GroundRules
Utah Code § 31A-45-403: Essential health benefits.
Where this section sits in the code
- Title 31A Insurance Code
- Chapter 31A-45 Managed Care Organizations
- Part 31A-45-4 Access to Services for Managed Care Enrollees
(1) The state designates the state's own essential health benefits benchmark plan and does not accept a federal determination of the essential health benefits benchmark plan under the PPACA.
(2) The commissioner shall make rules in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, that designate the essential health benefits benchmark plan for the state.
(3)
(a) The commissioner shall update the state's essential health benefits benchmark plan for plan years beginning on January 1, 2027.
(b) The commissioner shall include in the plan described in Subsection (3)(a):
(i) any state mandated health insurance benefit that applies to a health benefit plan effective on or after January 1, 2012, through January 1, 2025; and
(ii) additional benefits mandated by the PPACA.
(4) The commissioner may expand the state's essential health benefits plan if additional benefits are mandated by the PPACA.
Collected 2026-09-03T11:34:33Z. Source file · JSON