Section 647 - Insurer shared savings program.

UT Code § 31A-22-647 (2019) (N/A)
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(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.

(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.

(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.

(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.

(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.

(a) premium discounts;

(b) rebates;

(c) reduction of out-of-pocket costs; or

(d) other rewards or incentives developed by the insurer.