1998 Legislation
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SENATE BILL NO. 1454 – Small employer health ins, definitn

SENATE BILL NO. 1454

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Daily Data Tracking History



S1454.......................................by COMMERCE AND HUMAN RESOURCES
SMALL EMPLOYER HEALTH INSURANCE - Amends existing law to add a definition
of "plan year" and to amend the definition of "small employer."

02/13    Senate intro - 1st rdg - to printing
02/16    Rpt prt - to Com/HuRes
02/20    Rpt out - rec d/p - to 2nd rdg
02/23    2nd rdg - to 3rd rdg
02/26    3rd rdg - PASSED - 35-0-0
      AYES -- Andreason, Boatright, Branch, Bunderson, Burtenshaw, Cameron,
      Crow, Danielson, Darrington, Diede, Dunklin, Frasure, Geddes, Hansen,
      Hawkins, Ingram, Ipsen, Keough, King, Lee, McLaughlin, Noh, Parry,
      Richardson, Riggs, Risch, Sandy, Schroeder, Sorensen, Stennett,
      Sweeney, Thorne, Twiggs, Wheeler, Whitworth
      NAYS -- None
      Absent and excused -- None
    Floor Sponsor - Andreason
    Title apvd - to House
02/27    House intro - 1st rdg - to Bus
03/12    Rpt out - rec d/p - to 2nd rdg
03/13    2nd rdg - to 3rd rdg
03/16    3rd rdg - PASSED - 70-0-0
      AYES -- Alltus, Barraclough, Barrett, Bell, Bieter, Bivens,
      Black(15), Black(23), Boe, Bruneel, Callister, Campbell, Chase,
      Clark, Crane, Crow, Cuddy, Deal, Denney, Ellsworth, Field(13),
      Field(20), Gagner, Geddes, Gould, Hadley, Hansen, Henbest, Hornbeck,
      Jaquet, Jones(9) Jones(22), Jones(20), Judd, Kellogg, Kempton,
      Kendell, Kjellander, Kunz, Lake, Linford, Loertscher, Mader, Marley,
      McKague, Meyer, Miller, Mortensen, Newcomb, Pischner, Pomeroy,
      Reynolds, Richman, Ridinger, Robison, Sali, Schaefer, Stevenson,
      Stoicheff, Stone, Stubbs, Taylor, Tilman, Tippets, Trail, Watson,
      Wheeler, Wood, Zimmermann, Mr. Speaker.
      NAYS -- None
      Absent and excused -- None
    Floor Sponsor - Chase
    Title apvd - to Senate
03/16    To enrol
03/18    Rpt enrol - Pres signed
    Sp signed
03/19    To Governor
03/20    Governor signed
         Session Law Chapter 143
         Effective: 07/01/98

Bill Text


S1454


                                                                        
 ||||              LEGISLATURE OF THE STATE OF IDAHO             ||||
Fifty-fourth Legislature                 Second Regular Session - 1998
                                                                        

                                      IN THE SENATE

                                   SENATE BILL NO. 1454

                        BY COMMERCE AND HUMAN RESOURCES COMMITTEE

 1                                        AN ACT
 2    RELATING TO THE SMALL EMPLOYER HEALTH  INSURANCE  AVAILABILITY  ACT;  AMENDING
 3        SECTION  41-4703,  IDAHO  CODE,  TO ADD A DEFINITION OF "PLAN YEAR" AND TO
 4        AMEND THE DEFINITION OF "SMALL EMPLOYER"; AMENDING SECTION 41-4707,  IDAHO
 5        CODE,  TO  PROVIDE A CORRECT CODE REFERENCE; AND AMENDING SECTION 41-4708,
 6        IDAHO CODE, TO PROVIDE  A  CROSS-REFERENCE  TO  THE  DEFINITION  OF  SMALL
 7        EMPLOYER AND TO PROVIDE CORRECT CODE REFERENCES.

