State Codes and Statutes
Statutes > Utah > Title-49 > Chapter-20 > 49-20-40149-20-401. Program -- Powers and duties.
(1) The program shall:
(a) act as a self-insurer of employee benefit plans and administer those plans;
(b) enter into contracts with private insurers or carriers to underwrite employee benefitplans as considered appropriate by the program;
(c) indemnify employee benefit plans or purchase commercial reinsurance as consideredappropriate by the program;
(d) provide descriptions of all employee benefit plans under this chapter in cooperationwith covered employers;
(e) process claims for all employee benefit plans under this chapter or enter intocontracts, after competitive bids are taken, with other benefit administrators to provide for theadministration of the claims process;
(f) obtain an annual actuarial review of all health and dental benefit plans and a periodicreview of all other employee benefit plans;
(g) consult with the covered employers to evaluate employee benefit plans and developrecommendations for benefit changes;
(h) annually submit a budget and audited financial statements to the governor andLegislature which includes total projected benefit costs and administrative costs;
(i) maintain reserves sufficient to liquidate the unrevealed claims liability and otherliabilities of the employee benefit plans as certified by the program's consulting actuary;
(j) submit, in advance, its recommended benefit adjustments for state employees to:
(i) the Legislature; and
(ii) the executive director of the state Department of Human Resource Management;
(k) determine benefits and rates, upon approval of the board, for multiemployer riskpools, retiree coverage, and conversion coverage;
(l) determine benefits and rates based on the total estimated costs and the employeepremium share established by the Legislature, upon approval of the board, for state employees;
(m) administer benefits and rates, upon ratification of the board, for single employer riskpools;
(n) request proposals for provider networks or health and dental benefit plansadministered by third party carriers at least once every three years for the purposes of:
(i) stimulating competition for the benefit of covered individuals;
(ii) establishing better geographical distribution of medical care services; and
(iii) providing coverage for both active and retired covered individuals;
(o) offer proposals which meet the criteria specified in a request for proposals andaccepted by the program to active and retired state covered individuals and which may be offeredto active and retired covered individuals of other covered employers at the option of the coveredemployer;
(p) perform the same functions established in Subsections (1)(a), (b), (e), and (h) for theDepartment of Health if the program provides program benefits to children enrolled in the UtahChildren's Health Insurance Program created in Title 26, Chapter 40, Utah Children's HealthInsurance Act;
(q) establish rules and procedures governing the admission of political subdivisions oreducational institutions and their employees to the program;
(r) contract directly with medical providers to provide services for covered individuals;
and
(s) take additional actions necessary or appropriate to carry out the purposes of thischapter.
(2) (a) Funds budgeted and expended shall accrue from rates paid by the coveredemployers and covered individuals.
(b) Administrative costs shall be approved by the board and reported to the governor andthe Legislature.
(3) The Department of Human Resource Management shall include the benefitadjustments described in Subsection (1)(j) in the total compensation plan recommended to thegovernor required under Subsection 67-19-12(6)(a).
Amended by Chapter 176, 2008 General Session
