(1) For purposes of Sections 17B-2a-818.5, 19-1-206, 63A-5b-607, 63O-2-403, 72-6-107.5, and 79-2-404, “qualified health coverage” means, at the time the contract is entered into or renewed:

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Terms Used In Utah Code 26B-3-909

  • Contract: A legal written agreement that becomes binding when signed.
  • Equal: means , with respect to biological sex, of the same value. See Utah Code 68-3-12.5
  • Plan: means the department's plan submitted to the United States Department of Health and Human Services pursuant to Utah Code 26B-3-901
  • Program: means the Utah Children's Health Insurance Program created by this part. See Utah Code 26B-3-901
  • State: when applied to the different parts of the United States, includes a state, district, or territory of the United States. See Utah Code 68-3-12.5
     (1)(a) a health benefit plan and employer contribution level with a combined actuarial value at least actuarially equivalent to the combined actuarial value of:

          (1)(a)(i) the benchmark plan determined by the program under Subsection 26B-3-904(1)(a); and
          (1)(a)(ii) a contribution level at which the employer pays at least 50% of the premium or contribution amounts for the employee and the dependents of the employee who reside or work in the state; or
     (1)(b) a federally qualified high deductible health plan that, at a minimum:

          (1)(b)(i) has a deductible that is:

               (1)(b)(i)(A) the lowest deductible permitted for a federally qualified high deductible health plan; or
               (1)(b)(i)(B) a deductible that is higher than the lowest deductible permitted for a federally qualified high deductible health plan, but includes an employer contribution to a health savings account in a dollar amount at least equal to the dollar amount difference between the lowest deductible permitted for a federally qualified high deductible plan and the deductible for the employer offered federally qualified high deductible plan;
          (1)(b)(ii) has an out-of-pocket maximum that does not exceed three times the amount of the annual deductible; and
          (1)(b)(iii) provides that the employer pays 60% of the premium or contribution amounts for the employee and the dependents of the employee who work or reside in the state.
(2) The department shall:

     (2)(a) on or before July 1, 2016:

          (2)(a)(i) determine the commercial equivalent of the benchmark plan described in Subsection (1)(a); and
          (2)(a)(ii) post the commercially equivalent benchmark plan described in Subsection (2)(a)(i) on the department’s website, noting the date posted; and
     (2)(b) update the posted commercially equivalent benchmark plan annually and at the time of any change in the benchmark.