Section 421 – Prescription discount program.
Effective 7/1/2021 49-20-421. Prescription discount program. (1) As used in this section: (a) “Diabetes” means: (i) complete insulin deficiency or type 1 diabetes; (ii) insulin resistant with partial insulin deficiency or type 2 diabetes; or (iii) elevated blood glucose levels induced by pregnancy or gestational diabetes. (b) “Discount program” means a process developed by the […]
Section 501 – Title.
49-20-501. Title. This part is known as the “Pharmacy Benefits Manager Act.” Enacted by Chapter 83, 2011 General Session
Section 502 – Definitions.
Effective 5/5/2021 49-20-502. Definitions. As used in this part: (1) “Health benefit plan” means: (a) a health benefit plan as defined in Section 31A-1-301; or (b) a health, dental, medical, Medicare supplement, or conversion program offered under Title 49, Chapter 20, Public Employees’ Benefit and Insurance Program Act. (2) “Pharmacist” is as defined in Section […]
Section 503 – Request for proposals for pharmacy benefits manager for Public Employees’ Benefit and Insurance Program.
49-20-503. Request for proposals for pharmacy benefits manager for Public Employees’ Benefit and Insurance Program. (1) When the board issues a request for proposals for a pharmacy benefits manager to provide pharmacy benefits management services for the program, the request for proposals shall: (a) require each responder to comply with the pharmacy audit provisions of […]
Section 417 – Insurance coverage for amino acid-based formula.
Effective 1/1/2020 49-20-417. Insurance coverage for amino acid-based formula. (1) As used in this section: (a) “Amino acid-based elemental formula” means a nutrition formula: (i) made from individual nonallergenic amino acids that are broken down to enhance absorption and digestion; and (ii) designed for individuals who have a dysfunctional or shortened gastrointestinal tract and are […]
Section 418 – Expanded infertility treatment coverage pilot program.
Affected by 63I-1-249 on 1/1/2025 Effective 5/5/2021 49-20-418. Expanded infertility treatment coverage pilot program. (1) As used in this section: (a) “Assisted reproductive technology” means the same as the term is defined in 42 U.S.C. Sec. 263a-7. (b) “Physician” means the same as the term is defined in Section 58-67-102. (c) “Pilot program” means the […]
Section 419 – Coverage of exome sequence testing.
Effective 5/14/2019 49-20-419. Coverage of exome sequence testing. (1) As used in this section, “exome sequence testing” means a genomic technique for sequencing the genome of an individual for diagnostic purposes. (2) Beginning July 1, 2019, the program shall provide coverage for exome sequence testing: (a) for a covered individual within the state risk pool […]
Section 420 – Coverage for in vitro fertilization and genetic testing.
Affected by 63I-2-249 on 1/1/2030 Effective 5/12/2020 49-20-420. Coverage for in vitro fertilization and genetic testing. (1) As used in this section: (a) “Qualified condition” means: (i) cystic fibrosis; (ii) spinal muscular atrophy; (iii) Morquio Syndrome; (iv) myotonic dystrophy; or (v) sickle cell anemia. (b) “Qualified individual” means a covered individual who: (i) has been […]
Section 409 – Long-term disability — Cost of health coverage benefit.
49-20-409. Long-term disability — Cost of health coverage benefit. (1) Under the direction of the board, the program shall provide for health insurance coverage for state employees who receive a monthly disability benefit under Title 49, Chapter 21, Public Employees’ Long-Term Disability Act. (2) A risk pool, other than the state risk pool, may elect […]
Section 410 – High deductible health plan — Health savings account — Contributions.
Effective 7/1/2021 49-20-410. High deductible health plan — Health savings account — Contributions. (1) (a) In addition to other employee benefit plans offered under Subsection 49-20-201(1), the office shall offer at least one federally qualified high deductible health plan with a health savings account as an optional health plan. (b) The provisions and limitations of […]