(1) A small employer carrier may establish a separate class of business only to reflect substantial differences in expected claims experience or administrative costs related to the following reasons:
(a)  The small employer carrier uses more than one (1) type of system for the marketing and sale of health benefit plans to small employers;
(b)  The small employer carrier has acquired a class of business from another small employer carrier; or
(c)  The small employer carrier provides coverage to one (1) or more association groups that meet the requirements of section 41-2202, Idaho Code.
(2)  A small employer carrier may establish up to nine (9) separate classes of business under the provisions of subsection (1) of this section.
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Terms Used In Idaho Code 41-4705

  • Carrier: means any entity that provides, or is authorized to provide, health insurance in this state. See Idaho Code 41-4703
  • Class of business: means all or a separate grouping of small employers established pursuant to section 41-4705, Idaho Code. See Idaho Code 41-4703
  • Director: means the director of the department of insurance of the state of Idaho. See Idaho Code 41-4703
  • Small employer: means any person, firm, corporation, partnership or association that is actively engaged in business that employed an average of at least two (2) but no more than fifty (50) eligible employees on business days during the preceding calendar year and that employs at least two (2) but no more than fifty (50) eligible employees on the first day of the plan year, the majority of whom were and are employed within this state. See Idaho Code 41-4703
  • Small employer carrier: means a carrier that offers health benefit plans covering eligible employees of one (1) or more small employers in this state. See Idaho Code 41-4703
(3)  The director may establish regulations to provide for a period of transition in order for a small employer carrier to come into compliance with the provisions of subsection (2) of this section in the instance of acquisition of an additional class of business from another small employer carrier.
(4)  The director may approve the establishment of additional classes of business upon application to the director and a finding by the director that such action would enhance the efficiency and fairness of the small employer marketplace.