Section 404 - Contracting powers of department -- Health insurance coverage.

UT Code § 79-2-404 (2019) (N/A)
Copy with citation
Copy as parenthetical citation

(1) As used in this section: (a) "Aggregate" means the sum of all contracts, change orders, and modifications related to a single project. (b) "Change order" means the same as that term is defined in Section 63G-6a-103. (c) "Employee" means, as defined in Section 34A-2-104, an "employee," "worker," or "operative" who: (i) works at least 30 hours per calendar week; and (ii) meets employer eligibility waiting requirements for health care insurance, which may not exceed the first day of the calendar month following 60 days after the day on which the individual is hired. (d) "Health benefit plan" means the same as that term is defined in Section 31A-1-301. (e) "Qualified health insurance coverage" means the same as that term is defined in Section 26-40-115. (f) "Subcontractor" means the same as that term is defined in Section 63A-5-208.

(a) "Aggregate" means the sum of all contracts, change orders, and modifications related to a single project.

(b) "Change order" means the same as that term is defined in Section 63G-6a-103.

(c) "Employee" means, as defined in Section 34A-2-104, an "employee," "worker," or "operative" who: (i) works at least 30 hours per calendar week; and (ii) meets employer eligibility waiting requirements for health care insurance, which may not exceed the first day of the calendar month following 60 days after the day on which the individual is hired.

(i) works at least 30 hours per calendar week; and

(ii) meets employer eligibility waiting requirements for health care insurance, which may not exceed the first day of the calendar month following 60 days after the day on which the individual is hired.

(d) "Health benefit plan" means the same as that term is defined in Section 31A-1-301.

(e) "Qualified health insurance coverage" means the same as that term is defined in Section 26-40-115.

(f) "Subcontractor" means the same as that term is defined in Section 63A-5-208.

(2) Except as provided in Subsection (3), the requirements of this section apply to: (a) a contractor of a design or construction contract entered into by, or delegated to, the department or a division, board, or council of the department on or after July 1, 2009, if the prime contract is in an aggregate amount equal to or greater than $2,000,000; and (b) a subcontractor of a contractor of a design or construction contract entered into by, or delegated to, the department or a division, board, or council of the department on or after July 1, 2009, if the subcontract is in an aggregate amount equal to or greater than $1,000,000.

(a) a contractor of a design or construction contract entered into by, or delegated to, the department or a division, board, or council of the department on or after July 1, 2009, if the prime contract is in an aggregate amount equal to or greater than $2,000,000; and

(b) a subcontractor of a contractor of a design or construction contract entered into by, or delegated to, the department or a division, board, or council of the department on or after July 1, 2009, if the subcontract is in an aggregate amount equal to or greater than $1,000,000.

(3) This section does not apply to contracts entered into by the department or a division, board, or council of the department if: (a) the application of this section jeopardizes the receipt of federal funds; (b) the contract or agreement is between: (i) the department or a division, board, or council of the department; and (ii) (A) another agency of the state; (B) the federal government; (C) another state; (D) an interstate agency; (E) a political subdivision of this state; or (F) a political subdivision of another state; or (c) the contract or agreement is: (i) for the purpose of disbursing grants or loans authorized by statute; (ii) a sole source contract; or (iii) an emergency procurement.

(a) the application of this section jeopardizes the receipt of federal funds;

(b) the contract or agreement is between: (i) the department or a division, board, or council of the department; and (ii) (A) another agency of the state; (B) the federal government; (C) another state; (D) an interstate agency; (E) a political subdivision of this state; or (F) a political subdivision of another state; or

(i) the department or a division, board, or council of the department; and

(ii) (A) another agency of the state; (B) the federal government; (C) another state; (D) an interstate agency; (E) a political subdivision of this state; or (F) a political subdivision of another state; or

(A) another agency of the state;

(B) the federal government;

(C) another state;

(D) an interstate agency;

(E) a political subdivision of this state; or

(F) a political subdivision of another state; or

(c) the contract or agreement is: (i) for the purpose of disbursing grants or loans authorized by statute; (ii) a sole source contract; or (iii) an emergency procurement.

