26B-3-909. State contractor — Employee and dependent health benefit plan coverage.
| (1) |
For purposes of Sections 17B-2a-818.5, 19-1-206, 63A-5b-607, 63C-9-403, 72-6-107.5, and 79-2-404, “qualified health coverage” means, at the time the contract is entered into or renewed:
Terms Used In Utah Code 26B-3-909- Contract: A legal written agreement that becomes binding when signed.
- Dependent: A person dependent for support upon another.
- Plan: means the department's plan submitted to the United States Department of Health and Human Services pursuant to 42 U. See Utah Code 26B-3-901
- Program: means the Utah Children's Health Insurance Program created by this part. See Utah Code 26B-3-901
- State: when applied to the different parts of the United States, includes a state, district, or territory of the United States. See Utah Code 68-3-12.5
| (a) |
a health benefit plan and employer contribution level with a combined actuarial value at least actuarially equivalent to the combined actuarial value of:
| (i) |
the benchmark plan determined by the program under Subsection 26B-3-904(1)(a); and |
| (ii) |
a contribution level at which the employer pays at least 50% of the premium or contribution amounts for the employee and the dependents of the employee who reside or work in the state; or |
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| (b) |
a federally qualified high deductible health plan that, at a minimum:
| (i) |
has a deductible that is:
| (A) |
the lowest deductible permitted for a federally qualified high deductible health plan; or |
| (B) |
a deductible that is higher than the lowest deductible permitted for a federally qualified high deductible health plan, but includes an employer contribution to a health savings account in a dollar amount at least equal to the dollar amount difference between the lowest deductible permitted for a federally qualified high deductible plan and the deductible for the employer offered federally qualified high deductible plan; |
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| (ii) |
has an out-of-pocket maximum that does not exceed three times the amount of the annual deductible; and |
| (iii) |
provides that the employer pays 60% of the premium or contribution amounts for the employee and the dependents of the employee who work or reside in the state. |
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| (2) |
The department shall:
| (a) |
on or before July 1, 2016:
| (i) |
determine the commercial equivalent of the benchmark plan described in Subsection (1)(a); and |
| (ii) |
post the commercially equivalent benchmark plan described in Subsection (2)(a)(i) on the department’s website, noting the date posted; and |
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| (b) |
update the posted commercially equivalent benchmark plan annually and at the time of any change in the benchmark. |
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Renumbered and Amended by Chapter 306, 2023 General Session
