Section R916-5-6 - Requirements and Procedures a Contractor Must Follow(1) A contractor or subcontractor must comply with the following requirements and procedures and demonstrate to the department, no later than the date the contract is executed, full compliance with Section 72-6-107.5: (a) By providing a written certification to the Executive Director that the contractor and each subcontractor have and will maintain for the duration of the contract an offer of qualified health insurance coverage for each employee; and(b) a contractor must also provide such written certification from each subcontractor at any tier that is subject to the requirements of this rule prior to the date the contract is executed.(c) The contractor must: (i) Include a requirement in the subcontract and certify to the department that a subcontractor must obtain and maintain an offer of qualified health insurance coverage for the subcontractor's employees and the employee's dependents during the duration of the subcontract; and(ii) certify to the department that each subcontractor has and will maintain an offer of qualified health insurance coverage for each employee including dependents during the duration of the contract.(2) Recertification. The executive director or designee may require a contractor to recertify by submitting a written request to the contractor that must within ten business-days of receiving the written request; however, the contractor will not be required to demonstrate such compliance more than twice in any 12-month period.(3) Demonstrating Compliance with Actuarially Equivalent Determination.(a) When a contractor becomes subject to the requirements of Section 72-6-107.5, the contractor must obtain and submit to the executive director a written Statement of Compliance in the form published on the department's website.(b) When a subcontractor becomes subject to the requirements of Section 72-6-107.5, the contractor must obtain from the subcontractor a written Statement of Compliance in the form published on the division's website.(c) The commercially equivalent benchmark for the qualified health insurance coverage required pursuant to Section 72-6-107.5 that is provided by the Department of Health in accordance with Utah Code Subsection 26-40-115(2) is available on the department's website at: https://chip.health.utah.gov/wp-content/uploads/2017/07/2019-Benchmark.pdf. (4) The required offer of health insurance must be available to the employee on the first day of the calendar month following the initial 90 days from the date of hire.(5) Consultant Compliance Process. (a) Consultants that must comply with Section 72-6-107.5 must demonstrate compliance in their initial Financial Screening Application.(b) During the procurement process and no later than the execution of the contract, the consultant will confirm it and its subconsultants comply with this rule.(c) The contract must include a provision requiring the consultant and its subconsultants to maintain and confirm compliance with this rule.Utah Admin. Code R916-5-6
Amended by Utah State Bulletin Number 2016-23, effective 11/8/2016Adopted by Utah State Bulletin Number 2020-06, effective 3/10/2020