Utah Code 31A-30-112. Employee participation levels

31A-30-112. Employee participation levels.

(1)

Terms Used In Utah Code 31A-30-112

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

Covered carrier: means an individual carrier or small employer carrier subject to this chapter. See Utah Code 31A-30-103

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
(a)	For purposes of this section, “participation” means the same as that term is defined in Section 31A-1-301.

(b)

Except as provided in Subsection (2), a requirement used by a covered carrier in determining whether to provide coverage to a small employer, including a participation requirement and a minimum employer contribution requirement, shall be applied uniformly among all small employers with the same number of eligible employees applying for coverage or receiving coverage from the covered carrier.

(2)	A covered carrier may not increase a participation requirement or a requirement for minimum employer contribution, applicable to a small employer, at any time after the small employer is accepted for coverage.

Amended by Chapter 354, 2020 General Session

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