Section 414 – Telemedicine services — Reimbursement — Reporting.
Effective 5/14/2019 49-20-414. Telemedicine services — Reimbursement — Reporting. (1) As used in this section: (a) “Network provider” means a health care provider who has an agreement with the program to provide health care services to a patient with an expectation of receiving payment, other than coinsurance, copayments, or deductibles, directly from the managed care […]
Section 415 – Prescribing policies for certain opioid prescriptions.
Effective 5/9/2017 49-20-415. Prescribing policies for certain opioid prescriptions. A plan offered to state employees under this chapter may implement a prescribing policy for certain opioid prescriptions in accordance with Section 31A-22-615.5. Enacted by Chapter 53, 2017 General Session Technically renumbered to avoid duplication of section number also enacted in HB154, Chapter 241.
Section 416 – Screening, Brief Intervention, and Referral to Treatment program reimbursement.
Effective 5/9/2017 49-20-416. Screening, Brief Intervention, and Referral to Treatment program reimbursement. (1) As used in this section: (a) “Controlled substance prescriber” means a controlled substance prescriber, as that term is defined in Section 58-37-6.5, who: (i) has a record of having completed SBIRT training, in accordance with Subsection 58-37-6.5(2), before providing the SBIRT services; […]
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 301 – Payments made by employer and employee.
49-20-301. Payments made by employer and employee. The program shall be maintained on a financially and actuarially sound basis by payments from covered employers and covered individuals. Amended by Chapter 240, 2003 General Session
Section 401 – Program — Powers and duties.
Effective 5/4/2022 49-20-401. Program — Powers and duties. (1) The program shall: (a) act as a self-insurer of employee benefit plans and administer those plans; (b) enter into contracts with private insurers or carriers to underwrite employee benefit plans as considered appropriate by the program; (c) indemnify employee benefit plans or purchase commercial reinsurance as […]
Section 402 – Reserves to be held — Refunds.
49-20-402. Reserves to be held — Refunds. (1) The reserves in a risk pool in a given fiscal year shall be maintained at the level recommended by the program’s consulting actuary and approved or ratified by the board. If the reserves drop below that level, covered employers in the risk pool are required to cure […]
Section 403 – Assistance to members in purchase of life, health, dental, and medical insurance after retirement — Employment of personnel to administer section.
49-20-403. Assistance to members in purchase of life, health, dental, and medical insurance after retirement — Employment of personnel to administer section. (1) The program may assist active and retired covered individuals and inactive covered individuals of the covered employers to purchase life, health, dental, and medical coverage on a group basis which can be […]
Section 404 – Governors’ and legislative paid-up group health coverage benefit — Limitations — Medicare supplemental coverage — Spouse coverage — Limitations.
49-20-404. Governors’ and legislative paid-up group health coverage benefit — Limitations — Medicare supplemental coverage — Spouse coverage — Limitations. (1) (a) Except as provided under Subsection (1)(b), the state shall pay the percentage of the cost of providing paid-up group health coverage under Subsection (3) for members and their surviving spouses covered under Chapter […]
Section 405 – Audit required — Report to governor and Legislature.
49-20-405. Audit required — Report to governor and Legislature. The Insurance Department shall biennially audit the Public Employees’ Trust Fund and programs authorized under this chapter and report its findings to the governor and the Legislature, but the commissioner may accept the annual audited statement of the programs under this chapter in lieu of the […]