31A-22-647. Insurer shared savings program.

237 words·~1 min read·/ut/title-31a/chapter-22/31a-22-647

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

Effective 5/8/2018

(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