Section 100523 - Financial assistance; California Health Benefit Exchange(a) Beginning July 1, 2023, the Exchange shall administer a program of financial assistance to help Californians obtain and maintain health benefits through the Exchange if they lose employer-provided health care coverage as a result of a labor dispute. (1) An individual who has lost minimum essential coverage from an employer or joint labor management trust fund as a result of a strike, lockout, or other labor dispute is a prospective enrollee for purposes of financial assistance, including premium assistance and cost-sharing reduction subsidies, provided that the individual meets all eligibility requirements specified in Section 36B of the Internal Revenue Code and Section 18071 of Title 42 of the United States Code, except for the income requirements of those sections. Any household income of the prospective enrollee above 138.1 percent of the federal poverty level for a family of the prospective enrollee's size shall not be taken into account for the prospective enrollee and the members of their tax household. Consistent with existing federal law and rules, an individual shall be screened for eligibility for the federal Medicaid program.(2) An individual described in paragraph (1) shall receive subsidies for health insurance premiums and cost-sharing reductions that provide the same assistance that is provided to other individuals with incomes of 138.1 percent of the federal poverty level who qualify for financial assistance through the Exchange. The cost-sharing reductions shall use a standard benefit design that has an actuarial value of 94 percent or greater, and, effective January 1, 2024, the program design shall have zero deductibles for any covered benefit if the standard benefit design for this income has zero deductibles.(3) The modified adjusted gross income or household income of an individual described in paragraph (1) shall not be calculated to include strike benefits, lockout benefits, or unemployment compensation.(b)(1) To receive financial assistance pursuant to this section, an individual shall provide a self-attestation regarding the loss of minimum essential coverage as a result of a dispute. If further documentation is required, the Exchange shall contact the affected collective bargaining agent and may contact the employer.(2) Notwithstanding Sections 1399.848 and 1399.849 of the Health and Safety Code, and Sections 10965.3 and 10965.4 of the Insurance Code, the effective date of coverage shall be the date of the completed application or a later date, at the discretion of the enrollee.(c) The Exchange, on a monthly basis, shall notify an enrollee receiving financial assistance pursuant to this section that the enrollee is required to notify the Exchange if their household income changes or minimum essential coverage provided by the enrollee's employer is reinstated. The notice shall include information on the potential state and federal income tax consequences of any amount received as a subsidy provided under this section.(d)(1) The Exchange shall maximize federal affordability assistance for an individual enrolled pursuant to this section and shall use state affordability assistance funds for financial assistance not otherwise available under federal law.(2) Financial assistance provided pursuant to this section shall be funded upon appropriation by the Legislature.(e) Gross income, as defined in Section 17071 of the Revenue and Taxation Code, does not include any amount received as a state subsidy provided under this section.Added by Stats 2022 ch 695 (AB 2530),s 1, eff. 1/1/2023.