Utah Administrative Code
Topic - Environmental Quality
Title R305 - Administration
Rule R305-5 - Health Reform - Health Insurance Coverage in DEQ State Contracts - Implementation
Section R305-5-3 - Definitions
Universal Citation: UT Admin Code R 305-5-3
Current through Bulletin 2024-18, September 15, 2024
(1) "Employee" means an "employee," "worker," or "operative" as defined in UCA Section 34A-2-104 who works in the State at least 30 hours per calendar week, and meets employer eligibility waiting requirements for health care insurance which may not exceed the first day of the calendar month following 90 days from the date of hire.
(2) "Health benefit plan" has the same meaning as provided in UCA Section 31A-1-301.
(3) "Qualified health insurance coverage" means at the time the contract is entered into or renewed:
(a) a health benefit plan and employer
contribution level with a combined actuarial value at least actuarially
equivalent to the combined actuarial value of the benchmark plan (posted at
http://dfcm.utah.gov/downloads/Health%20Insurance%20Benchmark.pdf )
determined by the Children's Health Insurance Program under UCA Section
26-40-106(2)(a),
and a contribution level of 50% of the premium for the employee and the
dependents of the employee who reside or work in the state, in which:
(i) the employer pays at least 50% of the
premium for the employee and the dependents of the employee who reside or work
in the state; and
(ii) for purposes
of calculating actuarial equivalency under this Subsection (3)(a):
(A) rather than the benchmark plan's
deductible, and the benchmark plan's out-of-pocket maximum based on income
levels the deductible is $750 per individual and $2,250 per family; and the
out-of-pocket maximum is $3,000 per individual and $9,000 per family;
(B) dental coverage is not required;
and
(C) other than UCA Section
26-40-106(2)(a),
the provisions of UCA Section
26-40-106 do not
apply; or
(b)
(i) is a federally qualified high deductible
health plan that, at a minimum, has a deductible that is either the lowest
deductible permitted for a federally qualified high deductible health plan; or
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;
(ii) an out-of-pocket maximum that does not
exceed three times the amount of the annual deductible; and
(iii) under which the employer pays 75% of
the premium for the employee and the dependents of the employee who work or
reside in the state.
(4) "Subcontractor" has the same meaning provided for in UCA Section 63A-5-208.
Disclaimer: These regulations may not be the most recent version. Utah may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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