(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:

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Terms Used In Nebraska Statutes 44-5257

  • Action: shall include any proceeding in any court of this state. See Nebraska Statutes 49-801
  • Class of business: shall mean all or a separate grouping of small employers established pursuant to section Nebraska Statutes 44-5235
  • Director: shall mean the Director of Insurance. See Nebraska Statutes 44-5239
  • Small employer: shall mean any person, political subdivision, firm, corporation, limited liability company, partnership, or association that is actively engaged in business that, on at least fifty percent of its working days during the preceding calendar quarter, employed at least two and no more than fifty eligible employees, the majority of whom were employed within this state. See Nebraska Statutes 44-5253
  • Small employer carrier: shall mean a carrier that offers health benefit plans covering eligible employees of one or more small employers in this state. See Nebraska Statutes 44-5254

(a) The small employer carrier uses more than one 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 or more association groups that meet the requirements of section 44-760.

(2) A small employer carrier may establish up to nine separate classes of business.

(3) The director may adopt and promulgate rules and regulations to provide for a period of transition in order for a small employer carrier to come into compliance with 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.