 8    Be It Enacted by the Legislature of the State of Idaho:

 9        SECTION  1.  That  Section 41-4703, Idaho Code, be, and the same is hereby
10    amended to read as follows:

11        41-4703.  DEFINITIONS. As used in this chapter:
12        (1)  "Actuarial certification" means a written statement by  a  member  of
13    the American academy of actuaries or other individual acceptable to the direc-
14    tor that a small employer carrier is in compliance with the provisions of sec-
15    tion  41-4706, Idaho Code, based upon the person's examination and including a
16    review of the appropriate records and the actuarial  assumptions  and  methods
17    used  by the small employer carrier in establishing premium rates for applica-
18    ble health benefit plans.
19        (2)  "Affiliate" or "affiliated" means any entity or person  who  directly
20    or  indirectly  through  one  (1)  or more intermediaries, controls or is con-
21    trolled by, or is under common control with, a specified entity or person.
22        (3)  "Agent" means an agent as defined in section 41-1021, Idaho Code,  or
23    a broker as defined in section 41-1024, Idaho Code.
24        (4)  "Base  premium rate" means, for each class of business as to a rating
25    period, the lowest premium rate charged or that could have been charged  under
26    a  rating  system  for that class of business by the small employer carrier to
27    small employers with similar case characteristics  for  health  benefit  plans
28    with the same or similar coverage.
29        (5)  "Basic  health  benefit  plan" means a lower cost health benefit plan
30    developed pursuant to section 41-4712, Idaho Code.
31        (6)  "Board" means the board of directors of the program established  pur-
32    suant to section 41-4711, Idaho Code.
33        (7)  "Carrier"  means  any  entity  that provides health insurance in this
34    state. For the purposes of this chapter, carrier includes  an  insurance  com-
35    pany,  a  hospital  or  professional  service corporation, a fraternal benefit
36    society, a health   maintenance  organization,  any  entity  providing  health
37    insurance coverage or benefits to residents of this state as certificate hold-
38    ers  under  a  group policy issued or delivered outside of this state, and any
39    other entity providing a plan of health insurance or health  benefits  subject
40    to state insurance regulation.
41        (8)  "Case  characteristics"  means demographic or other objective charac-
42    teristics of a small employer that are considered by the small  employer  car-
43    rier  in  the  determination of premium rates for the small employer, provided


