Current through the 2024 Fourth Special Session
Section 31A-22-647 - Insurer shared savings program(1) As used in this section: (a) "Insurer" means a person who offers health care insurance, including a health maintenance organization as that term is defined in Section 31A-8-101.(b) "PEHP" means the Public Employees' Benefit and Insurance Program created in Section 49-20-103.(c) "Savings reward program" means a program to reward a health insurance enrollee if the enrollee receives services: (i) covered by the enrollee's health plan; and(ii) from a provider whose costs for services are lower than the average costs for the services.(2) An insurer may, in accordance with Subsection (4), establish a savings reward program for a health benefit plan that is:(a) offered by the insurer; and(b) entered into or renewed on or after January 1, 2019.(3) PEHP shall, in accordance with Subsection (4), establish a savings reward program for a health plan that is: (a) offered to state employees under Title 49, Chapter 20, Public Employees' Benefit and Insurance Program Act; and(b) entered into or renewed on or after July 1, 2019.(4) A savings reward program described in Subsection (2) or (3) may include, in accordance with federal and state law, rewards to the enrollee through:(c) reduction of out-of-pocket costs; or(d) other rewards or incentives developed by the insurer.Added by Chapter 181, 2018 General Session ,§ 1, eff. 5/8/2018.