31A-30-204. Employer responsibilities -- Defined contribution arrangements.
(1) (a) (i) An employer described in Subsection 31A-30-203(1) that chooses to
participate in a defined contribution arrangement may not offer a major medical health benefit
plan that is not a part of the defined contribution arrangement to an employee.
(ii) Subsection (1)(a)(i) does not prohibit the offer of supplemental or limited benefit
policies such as dental or vision coverage, or other types of federally qualified savings accounts
for health care expenses.
(b) (i) To the extent permitted by the risk adjustment plan adopted under Section
31A-42-202, the employer reserves the right to determine:
(A) the criteria for employee eligibility, enrollment, and participation in the employer's
health benefit plan; and
(B) the amount of the employer's contribution to that plan.
(ii) The determinations made under Subsection (1)(b) may only be changed during
periods of open enrollment.
(2) An employer that chooses to establish a defined contribution arrangement to provide
a health benefit plan for its employees shall:
(a) establish a mechanism for its employees to use pre-tax dollars to purchase a health
benefit plan from the defined contribution arrangement market on the Internet portal created in
Section 63M-1-2504, which may include:
(i) a health reimbursement arrangement;
(ii) a Section 125 Cafeteria plan; or
(iii) another plan or arrangement similar to Subsection (2)(a)(i) or (ii) which is excluded
or deducted from gross income under the Internal Revenue Code;
(b) by November 10 of the open enrollment period:
(i) inform each employee of the health benefit plan the employer has selected as the
default health benefit plan for the employer group;
(ii) offer each employee a choice of any of the health benefit plans available through the
defined contribution arrangement market on the Internet portal; and
(iii) notify the employee that the employee will be enrolled in the default health benefit
plan selected by the employer and payroll deductions initiated for premium payments, unless the
employee, prior to November 25 of the open enrollment period:
(A) notifies the employer that the employee has selected a different health benefit plan
available through the defined contribution arrangement in the Internet portal;
(B) provides proof of coverage from another health benefit plan; or
(C) specifically declines coverage in a health benefit plan.
(3) An employer shall enroll an employee in the default health benefit plan selected by
the employer if the employee does not make one of the choices described in Subsection (2)(b)(ii)
prior to November 25 of the open enrollment period.
(4) The employer's notice to the employee under Subsection (2)(b)(iii) shall inform the
employee that the failure to act under Subsections (2)(b)(iii)(A) through (C) is considered an
affirmative election under pre-tax payroll deductions for the employer to begin payroll
deductions for health benefit plan premiums.
Enacted by Chapter 12, 2009 General Session
Download Code Section Zipped WordPerfect 31A30_020400.ZIP 3,110 Bytes
Sections in this Chapter|Chapters in this Title|All Titles|Legislative Home Page
Last revised: Thursday, May 28, 2009