2005 Idaho Code - 41-4704 — APPLICABILITY AND SCOPE

                                  TITLE  41
                                  INSURANCE
                                  CHAPTER 47
                            SMALL EMPLOYER HEALTH
                          INSURANCE AVAILABILITY ACT
    41-4704.  APPLICABILITY AND SCOPE. With the exception of a health benefit
plan subject to regulation under chapter 52, title 41, Idaho Code, and to the
extent permitted by federal law, the provisions of this chapter shall apply to
any health benefit plan delivered or issued for delivery in the state of Idaho
that provides coverage to the employees of a small employer in this state if
any of the following conditions are met:
    (1)  Any portion of the premium or benefits is paid by or on behalf of the
small employer;
    (2)  An eligible employee or dependent is reimbursed, whether through wage
adjustments or otherwise, by or on behalf of the small employer for any
portion of the premium;
    (3)  The health benefit plan is treated by the employer or any of the
eligible employees or dependents as part of a plan or program for the purposes
of section 162, section 125 or section 106 of the United States internal
revenue code.
    (4)  (a) Except as provided in subsection (b) of this section, for the
    purposes of this chapter, carriers that are affiliated companies or that
    are eligible to file a consolidated tax return shall be treated as one (1)
    carrier and any restrictions or limitations imposed in this chapter shall
    apply as if all health benefit plans delivered or issued for delivery to
    small employers in this state by such affiliated carriers were issued by
    one (1) carrier.
    (b)  An affiliated carrier that is a health maintenance organization
    having a certificate of authority pursuant to the provisions of chapter
    39, title 41, Idaho Code, may be considered to be a separate carrier for
    the purposes of this chapter.
    (c)  Unless otherwise authorized by the director, a small employer carrier
    shall not enter into one (1) or more ceding arrangements with respect to
    health benefit plans delivered or issued for delivery to small employers
    in this state if such arrangements would result in less than fifty percent
    (50%) of the insurance obligation or risk for such health benefit plans
    being retained by the ceding carrier. The provisions of sections 41-510
    and 41-511, Idaho Code, shall apply if a small employer carrier cedes or
    assumes all of the insurance obligation or risk with respect to one (1) or
    more health benefit plans delivered or issued for delivery to small
    employers in this state.