Chief Sponsor: Daniel Hemmert

House Sponsor: Norman K. Thurston


9     General Description:
10          This concurrent resolution directs the Public Employees' Benefit and Insurance Program
11     to make certain changes to an offered health plan.
12     Highlighted Provisions:
13          This resolution:
14          ▸     directs the Public Employees' Benefit and Insurance Program to:
15               •     rename the "Utah Basic Plus" plan to "Consumer Plus"; and
16               •     adopt reference pricing as the preferred method of payment.
17     Special Clauses:
18          None

20     Be it resolved by the Legislature of the state of Utah, the Governor concurring therein:
21          WHEREAS, in accordance with Utah Code Section 49-20-201, the state participates in
22     the Public Employees' Benefit and Insurance Program;
23          WHEREAS, Utah Code Subsection 49-20-301(1)(g) provides that the program must
24     "consult with the covered employers to evaluate employee benefit plans and develop
25     recommendations for benefit changes";
26          WHEREAS, Utah Code Subsection 49-20-401(1)(j) provides that the program "submit,
27     in advance, its recommended benefit adjustments for state employees to . . . the Legislature;

28     and . . . the executive director of the state Department of Human Resource Management";
29          WHEREAS, the state currently offers three health plans to its employees, including
30     Utah Basic Plus, which is a Health Savings Account-qualified plan; and
31          WHEREAS, the state desires to give its employees the choice of a health plan that
32     maximizes consumer-driven health care and rewards consumer behavior to the benefit of the
33     employee and the Public Employees' Benefit and Insurance Program's medical risk pool for the
34     state of Utah:
35          NOW, THEREFORE, BE IT RESOLVED that the Legislature of the state of Utah, the
36     Governor concurring therein, directs the Public Employees' Benefit and Insurance Program to
37     change the name of the plan currently known as "Utah Basic Plus" to "Consumer Plus."
38          BE IT FURTHER RESOLVED that the Legislature and the Governor direct the Public
39     Employees' Benefit and Insurance Program to adopt reference pricing as the preferred method
40     of payment for the Consumer Plus plan where appropriate.
41          BE IT FURTHER RESOLVED that the preference for reference pricing:
42          (1) be established for covered medical services in a manner that:
43          (a) sets the reference price at a rate that is not lower than a rate that is available in the
44     market;
45          (b) takes appropriate members' cost sharing into account; and
46          (c) is designed to encourage plan members to save money for themselves and the plan;
47          (2) be designed so that plan members are financially responsible for any provider
48     charge above the applicable reference price and eligible to receive a financial incentive for a
49     provider charge below the reference price;
50          (3) does not cover circumstances when the preference for reference pricing would be
51     inappropriate for the Consumer Plus plan, as determined by the Public Employees' Benefit and
52     Insurance Program, including limits based on specific geographic areas;
53          (4) gives Consumer Plus members online access to reference prices and provides other
54     forms of member support;
55          (5) limits the use of provider contracts with network restrictions and facilitates
56     alternative payment arrangements that encourage consumerism and reduce costs;
57          (6) facilitates cash reimbursements for covered services; and
58          (7) adapts the Consumer Plus plan as necessary to comply with federal law.

59          BE IT FURTHER RESOLVED that a copy of this resolution be sent to the Public
60     Employees' Benefit and Insurance Program.

Legislative Review Note
Office of Legislative Research and General Counsel