Effective January 1, 2014, a covered carrier may establish up to four separate classes of business:
(1)
one class of business for individual health benefit plans that are not grandfathered under PPACA;
Terms Used In Utah Code 31A-30-105
Carrier: means a person that provides health insurance in this state including:
(a)
an insurance company;
(b)
a prepaid hospital or medical care plan;
(c)
a health maintenance organization;
(d)
a multiple employer welfare arrangement; and
(e)
another person providing a health insurance plan under this title. See Utah Code 31A-30-103
Class of business: means all or a separate grouping of covered insureds that is permitted by the commissioner in accordance with Section 31A-30-105. See Utah Code 31A-30-103
PPACA: means the Patient Protection and Affordable Care Act, Pub. See Utah Code 31A-1-301
Small employer: means , in connection with a health benefit plan and with respect to a calendar year and to a plan year, an employer who:
(i)
(A)
employed at least one but not more than 50 eligible employees on business days during the preceding calendar year; or
(B)
if the employer did not exist for the entirety of the preceding calendar year, reasonably expects to employ an average of at least one but not more than 50 eligible employees on business days during the current calendar year;
(ii)
employs at least one employee on the first day of the plan year; and
(iii)
for an employer who has common ownership with one or more other employers, is treated as a single employer under 26 U. See Utah Code 31A-1-301
(2)
one class of business for small employer health benefit plans that are not grandfathered under PPACA;
(3)
one class of business for individual health benefit plans that are grandfathered under PPACA; and
(4)
one class of business for small employer health benefit plans that are grandfathered under PPACA.
