Terms Used In Indiana Code > Title 27 > Article 8 > Chapter 15 - Small Employer Group Health Insurance

• actuarial certification: means a written statement by a member of the American Academy of Actuaries that a small employer insurer is in compliance with section 16 of this chapter, based upon the person's examination, including a review of the appropriate records and of the actuarial assumptions and methods utilized by the insurer in establishing premium rates for applicable health insurance plans. See Indiana Code 27-8-15-3
• base premium rate: means the lowest premium rate charged or that could have been charged under a rating system by the small employer insurer to small employers with similar case characteristics and benefit design characteristics. See Indiana Code 27-8-15-4
• benefit design characteristics: means the following:

  Indiana Code 27-8-15-5

• case characteristics: means demographic or other relevant characteristics of a small employer, as determined by a small employer insurer, that are considered by the insurer in the determination of premium rates for the small employer. See Indiana Code 27-8-15-6
• commissioner: refers to the commissioner of the department of insurance. See Indiana Code 27-8-15-7
• Contract: A legal written agreement that becomes binding when signed.
• Conviction: A judgement of guilt against a criminal defendant.
• Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
• department: refers to the department of insurance. See Indiana Code 27-8-15-8
• Dependent: A person dependent for support upon another.
• eligible employee: means an employee:

  Indiana Code 27-8-15-8.5

• Fraud: Intentional deception resulting in injury to another.
• 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
• Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
• 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. See Indiana Code 27-8-15-10.5
• midpoint rate: means for small employers with similar case and benefit design characteristics the arithmetic average of the applicable base premium rate and the corresponding highest premium rate. See Indiana Code 27-8-15-11
• minor: means a person less than eighteen (18) years of age. See Indiana Code 1-1-4-5
• Month: means a calendar month, unless otherwise expressed. See Indiana Code 1-1-4-5
• new business premium rate: means the premium rate charged or offered by the small employer insurer to small employers with similar case characteristics and benefit design characteristics for newly issued health insurance plans. See Indiana Code 27-8-15-12
• Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
• plan: means any:

  Indiana Code 27-8-15-9

• rating period: means the calendar period for which premium rates established by a small employer insurer are assumed to be in effect, as determined by the small employer insurer. See Indiana Code 27-8-15-13
• 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
• small employer insurer: means any insurer that offers a health insurance plan covering the employees of a small employer. See Indiana Code 27-8-15-15
• United States: includes the District of Columbia and the commonwealths, possessions, states in free association with the United States, and the territories. See Indiana Code 1-1-4-5
• Year: means a calendar year, unless otherwise expressed. See Indiana Code 1-1-4-5