Current through Bulletin 2024-18, September 15, 2024
A contractor (including consultants and designers) must
comply with the following requirements and procedures in order to demonstrate
compliance with Section
79-2-404.
(1) Demonstrating Compliance with Health
Insurance Requirements. A contractor (including design professional) shall
demonstrate compliance with Subsection
79-2-404(5)(a) or (b) at the time of execution of each
initial contract described in Subsection
79-2-404(2).
(a) The compliance is subject to an audit by
the Department or the Office of Legislative Auditor General.
(b) A contractor (including design
professional) subject to Subsection
79-2-404(2) shall demonstrate to the executive director that the contractor has and will
maintain an offer of qualified health insurance coverage for the contractor's
employees and employees' dependents.
(c) Such demonstration shall be a
certification on the form provided by the Department. The form shall also
require compliance with Section R634-2-5(2) regarding subcontractors.
(d) The actuarially equivalent determination
required for the qualified health insurance coverage is met by the contractor
if the contractor provides the Department with a written statement of actuarial
equivalency attached to the certification, which is not more than one year old,
regarding the contractor's offer of qualified health coverage from an actuary
selected by the contractor or the contractor's insurer, or an underwriter who
is responsible for developing the employer group's premium rates. The
Contractor is responsible for collecting the statements as required by law from
any of the subcontractors at any tier that must do so.
(2) For purposes of Rule R634-2-7,
actuarially equivalency is achieved by meeting or exceeding the commercially
equivalent benchmark for the qualified health insurance coverage identified in
Subsection
79-2-404(1)(c) that is provided by the Department of Health, in accordance with Section
26-40-115(2).
(3) The health insurance must be available
upon the first day of the calendar month following sixty (60) days from the
date of hire.
(4) Any contract
subject to R634-2 shall contain a provision requiring compliance with Rule
R634-2 from the time of execution and throughout the duration of the
contract.
(5) Hearing and
Penalties.
(a) Hearing. Any hearing for any
penalty under Rule R634-2 conducted by the Department shall be conducted in the
same manner as any hearing required for a suspension or debarment.
(b) Penalties that may be imposed by
Department. The penalties that may be imposed by the Department if a
contractor, consultant, subcontractor or subconsultant, at any tier,
intentionally violates the provisions of Section
79-2-404
or Rule R634-2 include:
(i) a three-month
suspension of the contractor or subcontractor from entering into future
contracts with the State upon the first violation, regardless of which tier the
contractor or subcontractor is involved with the future design and/or
construction contract;
(ii) a
six-month suspension of the contractor or subcontractor from entering into
future contracts with the State upon the second violation, regardless of which
tier the contractor or subcontractor is involved with the future design and/or
construction contract;
(iii) an
action for debarment of the contractor or subcontractor in accordance with
Section
63G-6a-904
upon the third or subsequent violation; and
(iv) monetary penalties which may not exceed
50 percent of the amount necessary to purchase qualified health insurance
coverage for an employee and the dependents of an employee of the contractor or
subcontractor who was not offered qualified health insurance coverage during
the duration of the contract.
(c)
(i) In
addition to the penalties imposed above, a contractor, consultant,
subcontractor or subconsultant who intentionally violates the provisions of
Section
79-2-404
shall be liable to the employee for health care costs that would have been
covered by qualified health insurance coverage.
(ii) An employer has an affirmative defense
to a cause of action under Subsection R634-2-7(5)(c)(i) as provided in
Subsection
79-2-404(7)(a).
An employee has a private right of action only against the employee's employer
to enforce the provision of Subsection
79-2-404(7).