(i) for the purpose of disbursing grants or loans authorized by statute;

(ii) a sole source contract; or

(iii) an emergency procurement.

(4) A person that intentionally uses change orders, contract modifications, or multiple contracts to circumvent the requirements of this section is guilty of an infraction.

(5) (a) A contractor subject to the requirements of this section shall demonstrate to the department that the contractor has and will maintain an offer of qualified health insurance coverage for the contractor's employees and the employees' dependents during the duration of the contract by submitting to the department a written statement that: (i) the contractor offers qualified health insurance coverage that complies with Section 26-40-115; (ii) is from: (A) an actuary selected by the contractor or the contractor's insurer; or (B) an underwriter who is responsible for developing the employer group's premium rates; and (iii) was created within one year before the day on which the statement is submitted. (b) A contractor that is subject to the requirements of this section shall: (i) place a requirement in each of the contractor's subcontracts that a subcontractor that is subject to the requirements of this section shall obtain and maintain an offer of qualified health insurance coverage for the subcontractor's employees and the employees' dependents during the duration of the subcontract; and (ii) obtain from a subcontractor that is subject to the requirements of this section a written statement that: (A) the subcontractor offers qualified health insurance coverage that complies with Section 26-40-115; (B) is from an actuary selected by the subcontractor or the subcontractor's insurer, or an underwriter who is responsible for developing the employer group's premium rates; and (C) was created within one year before the day on which the contractor obtains the statement. (c) (i) (A) A contractor that fails to maintain an offer of qualified health insurance coverage described in Subsection (5)(a) during the duration of the contract is subject to penalties in accordance with administrative rules adopted by the department under Subsection (6). (B) A contractor is not subject to penalties for the failure of a subcontractor to obtain and maintain an offer of qualified health insurance coverage described in Subsection (5)(b)(i). (ii) (A) A subcontractor that fails to obtain and maintain an offer of qualified health insurance coverage described in Subsection (5)(b) during the duration of the subcontract is subject to penalties in accordance with administrative rules adopted by the department under Subsection (6). (B) A subcontractor is not subject to penalties for the failure of a contractor to maintain an offer of qualified health insurance coverage described in Subsection (5)(a).

(a) A contractor subject to the requirements of this section shall demonstrate to the department that the contractor has and will maintain an offer of qualified health insurance coverage for the contractor's employees and the employees' dependents during the duration of the contract by submitting to the department a written statement that: (i) the contractor offers qualified health insurance coverage that complies with Section 26-40-115; (ii) is from: (A) an actuary selected by the contractor or the contractor's insurer; or (B) an underwriter who is responsible for developing the employer group's premium rates; and (iii) was created within one year before the day on which the statement is submitted.

(i) the contractor offers qualified health insurance coverage that complies with Section 26-40-115;

(ii) is from: (A) an actuary selected by the contractor or the contractor's insurer; or (B) an underwriter who is responsible for developing the employer group's premium rates; and

(A) an actuary selected by the contractor or the contractor's insurer; or

(B) an underwriter who is responsible for developing the employer group's premium rates; and

(iii) was created within one year before the day on which the statement is submitted.

(b) A contractor that is subject to the requirements of this section shall: (i) place a requirement in each of the contractor's subcontracts that a subcontractor that is subject to the requirements of this section shall obtain and maintain an offer of qualified health insurance coverage for the subcontractor's employees and the employees' dependents during the duration of the subcontract; and (ii) obtain from a subcontractor that is subject to the requirements of this section a written statement that: (A) the subcontractor offers qualified health insurance coverage that complies with Section 26-40-115; (B) is from an actuary selected by the subcontractor or the subcontractor's insurer, or an underwriter who is responsible for developing the employer group's premium rates; and (C) was created within one year before the day on which the contractor obtains the statement.

