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Indiana Code Title 27. Insurance § 27-8-15-14

Current as of January 02, 2024 | Updated by Findlaw Staff

Sec. 14. (a) This subsection applies only with respect to grandfathered health plan coverage described in 45 CFR 147.140.  As used in this chapter, “small employer” means any person, firm, corporation, limited liability company, partnership, or association actively engaged in business who, on at least fifty percent (50%) of the working days of the employer during the preceding calendar year, employed at least two (2) but not more than fifty (50) eligible employees, the majority of whom work in Indiana.  In determining the number of eligible employees, companies that are affiliated companies or that are eligible to file a combined tax return for purposes of state taxation are considered one (1) employer.

(b) This subsection applies only with respect to a health insurance plan that does not provide grandfathered health plan coverage described in 45 CFR 147.140.  As used in this chapter, “small employer” means any person, firm, corporation, limited liability company, partnership, or association actively engaged in business who:

(1) on at least fifty percent (50%) of the working days of the employer during the preceding calendar year, employed at least one (1) but not more than fifty (50) employees;  or

(2) employed at least one (1) but not more than fifty (50) employees during the preceding calendar year, as calculated under STEP FIVE of the following formula:

STEP ONE:  Determine the average number of employees who were employed to work an average of at least thirty (30) hours per week during the preceding calendar year.

STEP TWO:  Determine the aggregate number of hours worked by employees who were employed to work an average of less than thirty (30) hours per week during the preceding calendar year.

STEP THREE:  Divide the number determined in STEP TWO by twelve (12).

STEP FOUR:  Divide the quotient determined in STEP THREE by one hundred twenty (120).

STEP FIVE:  Add the number determined in STEP ONE and the quotient determined in STEP FOUR to determine the number of employees employed by an employer for purposes of this subdivision.

In determining the number of employees, companies that are treated as a single employer under Section 414(b), 414(c), 414(m), or 414(o) of the Internal Revenue Code are treated as one (1) employer.

(c) With respect to a health insurance plan subject to subsection (b), a small employer insurer shall:

(1) use either the definition under subsection (b)(1) or (b)(2);  and

(2) apply the definition under subsection (b)(1) or (b)(2) in a consistent manner without regard to the claims experience, health status, duration of coverage, or case characteristics of the employees of a small employer.

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Cite this article: FindLaw.com - Indiana Code Title 27. Insurance § 27-8-15-14 - last updated January 02, 2024 | https://codes.findlaw.com/in/title-27-insurance/in-code-sect-27-8-15-14/

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