56-7-3013 - Premiums. [Effective until June 30, 2010. See the Compiler's Notes.]
56-7-3013. Premiums. [Effective until June 30, 2010. See the Compiler's Notes.]
(a) On an annual basis, based on contracts entered into with contractors, the department shall determine the premiums for each plan offered through the program, including premiums for coverage for dependents, and shall specify:
(1) The amount or percentage of the premium to be contributed by the state through the department, subject to an appropriation for this purpose; provided, however, that the state's portion of the premium shall not exceed an average of fifty dollars ($50.00) per month per enrolled individual, unless otherwise specified in the general appropriations act;
(2) The minimum amount or percentage of the premium to be contributed by the contributing employer or the participating small employer;
(3) The maximum amount or percentage of the premium to be contributed by enrolled individuals who are employees of a contributing employer or a participating small employer; and
(4) The amount or percentage of the premium to be contributed by enrolled individuals who are not employees of a contributing employer or a participating small employer.
(b) The department may reduce or eliminate the premiums required by subdivision (a)(1) and may adjust the premium contributions required by subdivisions (a)(2) and (3) for employees receiving coverage solely pursuant to § 56-7-3005(c) or § 56-7-3006(c).
(c) Based on available appropriations, the department may limit the number of enrollees for whom the state will provide a premium contribution pursuant to subdivision (a)(1) by the state and/or may reduce the amount of premium contributions by the state for some or all contributing employers. To the extent that the state does not contribute to the premium of an enrollee or contributes a reduced amount, the employer, employee and/or individual contributions required pursuant to subdivisions (a)(2)-(4) shall be adjusted accordingly.
(d) The department may establish separate premium contribution levels for the state, employers, employees and individuals with respect to dependent coverage.
(e) Contributing employers or participating small employers may establish the amount of the required employer and employee premium contributions for their employees; provided, that the employer contribution is not less than the amount specified by the department pursuant to subdivision (a)(2) and the employee contribution is not more than the amount specified by the department pursuant to subdivision (a)(3). The sum of the employer and employee premium contributions must equal the sum of the amounts specified by the department pursuant to subdivisions (a)(2) and (3).
(f) During the first three (3) years of operation of the program, premium amounts charged to employers, employees and individuals pursuant to this section shall not increase more than ten percent (10%) per year.
(g) To the extent possible, the department shall ensure that premium schedules and required premium contributions are as simple and affordable as is feasible.
(h) The department may establish premium schedules based on age, tobacco use or obesity.
(i) The department may either:
(1) Establish a method to collect premium contributions from contributing employers, participating small employers and enrollees and pass such contributions, along with the state's contributions, to the plan; or
(2) Authorize contractors to collect premium contributions from contributing employers, participating small employers and enrollees.
[Acts 2006, ch. 867, §§ 5, 14(a).]