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Indiana Administrative Code (Last Updated: December 20, 2016) |
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Title 405. OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES |
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Article 405IAC10. HEALTHY INDIANA PLAN 2.0 |
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Rule 405IAC10-11. HIP Employer Benefit Link |
Section 405IAC10-11-10. HIP Link employer eligibility requirements
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(a) Election to participate in HIP Link is optional for the employer. An employer may withdraw from HIP Link at any time.
(b) An employer shall meet the following business operation requirements to participate in HIP Link:
(1) Maintain a valid certificate of existence or authorization issued by the state in which the employer is incorporated.
(2) Have a valid federal employer identification number.
(3) Employ at least one (1) employee who is a resident of the state of Indiana.
(c) An employer shall contribute at least fifty percent (50%) of the annual premium costs for the HIP Link eligible employee's ESI plan.
(d) In order for an employer's ESI plan to be approved for HIP Link, the employer must attest to and provide supporting documentation as requested by the office that the employer's ESI plan:
(1) complies with the Mental Health Parity and Addiction Equity Act of 2008, under 45 CFR 146.136 and 45 CFR 147.160;
(2) complies with IC 27-8-13.4-2(a) or IC 27-13-7-7.5; and
(3) offers health coverage benefits in compliance with the law, such that:
(A) its ESI plan complies with the essential health benefits requirements set forth in 42 CFR 440.347; or
(B) its ESI plan:
(i) provides the minimum value within the meaning of 26 U.S.C. 36B(c)(2)(C)(ii);
(ii) provides substantial equivalence to the benefits described in clause (A) as determined by the office; and
(iii) is recognized as minimum essential coverage within the meaning of 45 CFR 156.
(e) An ESI plan that is approved for HIP Link shall be affordable as defined in section 2(1) of this rule. The office shall review each ESI plan cost structure to determine whether the ESI plan is affordable.
(f) An employer shall meet the reporting requirements under section 11 of this rule to remain eligible to participate in HIP Link.
(g) An employer's continued compliance with this section is a condition of participation in HIP Link.
(h) An employer seeking to appeal an adverse determination under this rule shall do so in accordance with IC 4-21.5-3. (Office of the Secretary of Family and Social Services; 405 IAC 10-11-10; filed Apr 6, 2016, 11:20 a.m.: 20160504-IR-405150325FRA)