reglab/housing_qa huggingface dataset:
UT Code § 49-20-403 (2021)
2021 Utah Code|Title 49 - Utah State Retirement and Insurance Benefit Act|Chapter 20 - Public Employees' Benefit and Insurance Program Act|Part 4 - Insurance Program|Section 403 - Assistance to members in purchase of life, health, dental, and medical insurance after retirement -- Employment of personnel to administer section.

49-20-403. Assistance to members in purchase of life, health, dental, and medical insurance after retirement -- Employment of personnel to administer section.    (1) The program may assist active and retired covered individuals and inactive covered individuals of the covered employers to purchase life, health, dental, and medical coverage on a group basis which can be continued after retirement under rules adopted by the board.     (2) The executive director may employ any personnel, including consultants, to administer this section.    Enacted by Chapter 250, 2002 General Session
UT Code § 49-20-404 (2021)
2021 Utah Code|Title 49 - Utah State Retirement and Insurance Benefit Act|Chapter 20 - Public Employees' Benefit and Insurance Program Act|Part 4 - Insurance Program|Section 404 - Governors' and legislative paid-up group health coverage benefit -- Limitations -- Medicare supplemental coverage -- Spouse coverage -- Limitations.

49-20-404. Governors' and legislative paid-up group health coverage benefit -- Limitations -- Medicare supplemental coverage -- Spouse coverage -- Limitations.    (1)   (a) Except as provided under Subsection (1)(b), the state shall pay the percentage of the cost of providing paid-up group health coverage under Subsection (3) for members and their surviving spouses covered under Chapter 19, Utah Governors' and Legislators' Retirement Act, or governors and legislators, as defined in Section 49-19-102, and their surviving spouses covered under Chapter 22, New Public Employees' Tier II Contributory Retirement Act, who:   (i) retire after January 1, 1998;     (ii) are at least 62 but less than 65 years of age;     (iii) elect to receive and apply for this benefit to the program; and     (iv) are active members at the time of retirement or have continued coverage with the program until the date of eligibility for the benefit under this Subsection (1).       (b) A governor or a legislator who begins service as a governor or legislator on or after January 1, 2012, and a surviving spouse of the governor or the legislator who begins service as a governor or legislator on or after January 1, 2012, is not eligible for the benefit provided under this Subsection (1).       (2) The state shall pay the percentage of the cost of providing Medicare supplemental coverage under Subsection (3) for members and their surviving spouses covered under Chapter 19, Utah Governors' and Legislators' Retirement Act who:   (a) began service as a governor or legislator before July 1, 2013;     (b) retire after January 1, 1998;     (c) are at least 65 years of age; and     (d) elect to receive and apply for this benefit to the program.       (3) The following percentages apply to the benefit described in Subsections (1)(a) and (2):   (a) 100% if the member has accrued 10 or more years of service credit;     (b) 80% if the member has accrued 8 or more years of service credit;     (c) 60% if the member has accrued 6 or more years of service credit; and     (d) 40% if the member has accrued 4 or more years of service credit.      Amended by Chapter 410, 2013 General Session
UT Code § 49-20-405 (2021)
2021 Utah Code|Title 49 - Utah State Retirement and Insurance Benefit Act|Chapter 20 - Public Employees' Benefit and Insurance Program Act|Part 4 - Insurance Program|Section 405 - Audit required -- Report to governor and Legislature.

49-20-405. Audit required -- Report to governor and Legislature.  The Insurance Department shall biennially audit the Public Employees' Trust Fund and programs authorized under this chapter and report its findings to the governor and the Legislature, but the commissioner may accept the annual audited statement of the programs under this chapter in lieu of the biennial audit requirement.  Renumbered and Amended by Chapter 250, 2002 General Session
UT Code § 49-20-406 (2021)
2021 Utah Code|Title 49 - Utah State Retirement and Insurance Benefit Act|Chapter 20 - Public Employees' Benefit and Insurance Program Act|Part 4 - Insurance Program|Section 406 - Insurance benefits for employees' beneficiaries.

