Section 655 – Living organ donor coverage.
Effective 5/12/2020 31A-22-655. Living organ donor coverage. (1) For the purposes of this section, “living organ donor” means an individual who has donated all or part of an organ and is not deceased. (2) An insurer may not: (a) deny eligibility for coverage or limit coverage of a individual under an accident and health insurance […]
Section 656 – Coverage of epinephrine auto-injector.
Effective 7/1/2021 31A-22-656. Coverage of epinephrine auto-injector. A health benefit plan entered into or renewed on or after July 1, 2021, that provides coverage of an epinephrine auto-injector is not required to reimburse a participant, as that term is defined in Section 49-20-421, for an epinephrine auto-injector the participant obtains through the discount program described […]
Section 657 – Application of health insurance mandates.
Effective 5/4/2022 31A-22-657. Application of health insurance mandates. (1) As used in this section: (a) “Cost-sharing requirement” means a copayment, coinsurance, or deductible required by or on behalf of an enrollee in order to receive a benefit under a qualified high-deductible health plan. (b) “Health savings account” means the same as that term is defined […]
Section 652 – Coverage for mental health services in schools.
Effective 5/14/2019 31A-22-652. Coverage for mental health services in schools. (1) As used in this section, “local education agency” means: (a) a school district; (b) a charter school; or (c) the Utah Schools for the Deaf and the Blind. (2) A health benefit plan that is entered into or renewed on or after January 1, […]
Section 654 – Study of coverage for in vitro fertilization and genetic testing — Reporting — Coverage requirements.
Effective 5/5/2021 31A-22-654. Study of coverage for in vitro fertilization and genetic testing — Reporting — Coverage requirements. (1) As used in this section: (a) “Qualified condition” means the same as that term is defined in Section 49-20-420. (b) “Qualified insurer” means an insurer that provides a health benefit plan as defined in Section 31A-1-301 […]
Section 646 – Dental insurance — Contract provision for noncovered services.
Effective 5/9/2017 31A-22-646. Dental insurance — Contract provision for noncovered services. (1) For purposes of this section: (a) “Covered services” means dental services for which reimbursement: (i) is available or would be reimbursable under an enrollee’s dental plan but for the application of one or more of the following contractual provisions: (A) deductibles; (B) copayments; […]
Section 646.1 – Leasing requirements for dental plans.
Effective 5/5/2021 31A-22-646.1. Leasing requirements for dental plans. (1) As used in this section: (a) “Contracting entity” means a person that enters into a direct contract with a provider for the delivery of dental services in the ordinary course of business, including a third party administrator or a dental carrier. (b) “Dental carrier” means a […]
Section 647 – Insurer shared savings program.
Effective 5/8/2018 31A-22-647. Insurer shared savings program. (1) As used in this section: (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 […]
Section 648 – Vision insurance — Contract provisions.
Effective 5/14/2019 31A-22-648. Vision insurance — Contract provisions. (1) As used in this section: (a) “Covered individual” means an individual who has insurance coverage under a vision plan. (b) “Covered service” means a vision service that: (i) is reimbursable under or would be reimbursable under an enrollee’s vision plan, but for the application of at […]
Section 649 – Coverage of telepsychiatric consultations.
Effective 5/8/2018 31A-22-649. Coverage of telepsychiatric consultations. (1) As used in this section: (a) “Telehealth services” means the same as that term is defined in Section 26-60-102. (b) “Telepsychiatric consultation” means a consultation between a physician and a board certified psychiatrist, both of whom are licensed to engage in the practice of medicine in the […]