33-22-2006. Premium incentive payments, premium assistance payments, and tax credits for small employer health insurance premiums paid -- eligibility for small group coverage -- amounts. (1) An employer is eligible to apply for premium incentive payments and premium assistance payments or a tax credit under this part if the employer and any related employers:
(a) did not have more than the number of employees established for eligibility by the commissioner at the time of registering for premium incentive payments or premium assistance payments or a tax credit under 33-22-2008;
(b) provide or will provide a group health plan that meets the requirements of creditable coverage for the employer's and any related employer's employees;
(c) do not have delinquent state tax liability owing to the department of revenue from previous years;
(d) have been registered as eligible small employer participants by the commissioner as provided in 33-22-2008; and
(e) do not have any employees, not including an owner, partner, or shareholder of the business, who received more than $75,000 in wages, as defined in 39-71-123, from the small employer or related employer in the prior tax year.
(2) An owner, partner, or shareholder of a business who received more than $75,000 in wages, as defined in 39-71-123, and those individuals' spouses who are employees are not eligible under this chapter for:
(a) any premium assistance payment. However, a premium incentive payment may be made for the premium share paid by the business for group health insurance coverage for:
(i) the owner, partner, or shareholder;
(ii) a spouse of those listed in subsection (2)(a)(i) who is also an employee of the business; or
(iii) dependents of those listed in subsection (2)(a)(i).
(b) a tax credit for group health insurance premiums paid by the business or the owner, partner, or shareholder for group health insurance coverage for the individual or the individual's dependents.
(3) An employee, including an owner, partner, or shareholder or any dependent of an employee, who is also eligible for the children's health insurance program provided for under Title 53, chapter 4, part 10, or medicaid under Title XIX of the Social Security Act may become ineligible to receive a premium assistance payment.
(4) The commissioner shall establish, by rule, the maximum number of employees that may be employed to qualify as a small employer under subsection (1). However, the number may not be less than two employees or more than nine employees. The maximum number may be different for employers seeking premium incentive payments and premium assistance payments than for employers seeking a tax credit. The number must be set to maximize the number of employees receiving coverage under this part. The commissioner may not change the maximum employee number more often than every 6 months. If the maximum number of allowable employees is changed, the change does not disqualify registered employers with respect to the tax year for which the employer has registered.
(5) Except as provided in subsection (6), an eligible small employer may claim a tax credit in the following amounts:
(a) (i) not more than $100 each month for each employee and $100 each month for each employee's spouse, if the employer covers the employee's spouse, if the average age of the group is under 45 years of age; or
(ii) not more than $125 each month for each employee and $100 each month for each employee's spouse, if the employer covers the employee's spouse, if the average age of the group is 45 years of age or older; and
(b) not more than $40 each month for each dependent, other than the employee's spouse, if the employer is paying for coverage for the dependents, not to exceed two dependents of an employee in addition to the employee's spouse.
(6) An employer may not claim a tax credit:
(a) in excess of 50% of the total premiums paid by the employer for the qualifying small group;
(b) for premiums paid from a medical care savings account provided for in Title 15, chapter 61; or
(c) for premiums for which a deduction is claimed under 15-30-2131 or 15-31-114.
(7) An employer may not claim a premium incentive payment in excess of 50% of the total premiums paid by the employer for the qualifying small group.
History: En. Sec. 6, Ch. 595, L. 2005; amd. Sec. 3, Ch. 87, L. 2009; amd. Sec. 18, Ch. 227, L. 2011.