26B-3-903. Eligibility.

291 words·~1 min read·/ut/title-26b/chapter-3/26b-3-903

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

Effective 1/1/2024

(1)A traditionally eligible child may enroll in the program if the child:

(a)is a bona fide Utah resident;

(b)does not have access to or coverage under other health insurance, including any coverage available through a parent or legal guardian's employer;

(c)is ineligible for Medicaid benefits;

(d)resides in a household whose gross family income, as defined by rule, is at or below 200% of the federal poverty level; and

(e)is not an inmate of a public institution or a patient in an institution for mental diseases.

(2)A child who qualifies for enrollment in the program under Subsection

(1)may not be denied enrollment due to a diagnosis or pre-existing condition.

(a)The department shall determine eligibility and send notification of the eligibility decision within 30 days after receiving the application for coverage.

(b)If the department cannot reach a decision because the applicant fails to take a required action, or because there is an administrative or other emergency beyond the department's control, the department shall:

(i)document the reason for the delay in the applicant's case record; and

(ii)inform the applicant of the status of the application and time frame for completion.

(4)The department may not close enrollment in the program for a child who is eligible to enroll in the program under the provisions of Subsection

(1).

(5)The program shall:

(a)apply for grants to make technology system improvements necessary to implement a simplified enrollment and renewal process in accordance with Subsection (5)(b) ; and

(b)if funding is available, implement a simplified enrollment and renewal process.

Renumbered and Amended by Chapter 306 , 2023 General Session

Amended by Chapter 332 , 2023 General Session