Sec. 10.25.01.11. Calculation of the Premium Subsidy

A. At the time of initial application for the Premium Subsidy Program, the premium subsidy is the lower of:

(1) The amount from the maximum subsidy table applicable for the average wage of business and the type of coverage chosen by the employee; or

(2) 50 percent of the sum of:

(a) The premium for the type of coverage chosen by the eligible employee;

(b) The employer's eligible HSA contribution, if any; and

(c) The employee's eligible HSA contribution, if any.

B. At the time of renewal application for the Premium Subsidy Program, the premium subsidy is the lower of:

(1) The amount from the maximum subsidy table applicable for the average wage of business and the type of coverage chosen by the employee, multiplied by the size factor for the number of eligible employers; or

(2) 50 percent of the sum of:

(a) The premium for the type of coverage chosen by the eligible employee;

(b) The employer's eligible HSA contribution, if any; and

(c) The employee's eligible HSA contribution, if any.

C. For each health benefit plan offered by an enrolled employer, the premium subsidy remains constant throughout the policy year unless the premium changes during the policy year.