78, the tax penalty will be $685 per adult, and $347.50 per child, or 2.5% of annual household income, whichever is greater.


We are in the open enrollment season, when the majority of health care plans are renewed.

We will be happy to review the status of your health insurance for your business or for your family. We will help to ensure that you are in compliance with the new California Senate Bill 78. It is important to know what the current Health Insurance requirements are for you, your family, and your employees.


Please check your plan, or have your broker or advisor check your plan.

Interested in discussing your Health Insurance coverage needs? Contact us today to get started!


Key details directly from California Senate Bill 78 (CA SB 78):


This bill creates the Minimum Essential Coverage Individual Mandate requiring an individual who is a California resident to ensure that the individual, and any spouse or dependent of the individual, is enrolled in and maintains minimum essential coverage for each month beginning on and after January 1, 2020, except as specified. The bill requires the Exchange to grant exemptions from the mandate for reason of hardship or religious conscience, and requires the Exchange to establish a process for determining eligibility for an exemption. The bill imposes the Individual Shared Responsibility Penalty for the failure to maintain minimum essential coverage, as determined and collected by the Franchise Tax Board, in collaboration with the Exchange, as specified. The bill requires the Franchise Tax Board to provide specified information to the Exchange regarding individuals who do not maintain minimum essential coverage, and requires the Exchange to conduct annual outreach and enrollment efforts with those individuals. The bill requires an applicable entity, as defined, that provides minimum essential coverage to an individual to file specified returns to the Franchise Tax Board regarding that coverage, as prescribed.


Contact Art Young Insurance today to get started on a quote.

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