1     
RETIREMENT AND INSURANCE BENEFIT CLAIMS

2     
LIMITS

3     
2016 GENERAL SESSION

4     
STATE OF UTAH

5     
Chief Sponsor: Kraig Powell

6     
Senate Sponsor: Todd Weiler

7     

8     LONG TITLE
9     General Description:
10          This bill modifies the Utah State Retirement and Insurance Benefit Act by amending
11     provisions relating to limitations of retirement systems claims and actions.
12     Highlighted Provisions:
13          This bill:
14          ▸     provides that a request for a ruling to the executive director by a person who
15     disputes a benefit, right, obligation, or employment right under the Utah State
16     Retirement and Insurance Benefit Act shall constitute the initiation of an action for
17     purposes of the limitations periods;
18          ▸     specifies the time period a person has to request a review of a claim by a hearing
19     officer for a person who is dissatisfied by a ruling of the executive director with
20     respect to any benefit, right, obligation, or employment right;
21          ▸     requires that certain actions regarding a benefit, right, obligation, or employment
22     right brought under the Utah State Retirement and Insurance Benefit Act be
23     commenced only within a certain time frame;
24          ▸     provides that a cause of action accrues under the Utah State Retirement and
25     Insurance Benefit Act and the limitation period runs from the date when the
26     aggrieved party became aware, or through the exercise of reasonable diligence
27     should have become aware, of the facts giving rise to the cause of action;
28          ▸     provides that if a claim involves a retirement service credit issue:
29               •     a cause of action specifically accrues at the time the requisite retirement

30     contributions relating to that retirement service credit are paid or should have been paid to the
31     office; and
32               •     the person is deemed to be on notice of the payment or nonpayment of those
33     retirement contributions;
34          ▸     provides exceptions to the limitations period for certain actions; and
35          ▸     makes technical and conforming changes.
36     Money Appropriated in this Bill:
37          None
38     Other Special Clauses:
39          None
40     Utah Code Sections Affected:
41     AMENDS:
42          49-11-613, as last amended by Laws of Utah 2011, Chapter 439
43     ENACTS:
44          49-11-613.5, Utah Code Annotated 1953
45     

46     Be it enacted by the Legislature of the state of Utah:
47          Section 1. Section 49-11-613 is amended to read:
48          49-11-613. Appeals procedure -- Right of appeal to hearing officer -- Board
49     reconsideration -- Judicial review.
50          (1) (a) A member, retiree, participant, alternative payee, covered individual, employer,
51     participating employer, and covered employer shall inform themselves of their rights and
52     obligations under this title.
53          (b) Subject to the provisions in Subsection (8), any dispute regarding a benefit, right,
54     obligation, or employment right under this title is subject to the procedures provided under this
55     section.
56          (c) (i) A person who disputes a benefit, right, obligation, or employment right under
57     this title shall request a ruling by the executive director who may delegate the decision to the

58     deputy director.
59          (ii) A request for a ruling to the executive director under this section shall constitute
60     the initiation of an action for purposes of the limitations periods prescribed in Section
61     49-11-613.5.
62          (d) A person who is dissatisfied by a ruling under Subsection (1)(c) with respect to any
63     benefit, right, obligation, or employment right under this title shall have 30 days from the date
64     of the ruling to request a review of that claim by a hearing officer.
65          (e) The executive director, on behalf of the board, may request that the hearing officer
66     review a dispute regarding any benefit, right, obligation, or employment right under this title by
67     filing a notice of board action and providing notice to all affected parties in accordance with
68     rules adopted by the board.
69          (2) The hearing officer shall:
70          (a) be hired by the executive director after consultation with the board;
71          (b) follow the procedures and requirements of Title 63G, Chapter 4, Administrative
72     Procedures Act, except as specifically modified under this title;
73          (c) hear and determine all facts relevant to a decision, including facts pertaining to
74     applications for benefits under any system, plan, or program under this title and all matters
75     pertaining to the administration of the office; and
76          (d) make conclusions of law in determining the person's rights under any system, plan,
77     or program under this title and matters pertaining to the administration of the office.
78          (3) The board shall review and approve or deny all decisions of the hearing officer in
79     accordance with rules adopted by the board.
80          (4) The moving party in any proceeding brought under this section shall bear the
81     burden of proof.
82          (5) A party may file an application for reconsideration by the board upon any of the
83     following grounds:
84          (a) that the board acted in excess of its powers;
85          (b) that the order or award was procured by fraud;

86          (c) that the evidence does not justify the determination of the hearing officer; or
87          (d) that the party has discovered new material evidence that could not, with reasonable
88     diligence, have been discovered or procured prior to the hearing.
89          (6) The board shall affirm, reverse, or modify the decision of the hearing officer, or
90     remand the application to the hearing officer for further consideration.
91          (7) A party aggrieved by the board's decision may obtain judicial review by complying
92     with the procedures and requirements of Title 63G, Chapter 4, Administrative Procedures Act.
93          (8) The program shall provide an appeals process for medical claims that complies
94     with federal law.
95          (9) The board may make rules to implement this section.
96          Section 2. Section 49-11-613.5 is enacted to read:
97          49-11-613.5. Limitation of actions -- Cause of action.
98          (1) Subject to the procedures provided in Section 49-11-613 and except as provided in
99     Subsection (3), an action regarding a benefit, right, obligation, or employment right brought
100     under this title may be commenced only within four years of the date that the cause of action
101     accrues.
102          (2) (a) A cause of action accrues under this title and the limitation period in this section
103     runs from the date when the aggrieved party became aware, or through the exercise of
104     reasonable diligence should have become aware, of the facts giving rise to the cause of action,
105     including when:
106          (i) a benefit, right, or employment right is or should have been granted;
107          (ii) a payment is or should have been made; or
108          (iii) an obligation is or should have been performed.
109          (b) If a claim involves a retirement service credit issue under this title:
110          (i) a cause of action specifically accrues at the time the requisite retirement
111     contributions relating to that retirement service credit are paid or should have been paid to the
112     office; and
113          (ii) the person is deemed to be on notice of the payment or nonpayment of those

114     retirement contributions.
115          (3) If an aggrieved party fails to discover the facts giving rise to the cause of action due
116     to misrepresentation, fraud, intentional nondisclosure, or other affirmative steps to conceal the
117     cause of action, a limitation period prescribed in this section does not begin to run until the
118     aggrieved party actually discovers the existence of the cause of action.
119          (4) The person claiming a benefit, right, obligation, or employment right arising under
120     this title has the burden of bringing the action within the period prescribed in this section.
121          (5) Nothing in this section relieves a member, retiree, participant, alternative payee,
122     covered individual, employer, participating employer, or covered employer of the obligations
123     under this title.
124          (6) The office is not required to bring a claim on behalf of a member, retiree,
125     participant, alternative payee, covered individual, employer, participating employer, or covered
126     employer.
127          (7) (a) A limitation period provided in this section does not apply to actions for which
128     a specific limit is otherwise specified in this title or by contract, including master policies or
129     other insurance contracts.
130          (b) For actions arising under this title, this section supersedes any applicable limitation
131     period provided in Title 78B, Chapter 2, Statutes of Limitations.