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; and
     (d) have been registered as eligible small employer participants by the commissioner as provided in 33-22-2008.
     (2) In addition to the requirements in subsection (1), a small employer is eligible to apply for a tax credit under this part if the small employer and any related employers 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.
     (3) In addition to the requirements of subsections (1) and (2), an owner, partner, or shareholder of an eligible small employer 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 tax credit for group health plan premiums paid by the eligible small employer for group health plan coverage for the individual or the individual's dependents.
     (4) In addition to the requirements in subsection (1), an owner or employee is not eligible to apply for a premium assistance payment under this part if the owner or employee has a household income greater than 400% of the federal poverty level for the year in which an application or application renewal is made.
     (5) Subject to the requirements of subsection (4), the small business health insurance pool may authorize a premium incentive payment for the premium share paid by an eligible small employer and related employers for a group health plan for:
     (a) the owner or employee of the eligible small employer and related employers;
     (b) a spouse of an owner or employee provided for in subsection (5)(a); or
     (c) dependents of the owner or employee provided for in subsection (5)(a).
     (6) 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.
     (7) The commissioner shall establish, by rule, the maximum number of employees that an employer may employ to be qualified as an eligible small employer under subsection (1). The maximum number may be different for eligible small employers seeking premium incentive payments and premium assistance payments than for eligible small 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 eligible small employers with respect to the tax year for which the eligible small employer has registered.
     (8) Except as provided in subsection (3), 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 eligible small 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 eligible small 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 eligible small employer is paying for coverage for the dependents, not to exceed two dependents of an employee in addition to the employee's spouse.
     (9) An eligible small employer may not claim a tax credit:
     (a) in excess of 50% of the total premiums paid by the eligible small 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.
     (10) An eligible small employer may not claim a premium incentive payment in excess of 50% of the total premiums paid by the eligible small 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; amd. Sec. 2, Ch. 331, L. 2013.