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 103 – Creation of program.
49-21-103. Creation of program. There is created for eligible employees the “Public Employees’ Long-Term Disability Program.” Renumbered and Amended by Chapter 250, 2002 General Session
Section 105 – Purpose — Flexibility — Administration.
49-21-105. Purpose — Flexibility — Administration. (1) The purpose of this chapter is to provide long-term disability benefits for an eligible employee. (2) Subject to the provisions of Section 49-21-201, the program may include one or more long-term disability benefit plans that differ from the benefit plan specified by this chapter for an eligible employee […]
Section 201 – Program membership — Eligibility.
49-21-201. Program membership — Eligibility. (1) The state shall cover all of its eligible employees under this chapter. (2) Public safety service employees, as defined in Sections 49-14-102, 49-15-102, and 49-23-102 shall be covered under this chapter or a substantially similar long-term disability program in accordance with the provisions of Section 49-14-601, 49-15-601, or 49-23-601. […]
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 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 […]