100805.
(a) A premium assistance subsidy provided by the program shall be able to be advanced to program participants and shall be remitted by the Exchange to a qualified health plan issuer, based on the program participant’s projected household income, family size, and other factors determined pursuant to the program design and subject to reconciliation against actual household income, family size, and other factors determined pursuant to the program design as provided in Section 100810.(b) A premium assistance subsidy provided by the program shall be provided only to a California resident who is eligible for the federal premium tax credit authorized under Section 36B of the Internal Revenue Code, except that premium assistance subsidy shall not be subject to the income requirements of that section.
(c) Gross income, as defined in Section 17071 of the Revenue and Taxation Code, does not include an amount received as a premium assistance subsidy provided by the program.
(d) The premium assistance subsidy shall provide the following assistance:
(1) For a program participant with a household income at or below 138 percent of federal poverty level, the premium assistance subsidy shall reduce the premiums to zero.
(2) For a program participant with a household income of 139 percent to 400 percent, inclusive, of the federal poverty level, the premium assistance subsidy shall be scaled based on income to reduce the premiums to no more than 8 percent of the household income.
(3) For a program participant with a household income of 401 percent to 600 percent, inclusive, of the federal poverty level, the premium assistance subsidy shall be scaled based on income to reduce the premiums to 8 percent to 15 percent, inclusive, of the household income.