§ 27-8-15-14 — "Small employer"

Indiana § 27-8-15-14

• Jurisdiction: Indiana
• Title 27: INSURANCE
• Art. 8: LIFE, ACCIDENT, AND HEALTH
• Ch. 15: Small Employer Group Health Insurance

Text

(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.

Legislative History

As added by P.L.127-1992, SEC.1. Amended by P.L.8-1993, SEC.432; P.L.93-1995, SEC.13; P.L.190-1996, SEC.4; P.L.91-1998, SEC.16; P.L.146-2015, SEC.34; P.L.72-2016, SEC.20; P.L.86-2018, SEC.208; P.L.236-2025, SEC.12.