                                          2

 1    that claim experience, health status and duration of  coverage  shall  not  be
 2    case characteristics for the purposes of this chapter.
 3        (9)  "Catastrophic  health benefit plan" means a higher limit health bene-
 4    fit plan developed pursuant to section 41-4712, Idaho Code.
 5        (10) "Class of business" means all or a separate grouping of small employ-
 6    ers established pursuant to section 41-4705, Idaho Code.
 7        (11) "Committee" means the health benefit plan committee created  pursuant
 8    to section 41-4712, Idaho Code.
 9        (12) "Control"  shall  be  defined  in  the  same  manner  as  in  section
10    41-3801(2), Idaho Code.
11        (13) "Dependent"  means  a  spouse,  and  unmarried child under the age of
12    nineteen (19) years, and unmarried child who is a full-time student under  the
13    age  of twenty-three (23) years and who is financially dependent upon the par-
14    ent, and an unmarried child of any age who is medically certified as  disabled
15    and dependent upon the parent.
16        (14) "Director"  means  the director of the department of insurance of the
17    state of Idaho.
18        (15) "Eligible employee" means an employee who works on a full-time  basis
19    and  has  a  normal  work  week  of thirty (30) or more hours or, by agreement
20    between the employer and the carrier, an employee who  works   between  twenty
21    (20)  and  thirty  (30) hours per week. The term includes a sole proprietor, a
22    partner of a partnership, and an independent contractor, if the  sole  propri-
23    etor,  partner  or  independent  contractor is included as an employee under a
24    health benefit plan of a small employer, but does not include an employee  who
25    works on a part-time, temporary, seasonal or substitute basis. The term eligi-
26    ble  employee may include  public officers and public employees without regard
27    to the number of hours worked when designated by a small employer.
28        (16) "Established geographic service area" means  a  geographic  area,  as
29    approved  by  the director and based on the carrier's certificate of authority
30    to transact insurance in this state, within which the carrier is authorized to
31    provide coverage.
32        (17) "Health benefit plan" means any hospital or medical policy or certif-
33    icate, any subscriber contract provided by a hospital or professional  service
34    corporation,  or  health  maintenance organization subscriber contract. Health
35    benefit plan does not include policies or certificates of insurance  for  spe-
36    cific  disease, hospital confinement indemnity, accident-only, credit, dental,
37    vision, medicare supplement, long-term care, or disability  income  insurance,
38    student  health  benefits  only  coverage  issued as a supplement to liability
39    insurance, worker's compensation or similar insurance, automobile medical pay-
40    ment insurance or nonrenewable short-term coverage  issues  for  a  period  of
41    twelve (12) months or less.
42        (18) "Index  rate" means, for each class of business as to a rating period
43    for small employers with similar case characteristics, the arithmetic  average
44    of  the  applicable  base  premium  rate and the corresponding highest premium
45    rate.
46        (19) "Late enrollee" means an eligible employee or dependent who  requests
47    enrollment  in a health benefit plan of a small employer following the initial
48    enrollment period during which the individual is entitled to enroll under  the
49    terms  of the health benefit plan, provided that the initial enrollment period
50    is a period of at least thirty (30) days. However,  an  eligible  employee  or
51    dependent shall not be considered a late enrollee if:
52        (a)  The individual meets each of the following:
53             (i)   The  individual  was covered under qualifying previous coverage
54             at the time of the initial enrollment;
55             (ii)  The individual lost coverage under qualifying previous coverage


                                          3

 1             as a result of termination of employment or eligibility, the involun-
 2             tary termination of the qualifying previous coverage; and
 3             (iii) The individual requests  enrollment  within  thirty  (30)  days
 4             after termination of the qualifying previous coverage.
 5        (b)  The  individual  is  employed  by  an  employer which offers multiple
 6        health benefit plans and the individual elects a different plan during  an
 7        open enrollment period.
 8        (c)  A  court  has  ordered  coverage be provided for a spouse or minor or
 9        dependent child under a covered employee's health benefit plan and request
10        for enrollment is made within thirty (30) days after issuance of the court
11        order.
12        (d)  The individual first becomes eligible.
13        (e)  If an individual seeks to enroll a dependent during the  first  sixty
14        (60)  days  of  eligibility,  the  coverage  of the dependent shall become
15        effective:
16             (i)   In the case of marriage, not later than the first  day  of  the
17             first  month  beginning  after  the  date  the  completed request for
18             enrollment is received;
19             (ii)  In the case of a dependent's birth, as  of  the  date  of  such
20             birth; or
21             (iii) In  the  case  of a dependent's adoption or placement for adop-
22             tion, the date of such adoption or placement for adoption.
23        (20) "New business premium rate" means, for each class of business as to a
24    rating period, the lowest premium rate charged or offered or which could  have
25    been  charged or offered by the small employer carrier to small employers with
26    similar case characteristics  for newly issued health benefit plans  with  the
27    same or similar coverage.
28        (21) "Plan of operation" means the plan of operation of the program estab-
29    lished pursuant to section 41-4711, Idaho Code.
30        (22)   "Plan year" means the year that is designated as the plan year
31    in the plan document of a group health benefit plan, except that if  the  plan
32    document  does  not designate a plan year or if there is no plan document, the
33    year plan is:
34        (a)  The deductible/limit year used under the plan;
35        (b)  If the plan does not impose deductibles or limits on a yearly  basis,
36        then the plan year is the policy year;
37        (c)  If  the  plan does not impose deductibles or limits on a yearly basis
38        or the insurance policy is not renewed on an annual basis, then  the  plan
39        year is the employer's taxable year; or
40        (d)  In any other case, the plan year is the calendar year.
41        (23)  "Premium" means all moneys paid by a small employer and eligi-
42    ble  employees as a condition of receiving coverage from a small employer car-
43    rier, including any fees or other contributions  associated  with  the  health
44    benefit plan.
45        (2  3   4 ) "Program" means the Idaho small employer
46    reinsurance program created in section 41-4711, Idaho Code.
47        (2  4    5  ) "Qualifying  previous  coverage"   and
48    "qualifying existing coverage" means benefits or coverage provided under:
49        (a)  Medicare  or  medicaid,  civilian  health  and  medical  program  for
50        uniformed  services  (CHAMPUS), the Indian health service program, a state
51        health benefit risk pool or any other similar publicly sponsored  program;
52        or
53        (b)  Any other group or individual health insurance policy or health bene-
54        fit  arrangement  whether  or  not  subject  to  the state insurance laws,
55        including coverage provided by a health maintenance organization, hospital


