Section 651 – Insurance coverage for assisted outpatient treatment.
Effective 5/14/2019 31A-22-651. Insurance coverage for assisted outpatient treatment. (1) As used in this section, “assisted outpatient treatment” means the same as that term is defined in Section 62A-15-602. (2) A health insurance provider may not deny an insured the benefits of the insured’s policy solely because the health care that the insured receives is […]
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 641 – Cancer treatment parity.
31A-22-641. Cancer treatment parity. (1) For purposes of this section: (a) “Cost sharing” means the enrollee’s maximum out-of-pocket costs as defined by the health benefit plan. (b) “Health insurer” is as defined in Subsection 31A-22-634(1). (c) “Intravenously administered chemotherapy” means a physician-prescribed cancer treatment that is used to kill or slow the growth of cancer […]
Section 642 – Insurance coverage for autism spectrum disorder.
Effective 5/4/2022 31A-22-642. Insurance coverage for autism spectrum disorder. (1) As used in this section: (a) “Applied behavior analysis” means the design, implementation, and evaluation of environmental modifications, using behavioral stimuli and consequences, to produce socially significant improvement in human behavior, including the use of direct observation, measurement, and functional analysis of the relationship between […]
Section 643 – Prescription synchronization — Copay and dispensing fee restrictions.
Effective 5/13/2014 31A-22-643. Prescription synchronization — Copay and dispensing fee restrictions. (1) For purposes of this section: (a) “Copay” means the copay normally charged for a prescription drug. (b) “Health insurer” means an insurer, as defined in Subsection 31A-22-634(1). (c) “Network pharmacy” means a pharmacy included in a health insurance plan’s network of pharmacy providers. […]
Section 644 – Denial of coverage under a health benefit plan because of life expectancy or terminal condition.
Effective 5/12/2015 31A-22-644. Denial of coverage under a health benefit plan because of life expectancy or terminal condition. (1) As used in this section: (a) “Health benefit plan” means the same as that term is defined in Section 31A-1-301. (b) “Terminal condition” means an irreversible condition: (i) caused by disease, illness, or injury; and (ii) […]
Section 645 – Alcohol and drug dependency treatment.
Effective 5/9/2017 31A-22-645. Alcohol and drug dependency treatment. (1) An insurer offering a health benefit plan providing coverage for alcohol or drug dependency treatment may require an inpatient facility to be licensed by: (a) (i) the Department of Human Services, under Title 62A, Chapter 2, Licensure of Programs and Facilities; or (ii) the Department of […]
Section 635 – Uniform application — Uniform waiver of coverage.
Effective 1/1/2018 31A-22-635. Uniform application — Uniform waiver of coverage. (1) For purposes of this section, “insurer”: (a) is defined in Subsection 31A-22-634(1); and (b) includes the state employee’s risk pool under Section 49-20-202. (2) (a) Insurers offering a health benefit plan to an individual or small employer shall use a uniform application form. (b) […]
Section 636 – Standardized health insurance information cards.
Effective 5/4/2022 31A-22-636. Standardized health insurance information cards. (1) As used in this section, “insurer” means: (a) an insurer governed by this part as described in Section 31A-22-600; (b) a health maintenance organization governed by Chapter 8, Health Maintenance Organizations and Limited Health Plans; (c) a third party administrator; and (d) notwithstanding Subsection 31A-1-103(3)(f) and […]