(i) place a requirement in each of the contractor's subcontracts that a subcontractor that is subject to the requirements of this section shall obtain and maintain an offer of qualified health insurance coverage for the subcontractor's employees and the employees' dependents during the duration of the subcontract; and

(ii) obtain from a subcontractor that is subject to the requirements of this section a written statement that: (A) the subcontractor offers qualified health insurance coverage that complies with Section 26-40-115; (B) is from an actuary selected by the subcontractor or the subcontractor's insurer, or an underwriter who is responsible for developing the employer group's premium rates; and (C) was created within one year before the day on which the contractor obtains the statement.

(A) the subcontractor offers qualified health insurance coverage that complies with Section 26-40-115;

(B) is from an actuary selected by the subcontractor or the subcontractor's insurer, or an underwriter who is responsible for developing the employer group's premium rates; and

(C) was created within one year before the day on which the contractor obtains the statement.

(c) (i) (A) A contractor that fails to maintain an offer of qualified health insurance coverage described in Subsection (5)(a) during the duration of the contract is subject to penalties in accordance with administrative rules adopted by the department under Subsection (6). (B) A contractor is not subject to penalties for the failure of a subcontractor to obtain and maintain an offer of qualified health insurance coverage described in Subsection (5)(b)(i). (ii) (A) A subcontractor that fails to obtain and maintain an offer of qualified health insurance coverage described in Subsection (5)(b) during the duration of the subcontract is subject to penalties in accordance with administrative rules adopted by the department under Subsection (6). (B) A subcontractor is not subject to penalties for the failure of a contractor to maintain an offer of qualified health insurance coverage described in Subsection (5)(a).

(i) (A) A contractor that fails to maintain an offer of qualified health insurance coverage described in Subsection (5)(a) during the duration of the contract is subject to penalties in accordance with administrative rules adopted by the department under Subsection (6). (B) A contractor is not subject to penalties for the failure of a subcontractor to obtain and maintain an offer of qualified health insurance coverage described in Subsection (5)(b)(i).

(A) A contractor that fails to maintain an offer of qualified health insurance coverage described in Subsection (5)(a) during the duration of the contract is subject to penalties in accordance with administrative rules adopted by the department under Subsection (6).

(B) A contractor is not subject to penalties for the failure of a subcontractor to obtain and maintain an offer of qualified health insurance coverage described in Subsection (5)(b)(i).

(ii) (A) A subcontractor that fails to obtain and maintain an offer of qualified health insurance coverage described in Subsection (5)(b) during the duration of the subcontract is subject to penalties in accordance with administrative rules adopted by the department under Subsection (6). (B) A subcontractor is not subject to penalties for the failure of a contractor to maintain an offer of qualified health insurance coverage described in Subsection (5)(a).

(A) A subcontractor that fails to obtain and maintain an offer of qualified health insurance coverage described in Subsection (5)(b) during the duration of the subcontract is subject to penalties in accordance with administrative rules adopted by the department under Subsection (6).

(B) A subcontractor is not subject to penalties for the failure of a contractor to maintain an offer of qualified health insurance coverage described in Subsection (5)(a).

(6) The department shall adopt administrative rules: (a) in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act; (b) in coordination with: (i) the Department of Environmental Quality in accordance with Section 19-1-206; (ii) a public transit district in accordance with Section 17B-2a-818.5; (iii) the State Building Board in accordance with Section 63A-5-205.5; (iv) the State Capitol Preservation Board in accordance with Section 63C-9-403; (v) the Department of Transportation in accordance with Section 72-6-107.5; and (vi) the Legislature's Administrative Rules Review Committee; and (c) that establish: (i) the requirements and procedures a contractor and a subcontractor shall follow to demonstrate compliance with this section, including: (A) that a contractor or subcontractor's compliance with this section is subject to an audit by the department or the Office of the Legislative Auditor General; (B) that a contractor that is subject to the requirements of this section shall obtain a written statement described in Subsection (5)(a); and (C) that a subcontractor that is subject to the requirements of this section shall obtain a written statement described in Subsection (5)(b)(ii); (ii) the penalties that may be imposed if a contractor or subcontractor intentionally violates the provisions of this section, which may include: (A) a three-month suspension of the contractor or subcontractor from entering into future contracts with the state upon the first violation; (B) a six-month suspension of the contractor or subcontractor from entering into future contracts with the state upon the second violation; (C) an action for debarment of the contractor or subcontractor in accordance with Section 63G-6a-904 upon the third or subsequent violation; and (D) monetary penalties which may not exceed 50% of the amount necessary to purchase qualified health insurance coverage for an employee and a dependent of an employee of the contractor or subcontractor who was not offered qualified health insurance coverage during the duration of the contract; and (iii) a website on which the department shall post the commercially equivalent benchmark, for the qualified health insurance coverage identified in Subsection (1)(e), provided by the Department of Health, in accordance with Subsection 26-40-115(2).