                                          4

 1        or professional service corporation, or a fraternal benefit society,  that
 2        provides  benefits  similar  to  or  exceeding benefits provided under the
 3        basic health benefit plan.
 4        (2 5  6 ) "Rating period" means the calendar  period
 5    for which premium rates established by a small employer carrier are assumed to
 6    be in effect.
 7        (2  6    7  ) "Reinsuring  carrier"  means  a  small
 8    employer  carrier participating in the reinsurance program pursuant to section
 9    41-4711, Idaho Code.
10        (2 7  8 ) "Restricted network provision"  means  any
11    provision of a health benefit plan that conditions the payment of benefits, in
12    whole or in part, on the use of health care providers that have entered into a
13    contractual  arrangement  with  the carrier to provide health care services to
14    covered individuals.
15        (2 8  9  ) "Risk-assuming  carrier"  means  a  small
16    employer  carrier  whose  application  is approved by the director pursuant to
17    section 41-4710, Idaho Code.
18        ( 29  30 ) "Small employer" means any person,  firm,
19    corporation,  partnership  or association that is actively engaged in business
20    that,  on at least fifty percent (50%) of its  working  days  during  the
21    preceding  calendar year,  employed an average of at least two (2) 
22    eligible employees on the first day of the plan year,  but no more  than
23    fifty (50) eligible employees  on business days during the preceding cal-
24    endar year and that employs at least two (2) but no more than fifty (50)  eli-
25    gible employees on the first day of the plan year , the majority of whom
26    were   and are  employed within this state. In determining the num-
27    ber of eligible employees, companies that are affiliated  companies,  or  that
28    are  eligible  to  file  a combined tax return for purposes of state taxation,
29    shall be considered one (1) employer.
30        (3 0  1 ) "Small employer carrier" means  a  carrier
31    that  offers  health  benefit  plans covering eligible employees of one (1) or
32    more small employers in this state.
33        (3 1  2 ) "Standard health  benefit  plan"  means  a
34    health benefit plan developed pursuant to section 41-4712, Idaho Code.

35        SECTION  2.  That  Section 41-4707, Idaho Code, be, and the same is hereby
36    amended to read as follows:

37        41-4707.  RENEWABILITY OF COVERAGE. (1) A health benefit plan  subject  to
38    the provisions of this chapter shall be renewable with respect to all eligible
39    employees or dependents, at the option of the small employer, except in any of
40    the following cases:
41        (a)  Nonpayment of the required premiums;
42        (b)  Fraud  or intentional misrepresentation of material fact by the small
43        employer;
44        (c)  Noncompliance with the carrier's minimum participation requirements;
45        (d)  Noncompliance with the carrier's employer contribution requirements;
46        (e)  In the case of health benefit plans that are made  available  in  the
47        small employer market only through one (1) or more associations as defined
48        in section 41-2202, Idaho Code, the membership of an employer in the asso-
49        ciation,  on  the basis of which the coverage is provided ceases, but only
50        if the coverage is  terminated  under  this  paragraph  uniformly  without
51        regard  to  any health status-related factor relating to any covered indi-
52        vidual;
53        (f)  The small employer  no  longer  meets  the  requirements  of  section


