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Utah Code Title 31A. Insurance Code § 31A-45-403. Essential health benefits

Current as of January 01, 2025 | Updated by Findlaw Staff

(1) The state designates the state's own essential health benefits and does not accept a federal determination of the essential health benefits under the PPACA.

(2) Subject to Subsections (3) and (4), the commissioner shall make rules in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, that designate the essential health benefits for the state.

(3) Before the commissioner makes rules in accordance with Subsection (2):

(a) the commissioner shall present a summary of the commissioner's planned rules to the Health Reform Task Force; and

(b) the Health Reform Task Force shall recommend whether the commissioner makes rules in accordance with the presented summary.

(4) The essential health benefits plan:

(a) may not include a state mandate if the inclusion of the state mandate would require the state to contribute to premium subsidies under the PPACA; and

(b) may add benefits in addition to the benefits included in a benchmark plan adopted in accordance with this section if the additional benefits are mandated under the PPACA.

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Cite this article: FindLaw.com - Utah Code Title 31A. Insurance Code § 31A-45-403. Essential health benefits - last updated January 01, 2025 | https://codes.findlaw.com/ut/title-31a-insurance-code/ut-code-sect-31a-45-403/

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