(19)

632.745 (19) .

635.02(5)

(5)

 

“New business premium rate” means the premium rate charged or offered to small employers with similar case characteristics in the same class of business for newly issued health insurance with the same or similar benefit design characteristics.

635.02(6)

(6)

 

“Rating period” means the period, determined by a small employer insurer, during which a premium rate established by the small employer insurer remains in effect.

635.02(6m)

(6m)

 

“Restricted network provision” means a provision of a health benefit plan that conditions the payment of benefits, in whole or in part, on obtaining services or articles from health care providers that have contracted with the small employer insurer to provide health care services or articles to covered individuals.

635.02(7)

(7)

 

635.02(7)(a)

(a)

“Small employer” means, with respect to a calendar year and a plan year, an employer that employed an average of at least 2 but not more than 50 employees on business days during the preceding calendar year, or that is reasonably expected to employ an average of at least 2 but not more than 50 employees on business days during the current calendar year if the employer was not in existence during the preceding calendar year, and that employs at least 2 employees on the first day of the plan year.

635.02(7)(b)

(b)

Notwithstanding par. (a) , “small employer” does not include any of the following:

635.02(7)(b)1.

1.

A health benefit purchasing cooperative under s.