(a) in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act;

(b) in coordination with: (i) the Department of Environmental Quality in accordance with Section 19-1-206; (ii) a public transit district in accordance with Section 17B-2a-818.5; (iii) the State Building Board in accordance with Section 63A-5-205.5; (iv) the State Capitol Preservation Board in accordance with Section 63C-9-403; (v) the Department of Transportation in accordance with Section 72-6-107.5; and (vi) the Legislature's Administrative Rules Review Committee; and

(i) the Department of Environmental Quality in accordance with Section 19-1-206;

(ii) a public transit district in accordance with Section 17B-2a-818.5;

(iii) the State Building Board in accordance with Section 63A-5-205.5;

(iv) the State Capitol Preservation Board in accordance with Section 63C-9-403;

(v) the Department of Transportation in accordance with Section 72-6-107.5; and

(vi) the Legislature's Administrative Rules Review Committee; and

(c) that establish: (i) the requirements and procedures a contractor and a subcontractor shall follow to demonstrate compliance with this section, including: (A) that a contractor or subcontractor's compliance with this section is subject to an audit by the department or the Office of the Legislative Auditor General; (B) that a contractor that is subject to the requirements of this section shall obtain a written statement described in Subsection (5)(a); and (C) that a subcontractor that is subject to the requirements of this section shall obtain a written statement described in Subsection (5)(b)(ii); (ii) the penalties that may be imposed if a contractor or subcontractor intentionally violates the provisions of this section, which may include: (A) a three-month suspension of the contractor or subcontractor from entering into future contracts with the state upon the first violation; (B) a six-month suspension of the contractor or subcontractor from entering into future contracts with the state upon the second violation; (C) an action for debarment of the contractor or subcontractor in accordance with Section 63G-6a-904 upon the third or subsequent violation; and (D) monetary penalties which may not exceed 50% of the amount necessary to purchase qualified health insurance coverage for an employee and a dependent of an employee of the contractor or subcontractor who was not offered qualified health insurance coverage during the duration of the contract; and (iii) a website on which the department shall post the commercially equivalent benchmark, for the qualified health insurance coverage identified in Subsection (1)(e), provided by the Department of Health, in accordance with Subsection 26-40-115(2).

(i) the requirements and procedures a contractor and a subcontractor shall follow to demonstrate compliance with this section, including: (A) that a contractor or subcontractor's compliance with this section is subject to an audit by the department or the Office of the Legislative Auditor General; (B) that a contractor that is subject to the requirements of this section shall obtain a written statement described in Subsection (5)(a); and (C) that a subcontractor that is subject to the requirements of this section shall obtain a written statement described in Subsection (5)(b)(ii);

(A) that a contractor or subcontractor's compliance with this section is subject to an audit by the department or the Office of the Legislative Auditor General;

(B) that a contractor that is subject to the requirements of this section shall obtain a written statement described in Subsection (5)(a); and

(C) that a subcontractor that is subject to the requirements of this section shall obtain a written statement described in Subsection (5)(b)(ii);

(ii) the penalties that may be imposed if a contractor or subcontractor intentionally violates the provisions of this section, which may include: (A) a three-month suspension of the contractor or subcontractor from entering into future contracts with the state upon the first violation; (B) a six-month suspension of the contractor or subcontractor from entering into future contracts with the state upon the second violation; (C) an action for debarment of the contractor or subcontractor in accordance with Section 63G-6a-904 upon the third or subsequent violation; and (D) monetary penalties which may not exceed 50% of the amount necessary to purchase qualified health insurance coverage for an employee and a dependent of an employee of the contractor or subcontractor who was not offered qualified health insurance coverage during the duration of the contract; and

(A) a three-month suspension of the contractor or subcontractor from entering into future contracts with the state upon the first violation;

(B) a six-month suspension of the contractor or subcontractor from entering into future contracts with the state upon the second violation;

(C) an action for debarment of the contractor or subcontractor in accordance with Section 63G-6a-904 upon the third or subsequent violation; and

(D) monetary penalties which may not exceed 50% of the amount necessary to purchase qualified health insurance coverage for an employee and a dependent of an employee of the contractor or subcontractor who was not offered qualified health insurance coverage during the duration of the contract; and

(iii) a website on which the department shall post the commercially equivalent benchmark, for the qualified health insurance coverage identified in Subsection (1)(e), provided by the Department of Health, in accordance with Subsection 26-40-115(2).

(7) (a) (i) In addition to the penalties imposed under Subsection (6)(c)(ii), a contractor or subcontractor who intentionally violates the provisions of this section is liable to the employee for health care costs that would have been covered by qualified health insurance coverage. (ii) An employer has an affirmative defense to a cause of action under Subsection (7)(a)(i) if: (A) the employer relied in good faith on a written statement described in Subsection (5)(a) or (5)(b)(ii); or (B) the department determines that compliance with this section is not required under the provisions of Subsection (3). (b) An employee has a private right of action only against the employee's employer to enforce the provisions of this Subsection (7).

(a) (i) In addition to the penalties imposed under Subsection (6)(c)(ii), a contractor or subcontractor who intentionally violates the provisions of this section is liable to the employee for health care costs that would have been covered by qualified health insurance coverage. (ii) An employer has an affirmative defense to a cause of action under Subsection (7)(a)(i) if: (A) the employer relied in good faith on a written statement described in Subsection (5)(a) or (5)(b)(ii); or (B) the department determines that compliance with this section is not required under the provisions of Subsection (3).

(i) In addition to the penalties imposed under Subsection (6)(c)(ii), a contractor or subcontractor who intentionally violates the provisions of this section is liable to the employee for health care costs that would have been covered by qualified health insurance coverage.

(ii) An employer has an affirmative defense to a cause of action under Subsection (7)(a)(i) if: (A) the employer relied in good faith on a written statement described in Subsection (5)(a) or (5)(b)(ii); or (B) the department determines that compliance with this section is not required under the provisions of Subsection (3).

(A) the employer relied in good faith on a written statement described in Subsection (5)(a) or (5)(b)(ii); or

(B) the department determines that compliance with this section is not required under the provisions of Subsection (3).

(b) An employee has a private right of action only against the employee's employer to enforce the provisions of this Subsection (7).

(8) Any penalties imposed and collected under this section shall be deposited into the Medicaid Restricted Account created in Section 26-18-402.

(9) The failure of a contractor or subcontractor to provide qualified health insurance coverage as required by this section: (a) may not be the basis for a protest or other action from a prospective bidder, offeror, or contractor under: (i) Section 63G-6a-1602; or (ii) any other provision in Title 63G, Chapter 6a, Utah Procurement Code; and (b) may not be used by the procurement entity or a prospective bidder, offeror, or contractor as a basis for any action or suit that would suspend, disrupt, or terminate the design or construction.

(a) may not be the basis for a protest or other action from a prospective bidder, offeror, or contractor under: (i) Section 63G-6a-1602; or (ii) any other provision in Title 63G, Chapter 6a, Utah Procurement Code; and

(i) Section 63G-6a-1602; or

(ii) any other provision in Title 63G, Chapter 6a, Utah Procurement Code; and

(b) may not be used by the procurement entity or a prospective bidder, offeror, or contractor as a basis for any action or suit that would suspend, disrupt, or terminate the design or construction.