Sec. 10.5. (a) As used in this chapter, “late enrollee” means an eligible employee or a dependent of an eligible employee who did not request enrollment in a health insurance plan of a small employer during the initial enrollment period during which the individual was entitled to enroll under the health insurance plan.

     (b) The term “late enrollee” does not include an eligible employee or the dependent of an eligible employee:

Terms Used In Indiana Code 27-8-15-10.5

  • Dependent: A person dependent for support upon another.
  • eligible employee: means an employee:

    Indiana Code 27-8-15-8.5

  • in writing: include printing, lithographing, or other mode of representing words and letters. See Indiana Code 1-1-4-5
  • insurer: means any person who provides health insurance in Indiana. See Indiana Code 27-8-15-10
  • minor: means a person less than eighteen (18) years of age. See Indiana Code 1-1-4-5
  • plan: means any:

    Indiana Code 27-8-15-9

  • 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. See Indiana Code 27-8-15-14
(1) who was covered under a health insurance plan or had health insurance coverage at the time coverage was previously offered to the employee or to the dependent of the employee;

(2) who stated in writing at the time coverage was offered that coverage under another health insurance plan was the reason for declining the enrollment, but only if the insurer required such a statement at the time and provided the employee with notice of the requirement (and the consequences of the requirement) at the time;

(3) whose coverage under this subsection:

(A) was under a COBRA continuation provision and the coverage under the provision was exhausted; or

(B) was not under a COBRA continuation provision and either the coverage was terminated as a result of loss of eligibility for the coverage (including as a result of legal separation, divorce, death, termination of employment, or reduction in the number of hours of employment) or employer contributions toward the coverage were terminated; and

(4) who requests enrollment under the terms of the plan not later than thirty (30) days after the date of exhaustion of coverage as described in subdivision (3)(A) or the termination of coverage or employer contributions as described in subdivision (3)(B).

     (c) The term “late enrollee” does not include an eligible employee who is employed by a small employer that offers multiple health insurance plans and who elects a different plan during an open enrollment period.

     (d) The term “late enrollee” does not include an eligible employee or the eligible employee’s spouse or minor or dependent child where:

(1) a court has ordered that health insurance coverage be provided for the spouse or minor or dependent child of an eligible employee under the eligible employee’s insurance plan; and

(2) the request for enrollment is made not more than thirty (30) days after the issuance of the court order.

As added by P.L.93-1995, SEC.12. Amended by P.L.190-1996, SEC.3; P.L.91-1998, SEC.15.

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