Code of Massachusetts Regulations
956 CMR - COMMONWEALTH HEALTH INSURANCE CONNECTOR AUTHORITY
Title 956 CMR 11.00 - Employer Fair Share Contribution
Section 11.02 - Definitions

Meaning of Terms: As used in 956 CMR 11.00, unless the context otherwise requires, terms have the following meanings:

Client Company. A person, association, partnership, corporation or other entity that is a co-employer of workers provided by a Employee Leasing Company pursuant to a contract.

Connector. Commonwealth Health Insurance Connector Authority established under M.G.L. c. 176Q, § 2.

Contributing Employer. An Employer that offers a Group Health Plan to which the Employer makes a fair and reasonable premium contribution as defined in 956 CMR 11.03.

Employee. An individual employed for at least one month during the 12 month period ending with the last day of the applicable reporting period by an Employer at a Massachusetts location subject to M.G.L. c. 149, § 188.

Employee Leasing Company. A sole proprietorship, partnership, corporation or other form of business entity whose business consists largely of leasing employees to one or more Client Companies under contractual arrangements that retain for such employee leasing companies a substantial portion of personnel management functions, such as payroll, direction and control of workers, and the right to hire and fire workers provided by the employee leasing company; provided, however, that the leasing arrangement is long term and not an arrangement to provide the client company temporary help services during seasonal or unusual conditions. Notwithstanding any arrangement between a client company and an Employee Leasing Company, the Client Company is the Employer for purposes of M.G.L. c. 149, § 188 and 956 CMR 11.00.

Employer. An employing unit as defined in M.G.L. c. 151A, § 1 of M.G.L. c. 152.

Enrolled Employee. An employee who has accepted and is enrolled in the employer's sponsored Group Health Plan.

Full-time Employee. A Full-time Employee is an Employee that works the lower of:

(a) 35 or more hours per week; or

(b) at least the minimum number of weekly payroll hours required for any employee to be eligible for the Employer's Full-time Health Plan Benefits.

Full-time Health Plan Benefits. The level of employer contribution to the Group Health Plan that is equivalent to the contribution offered to Full-time Employees.

Group Health Plan. A group health plan, as defined in 26 U.S.C. § 5000(b), to provide Medical Care, whether insured or self-funded, that is:

(a) sponsored and paid for, in whole or in part, by an employer; or

(b) sponsored by a self-employed person or an employee organization, for the purpose of providing health care (directly or otherwise) to the employees, former employees, self-employed individuals, or others associated or formerly associated with an employer or self-employed individual in a business relationship, or their families to which the employer contributed.

Independent Contractor. An individual that provides services not deemed to be employment under M.G.L. c. 151A, § 2 or M.G.L. c. 152 in the case of services for employing units not subject to M.G.L. c. 151A.

Medical Care. Medical services for the diagnosis, cure, treatment, or prevention of disease, as defined in Internal Revenue Code § 213(d)(1)(A) and (B).

Multi-employer Group Health Plan. A Multi-employer Health Plan is a Group Health Plan to which more than one employer is required to contribute, and which is maintained pursuant to one or more collective bargaining agreements between employee organization(s) and the employers.

Premium Reimbursement Arrangement. An arrangement under which an employer offers in writing to reimburse its employees for a portion of the premium expense of an individual health plan. The employee pays all of the monthly premium cost directly to the carrier. The employee submits documentation of the premium expense to the employer for reimbursement up to the monthly limit established by the arrangement.

Seasonal Employee. An individual hired to perform services for wages by a seasonal employer under M.G.L. c. 151A during the seasonal period in the employer's seasonal operations for a specific temporary seasonal period; that has been notified by the Division of Unemployment Assistance that the individual is performing services in seasonal employment for a seasonal employer; whose employment is limited to the beginning and ending dates of the employer's seasonal period; and whose employment does not exceed 16 weeks.