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HOUSE BILL NO. 504
INTRODUCED BY K. OHS, C. AHNER, D. GRIMES, J. HERTEL, B. MCCARTHY, K. MILLER, D. MOOD, B. PAVLOVICH, R. SOMERVILLE, B. TASH, B. THOMAS, J. WITT
AN ACT PROVIDING THAT THE SMALL EMPLOYER HEALTH CARE INSURANCE AVAILABILITY ACT DOES NOT APPLY TO AN INDIVIDUAL HEALTH BENEFIT PLAN IF THE EMPLOYEE OR DEPENDENT ELIGIBLE FOR COVERAGE UNDER THAT PLAN IS REIMBURSED BY THE SMALL EMPLOYER FOR ANY PART OF THE PLAN PREMIUMS UNLESS THE EMPLOYER HAS HAD IN PLACE AN EMPLOYER-SPONSORED GROUP HEALTH BENEFIT PLAN IN THE 12 MONTHS PRECEDING THE REIMBURSEMENT; AND AMENDING SECTION 33-22-1804, MCA.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MONTANA:
Section 1. Section 33-22-1804, MCA, is amended to read:
"33-22-1804. Applicability and scope. (1) This part applies to a health benefit plan marketed through a small employer that provides coverage to the employees of a small employer in this state if any of the following conditions are met:
(a) a portion of the premium or benefits is paid by or on behalf of the small employer;
(b) an eligible employee or dependent is reimbursed, whether through wage adjustments or otherwise, by or on behalf of the small employer for any portion of the premium;
(c) the health benefit plan is treated by the employer or any of the eligible employees or dependents as part of a plan or program for the purposes of section 106, 125, or 162 of the Internal Revenue Code, except a plan or program that is funded entirely by contributions from the employees; or
(d) all of the premium is paid by the employee who obtains coverage through the employer's group health benefit plan.
(2) This part does not apply to an individual health benefit plan for which the entire premium is paid by an employee through payroll deduction or other means.
This Unless prohibited by a written opinion from a federal agency, by final regulations implementing Public Law
104-191, or by a ruling by a court of competent jurisdiction, this part applies does not apply to an individual health benefit
plan if the eligible employee or dependent is directly or indirectly reimbursed, whether through wage adjustments or
otherwise, by or on behalf of the small employer for any portion of the premium. However, this part does apply to an
individual health benefit plan if the employer making the direct or indirect reimbursement for any portion of the premium
has had in place an employer-sponsored group health benefit plan in the 12 months preceding the reimbursement."
Section 2. Saving clause. [This act] does not affect rights and duties that matured, penalties that were incurred, or proceedings that were begun before [the effective date of this act].
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