Section 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 a program to reward a health insurance enrollee if the enrollee receives services:
    • (i) covered by the enrollee’s health plan; and
    • (ii) from a provider whose costs for services are lower than the average costs for the services.

• (2) An insurer may, in accordance with Subsection (4), establish a savings reward program for a health benefit plan that is:
  • (a) offered by the insurer; and
  • (b) entered into or renewed on or after January 1, 2019.

• (3) PEHP shall, in accordance with Subsection (4), establish a savings reward program for a health plan that is:
  • (a) offered to state employees under Title 49, Chapter 20, Public Employees’ Benefit and Insurance Program Act; and
  • (b) entered into or renewed on or after July 1, 2019.

• (4) A savings reward program described in Subsection (2) or (3) may include, in accordance with federal and state law, rewards to the enrollee through:
  • (a) premium discounts;
  • (b) rebates;
  • (c) reduction of out-of-pocket costs; or
  • (d) other rewards or incentives developed by the insurer.

Enacted by Chapter 181, 2018 General Session