Health benefit plan: means a policy, contract, certificate, or agreement offered or issued by an insurer to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care, including major medical expense coverage. See Utah Code 31A-1-301
Health care: means any of the following intended for use in the diagnosis, treatment, mitigation, or prevention of a human ailment or impairment:
a risk distributing arrangement providing for compensation or replacement for damages or loss through the provision of a service or a benefit in kind;
(ii)
a contract of guaranty or suretyship entered into by the guarantor or surety as a business and not as merely incidental to a business transaction; and
(iii)
a plan in which the risk does not rest upon the person who makes an arrangement, but with a class of persons who have agreed to share the risk. See Utah Code 31A-1-301
Person: includes :
(a)
an individual;
(b)
a partnership;
(c)
a corporation;
(d)
an incorporated or unincorporated association;
(e)
a joint stock company;
(f)
a trust;
(g)
a limited liability company;
(h)
a reciprocal;
(i)
a syndicate; or
(j)
another similar entity or combination of entities acting in concert. See Utah Code 31A-1-301
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)
“Insurer” means a person who offers health care insurance, including a health maintenance organization as that term is defined in Section 31A-8-101.
(b)
“PEHP” means the Public Employees’ Benefit and Insurance Program created in Section 49-20-103.
(c)
“Savings reward program” means a program to reward a health insuranceenrollee if the enrollee receives services:
(i)
covered by the enrollee’s health plan; and
(ii)
from a provider whose costs for services are lower than the average costs for the services.
(2)
An insurer may, in accordance with Subsection (4), establish a savings reward program for a health benefit plan that is:
(a)
offered by the insurer; and
(b)
entered into or renewed on or after January 1, 2019.
(3)
PEHP shall, in accordance with Subsection (4), establish a savings reward program for a health plan that is:
