Utah Admin. Code R590-266-4 - Utah Essential Health Benefits
(1)
(a) The
PEHP Utah Basic Plus 2013 plan is designated as the Utah essential health
benefits package.
(b) The PEHP Utah
Basic Plus 2013 Plan is available at
https://insurance.utah.gov/consumer/health/reform.
(c) The PEHP Utah Basic Plus 2013 Plan was
issued on July 1, 2013, and some of the benchmark plan benefits may not comply
with current state or federal requirements.
(2)
(a)
Except as provided in Subsections (2)(b) and (2)(c), an individual or small
employer insurer who issues or renews a non-grandfathered plan on or after
January 1, 2014, must include at least the benefits of the Utah essential
health benefits package.
(b) An
insurer may substitute coverage provided in the Utah essential health benefits
package if the substitution is actuarially equivalent and complies with
42 CFR
457.431.
(c) A health benefit plan may exclude the
pediatric dental essential health benefit if there is at least one insurer
offering a certified stand-alone dental plan that provides the pediatric dental
essential health benefit in the PEHP Utah Basic Plus 2013
Plan.
(3) An individual
or small employer insurer may offer a non-grandfathered plan with benefits in
addition to the Utah essential health benefits package.
Notes
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No prior version found.