Health Care Benefits: California

Federal law and guidance on this subject should be reviewed together with this section.

Author: Jayne Zanglein, Western Carolina University

Summary

• California chose to establish a state-based Marketplace under the Affordable Care Act. See Health Insurance Marketplaces Under the ACA.
• California has an individual health insurance mandate. See Individual Health Insurance Mandate.
• Same-sex marriage is legal nationwide. California also recognizes same-sex domestic partnerships. See Same-Sex Partner Benefits.
• California health insurance mandates apply to fully insured group health plans. See Scope of Mandates.
• Group health plans that allow dependents to enroll must include other dependent coverage. See Dependent Coverage.
• Group health plans must provide coverage for certain illnesses, services and supplies. See Required Coverage Provisions.
• Group health plans must provide parity for mental health and substance use disorder benefits. See Mental Health Benefits and Parity.
• Group health plans must provide coverage for certain specified health providers. See Coverage for Specified Providers.
• Employers have notification requirements related to employer-sponsored health coverage and flexible spending accounts (FSAs). See Notice Requirements.
• San Francisco has requirements pertaining to Health Care Benefits. See Local Requirements.