                                          5

 1        41-4703( 28  30 ), Idaho Code;
 2        (g)  The small employer carrier elects to nonrenew all of its health bene-
 3        fit  plans  delivered  or  issued  for delivery to small employers in this
 4        state. In such a case the carrier shall:
 5             (i)   Provide advance notice of its decision under this paragraph  to
 6             the director in each state in which it is licensed; and
 7             (ii)  Provide  notice  of  the  decision not to renew coverage to all
 8             affected small employers and to the director  at  least  one  hundred
 9             eighty (180) days prior to the nonrenewal of any health benefit plans
10             by  the  carrier. Notice to the director under the provisions of this
11             paragraph shall be provided at least three (3) working days prior  to
12             the notice to the affected small employers; or
13        (h)  The director finds that the continuation of the coverage would:
14             (i)   Not  be  in the best interests of the policyholders or certifi-
15             cate holders; or
16             (ii)  Impair the carrier's ability to meet  its  contractual  obliga-
17             tions.
18        In  such  instance  the  director shall assist affected small employers in
19        finding replacement coverage.
20        (2)  A small employer carrier that elects not to renew  a  health  benefit
21    plan  under the provisions of subsection (1)(g) of this section shall  be pro-
22    hibited from writing new business in the small employer market in  this  state
23    for a period of five (5) years from the date of notice to the director.
24        (3)  In  the  case  of  a small employer carrier doing business in one (1)
25    established geographic service area of the state, the rules set forth in  this
26    subsection shall apply only to the carrier's operations in that service area.

27        SECTION  3.  That  Section 41-4708, Idaho Code, be, and the same is hereby
28    amended to read as follows:

29        41-4708.  AVAILABILITY OF COVERAGE.
30        (1)  (a) Every small employer carrier shall, as a  condition  of  offering
31        health  benefit  plans in this state to small employers, actively offer to
32        small employers at least three (3) health benefit plans.  One  (1)  health
33        benefit  plan  offered  by  each  small  employer carrier shall be a basic
34        health benefit plan, one (1) plan shall be a standard health benefit plan,
35        and one (1) plan shall be a catastrophic benefit plan.
36             (b)  (i) A small employer carrier shall issue a  basic,  standard  or
37             catastrophic  health benefit plan to any eligible small employer that
38             applies for either such plan and agrees to make the required  premium
39             payments and to satisfy the other reasonable provisions of the health
40             benefit plan not inconsistent with the provisions of this chapter.
41             (ii)  In  the  case of a small employer carrier that establishes more
42             than one (1) class of business pursuant to the provisions of  section
43             41-4705,  Idaho  Code,  the small employer carrier shall maintain and
44             issue to eligible small employers at least one (1) basic health bene-
45             fit plan, at least one (1) standard health benefit plan and at  least
46             one (1) catastrophic benefit plan in each class of business so estab-
47             lished.  A  small  employer carrier may apply reasonable criteria  in
48             determining whether to accept a small employer into a class of  busi-
49             ness, provided that:
50                  (A)  The  criteria  are  not  intended  to discourage or prevent
51                  acceptance of small employers applying for a basic, standard  or
52                  catastrophic health benefit plan;
53                  (B)  The  criteria are not related to the health status or claim


