1. The division shall adopt rules to implement and administer the premium credit authorized by this section, which rules shall include the minimum standard application form for premium credit eligibility. Forms shall be printed by participating insurance companies and provided to employers and employers' employees wishing to apply for premium credit eligibility.
2. The amount of the premium credit is equal to twenty- five dollars per month, per participating eligible employee for which the employer provides an employer-sponsored group basic benefit plan approved by the commissioner of insurance pursuant to section 513B.41, provided that the employer satisfies all of the following conditions:
a. The employer has not provided health insurance coverage, in whole or in part, to employees within the immediately preceding twelve months before contracting with an insurance carrier for basic benefit insurance approved pursuant to section 513B.41.
b. The employer, on at least fifty percent of the employer's working days during the preceding year, employed not less than two and not more than twenty-five full-time equivalent employees.
c. The employer paid either of the following:
(1) Seventy-five percent or more of the premium for individual coverage of the participating eligible employee.
(2) Fifty percent or more of the premium for family coverage of the participating eligible employee and the employee's spouse and dependents.
3. An employee is eligible for participation in the subsidized insurance premium credit group health insurance plan if the family income of the employee is less than or equal to one hundred fifty percent of the federal poverty level as reported annually in the federal register. An employee application for eligibility is current for up to one year.
4. Earned premium credit is limited to the first five thousand full-year equivalent participating eligible employee applications under this section preapproved by the division in any single fiscal year.
5. The carrier shall credit to the participating employer's premium liability, an amount equal to the premium credit earned pursuant to subsection 2, against the premium due in the year after the credit is earned.
6. The premium credit provided by this section is only available in connection with either of the following:
a. A basic benefit plan approved by the commissioner.
b. A major medical policy approved by the commissioner providing coverage to an eligible individual either on a group or individual basis.
The policy shall also satisfy any conditions imposed by rules adopted pursuant to subsection 1 which the commissioner determines are necessary or convenient to implement and administer the premium credit.
7. a. A person submitting an intentionally fraudulent premium credit application forfeits the credit and shall pay to the division a liquidated damages penalty of one hundred percent of the credit forfeited.
b. A person submitting a premium credit application which that person should have known was false forfeits the credit and shall pay to the division a liquidated damages penalty of ten percent of the credit forfeited.
8. The insurance carrier shall receive a premium tax credit equal to, at a minimum, the premium credit earned by the carrier's insureds pursuant to subsection 2.
91 Acts, ch 244, § 22
CS91, § 514H.12
92 Acts, ch 1162, § 35; 93 Acts, ch 80, § 18, 20
CS93, § 513B.43
Referred to in § 432.12, 513B.41
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