(1)  A person is eligible to enroll for coverage under the terms of an employer’s group health benefit plan if:

Terms Used In Utah Code 31A-22-725

  • Dependent: A person dependent for support upon another.
  • Employee: means :
(a) an individual employed by an employer; or
(b) an individual who meets the requirements of Subsection (53)(b). See Utah Code 31A-1-301
  • Group health plan: means an employee welfare benefit plan to the extent that the plan provides medical care:
    (a) 
    (i) to an employee; or
    (ii) to a dependent of an employee; and
    (b) 
    (i) directly;
    (ii) through insurance reimbursement; or
    (iii) through another method. See Utah Code 31A-1-301
  • 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
  • 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
  • Security: means a:
    (i) note;
    (ii) stock;
    (iii) bond;
    (iv) debenture;
    (v) evidence of indebtedness;
    (vi) certificate of interest or participation in a profit-sharing agreement;
    (vii) collateral-trust certificate;
    (viii) preorganization certificate or subscription;
    (ix) transferable share;
    (x) investment contract;
    (xi) voting trust certificate;
    (xii) certificate of deposit for a security;
    (xiii) certificate of interest of participation in an oil, gas, or mining title or lease or in payments out of production under such a title or lease;
    (xiv) commodity contract or commodity option;
    (xv) certificate of interest or participation in, temporary or interim certificate for, receipt for, guarantee of, or warrant or right to subscribe to or purchase any of the items listed in Subsections (171)(a)(i) through (xiv); or
    (xvi) another interest or instrument commonly known as a security. 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)  the person is:

    (i)  an employee who is eligible, but not enrolled, for coverage under the terms of the employer’s group health benefit plan; or

    (ii)  a dependent of an employee, if the dependent is eligible, but not enrolled, for coverage under the terms of the employer’s group health benefit plan; and

    (b)  the conditions of either Subsection (2) or (3) are met.
  • (2)  Subsection (1) applies if:

    (a)  the employee or dependent is covered under:

    (i)  a Medicaid health benefit plan under Title XIX of the Social Security Act; or

    (ii)  a state child health benefit plan under Title XXI of the Social Security Act;

    (b)  coverage of the employee or dependent described in Subsection (2)(a) is terminated as a result of loss of eligibility for the coverage; and

    (c)  the employee requests coverage under the employer’s group health plan no later than 60 days after the date of termination of the coverage described in Subsection (2)(a).

    (3)  Subsection (1) applies if:

    (a)  the employee or dependent becomes eligible for assistance, with respect to coverage under the employer’s group health plan under a plan described in Subsection (2)(a), including under a waiver or demonstration project conducted under or in relation to a plan described in Subsection (2)(a); and

    (b)  the employee requests coverage under the employer’s group health plan no later than 60 days after the date the employee or dependent is determined to be eligible for the assistance described in Subsection (3)(a).

    Enacted by Chapter 10, 2010 General Session