                                          6

 1                  experience of the small employer;
 2                  (C)  The criteria are applied consistently to all small  employ-
 3                  ers applying for coverage in the class of business; and
 4                  (D)  The  small  employer carrier provides for the acceptance of
 5                  all eligible small employers into one (1)  or  more  classes  of
 6                  business.
 7             The  provisions of this paragraph shall not apply to a class of busi-
 8             ness into which the small employer carrier is no longer enrolling new
 9             small businesses.
10        (c)  A small employer is eligible under the provisions of paragraph (b) of
11        this section if it  employed  at  least  two  (2)  or  more  eligible
12        employees within this state on the first day of the plan year  
13        satisfies  the  definition  of  "small  employer"  set  forth  in  section
14        41-4703(30), Idaho Code .
15        (2)  (a) A  small  employer  carrier  shall  file  with the director, in a
16        format and manner prescribed by the director, the basic, standard and cat-
17        astrophic health benefit plans to be used by the carrier. A health benefit
18        plan filed pursuant to the provisions of this paragraph may be used  by  a
19        small employer carrier beginning thirty (30) days after it is filed unless
20        the director disapproves its use.
21        (b)  The  director at any time may, after providing notice and an opportu-
22        nity for a hearing to the small employer carrier, disapprove the continued
23        use by a small employer carrier  of  a  basic,  standard  or  catastrophic
24        health  benefit  plan  on  the  grounds  that  the  plan does not meet the
25        requirements of this chapter.
26        (3)  Health benefit plans covering small employers shall comply  with  the
27    following provisions:
28        (a)  A health benefit plan shall not deny, exclude or limit benefits for a
29        covered  individual  for  covered  expenses incurred more than twelve (12)
30        months following the effective date of the individual's coverage due to  a
31        preexisting condition. A  health benefit plan shall not define a preexist-
32        ing  condition  more  restrictively  than a condition, whether physical or
33        mental, regardless of the  cause  of  the  condition,  for  which  medical
34        advice,  diagnosis,  care  or treatment was recommended or received during
35        the six (6) months immediately preceding the effective date of coverage.
36        (b)  Genetic information shall not be considered as a condition  described
37        in  subsection (3)(a) of this section in the absence of a diagnosis of the
38        condition related to such information.
39        (c)  A health benefit plan shall waive any time  period  applicable  to  a
40        preexisting  condition exclusion or limitation period with respect to par-
41        ticular services for the period of time an individual was previously  cov-
42        ered  by  qualifying previous coverage that provided benefits with respect
43        to such services, provided that the qualifying previous coverage was  con-
44        tinuous  to a date not more than sixty-three (63) days prior to the effec-
45        tive date of the new coverage. The period of continuous coverage shall not
46        include any waiting period for the effective  date  of  the  new  coverage
47        applied  by  the employer or the carrier. This paragraph does not preclude
48        application of any waiting period applicable to all  new  enrollees  under
49        the health benefit plan.
50        (d)  A health benefit plan may exclude coverage for late enrollees for the
51        greater  of twelve (12) months or for a twelve (12) month preexisting con-
52        dition exclusion; provided that if both a period of exclusion from  cover-
53        age  and  a  preexisting  condition  exclusion  are  applicable  to a late
54        enrollee, the combined period shall not exceed twelve (12) months from the
55        date the individual enrolls for coverage under the health benefit plan.


                                          7

 1        (e)  (i) Except as  provided  in  subsection  (3)(  d    e
 2             )(iv)  of  this  section, requirements used by a small employer
 3             carrier in  determining  whether  to  provide  coverage  to  a  small
 4             employer,  including requirements for minimum participation of eligi-
 5             ble employees and minimum employer contributions,  shall  be  applied
 6             uniformly  among all small employers with the same number of eligible
 7             employees applying for coverage or receiving coverage from the  small
 8             employer carrier.
 9             (ii)  A  small  employer carrier may vary application of minimum par-
10             ticipation requirements and minimum  employer  contribution  require-
11             ments only by the size of the small employer group.
12             (iii) In  applying minimum participation requirements with respect to
13             a small employer, a small employer carrier shall not consider employ-
14             ees or dependents who have qualifying existing coverage in  determin-
15             ing whether the applicable percentage of participation is met.
16             (iv)  A small employer carrier shall not increase any requirement for
17             minimum   employee  participation  or  any  requirement  for  minimum
18             employer contribution applicable to a  small  employer  at  any  time
19             after the small employer has been accepted for coverage.
20        (f)  (i) If  a small employer carrier offers coverage to a small employer,
21             the small employer carrier shall offer coverage to all of the  eligi-
22             ble  employees  of  a  small  employer  and their dependents. A small
23             employer carrier shall not offer coverage to only certain individuals
24             in a small employer group or to only part of the group, except in the
25             case of late enrollees as provided in paragraph ( c  
26             d ) of this  sub section.
27             (ii)  A  small employer carrier shall not modify a basic, standard or
28             catastrophic health benefit plan with respect to a small employer  or
29             any  eligible  employee  or dependent through riders, endorsements or
30             otherwise, to restrict or exclude coverage for  certain  diseases  or
31             medical conditions otherwise covered by the health benefit plan.
32        (4)  (a) A  small employer carrier shall not be required to offer coverage
33        or accept applications pursuant to the provisions  of  subsection  (1)  of
34        this section in the case of the following:
35             (i)   To a small employer, where the small employer is not physically
36             located in the carrier's established geographic service area;
37             (ii)  To  an  employee,  when  the  employee  does not work or reside
38             within the carrier's established geographic service area; or
39             (iii) Within an area where  the  small  employer  carrier  reasonably
40             anticipates,  and  demonstrates  to the satisfaction of the director,
41             that it will not have the capacity within its established  geographic
42             service  area  to  deliver  service adequately to the members of such
43             groups because of its obligations to existing group policyholders and
44             enrollees.
45        (b)  A small employer carrier that cannot offer coverage pursuant  to  the
46        provisions  of subsection (4)(a)(iii) of this section may not offer cover-
47        age in the applicable area to new cases of employer groups with more  than
48        fifty  (50)  eligible  employees or to any small employer groups until the
49        later of one hundred eighty (180) days following each such refusal or  the
50        date  on  which  the  carrier  notifies  the director that it has regained
51        capacity to deliver services to small employer groups.
52        (5)  A small employer carrier shall not be required to provide coverage to
53    small employers pursuant to the provisions of subsection (1) of  this  section
54    for  any  period  of time for which the director determines that requiring the
55    acceptance of small employers in accordance with the provisions of  subsection


                                          8

 1    (1)  of  this  section would place the small employer carrier in a financially
 2    impaired condition.
 3        (6)  A small employer carrier shall not be required  to  comply  with  the
 4    provisions  of  this  section  until  the director has approved or adopted the
 5    revised plan of operation as provided in section 41-4711, Idaho Code.

Statement of Purpose / Fiscal Impact


    





    STATEMENT OF PURPOSE
            RS 07991
            
    
    A new subsection defining "plan year" as that term is used in the definition of "small employer 
    ' is proposed to be inserted at section 41-4703(22), Idaho Code, and subsequent subsections 
    are to be renumbered Section 41-4703(29), Idaho Code, currently defines "small employer". 
    This section was amended in 199?, however, the suggested changes to the definition were not 
    implemented apparently through mistake or inadvertence. The current definition is difficult to 
    understand. The proposed definition redesignated at section 41-4703(30), Idaho Code, is 
    similar to that proposed by the Department last year set forth in Senate Bill No. 1249 and is 
    consistent with the definition in HIPAA. Section 41 4707(1)(f), Idaho Code, is sought to be 
    amended to correct the citation reference to the subsection defining "small employer". Section 
    41 4708(1)(c), Idaho Code, is sought to be amended to make the eligibility requirement for 
    small employers consistent with the definition of "small employer'". Section 41-4708(3)(e)(i), 
    Idaho Code, should be amended to correct an incorrect reference to a latter subsection. 
    Section 41-4708(3)(f)(i), Idaho Code, should be amended to correct an incorrect reference to 
    a prior subsection.
    
    FISCAL IMPACT
    
    None.
    
    Contact:
    Name: James M. Alcorn
    Agency Department of Insurance
    Phone 334-4250
    Statement of Purpose/Fiscal Impact
    
    S1454