 Effective 5/8/2018  49-20-406. Insurance benefits for employees' beneficiaries.    (1) As used in this section:   (a) "Children" includes stepchildren and legally adopted children.     (b)   (i) "Line-of-duty death" means a death resulting from:   (A) external force or violence occasioned by an act of duty as an employee; or     (B) strenuous activity, including a heart attack or stroke, that occurs during strenuous training or another strenuous activity required as an act of duty as an employee.       (ii) "Line-of-duty death" does not include a death that:   (A) occurs during an activity that is required as an act of duty as an employee if the activity is not a strenuous activity, including an activity that is clerical, administrative, or of a nonmanual nature contributes to the employee's death;     (B) occurs during the commission of a crime committed by the employee;     (C) the employee's intoxication or use of alcohol or drugs, whether prescribed or nonprescribed, contributes to the employee's death; or     (D) occurs in a manner other than as described in Subsection (1)(b)(i).         (c)   (i) "Strenuous activity" means engagement involving a difficult, stressful, or vigorous fire suppression, rescue, hazardous material response, emergency medical service, physical law enforcement, prison security, disaster relief, or other emergency response activity.     (ii) "Strenuous activity" includes participating in a participating employer sanctioned and funded training exercise that involves difficult, stressful, or vigorous physical activity.         (2) The beneficiary of a covered individual who is employed by the state and who has a line-of-duty death shall receive:   (a) the proceeds of a $50,000 group term life insurance policy paid for by the state and administered and provided as part of the group life insurance program under this chapter; and     (b) group health coverage paid for by the state that covers the covered individual's:   (i) surviving spouse until becoming eligible for Medicare as long as the surviving spouse continues coverage with the program; and     (ii) unmarried children up to the age of 26.         (3) A covered employer not required to provide the benefits under Subsection (2) may provide either or both of the benefits under Subsection (2) by paying rates established by the program.     (4) The benefit provided under Subsection (2)(a) is subject to the same terms and conditions as the group life insurance program provided under this chapter.    Amended by Chapter 210, 2018 General Session
UT Code § 49-20-407 (2021)
2021 Utah Code|Title 49 - Utah State Retirement and Insurance Benefit Act|Chapter 20 - Public Employees' Benefit and Insurance Program Act|Part 4 - Insurance Program|Section 407 - Insurance mandates.

 Effective 1/1/2018  49-20-407. Insurance mandates.  Notwithstanding the provisions of Subsection 31A-1-103(3)(f):  (1) health coverage offered to the state employee risk pool under Subsection 49-20-202(1)(a) shall comply with the provisions of Sections 31A-22-605.5 and 31A-45-501; and     (2) a health plan offered to public school districts, charter schools, and institutions of higher education under Subsection 49-20-201(1)(b) shall comply with the provisions of Section 31A-22-605.5.    Amended by Chapter 292, 2017 General Session
UT Code § 49-20-408 (2021)
2021 Utah Code|Title 49 - Utah State Retirement and Insurance Benefit Act|Chapter 20 - Public Employees' Benefit and Insurance Program Act|Part 4 - Insurance Program|Section 408 - Prohibition against certain uses of Social Security numbers.

49-20-408. Prohibition against certain uses of Social Security numbers.  Notwithstanding the provisions of Subsection 31A-1-103(3)(f), health, dental, medical, Medicare supplement, or conversion coverage offered under Section 49-20-202 shall comply with the provisions of Section 31A-22-634.  Enacted by Chapter 188, 2003 General Session
UT Code § 49-20-409 (2021)
2021 Utah Code|Title 49 - Utah State Retirement and Insurance Benefit Act|Chapter 20 - Public Employees' Benefit and Insurance Program Act|Part 4 - Insurance Program|Section 409 - Long-term disability -- Cost of health coverage benefit.

49-20-409. Long-term disability -- Cost of health coverage benefit.    (1) Under the direction of the board, the program shall provide for health insurance coverage for state employees who receive a monthly disability benefit under Title 49, Chapter 21, Public Employees' Long-Term Disability Act.     (2) A risk pool, other than the state risk pool, may elect to provide a benefit for its employees similar to the benefit provided under Subsection (1).    Amended by Chapter 130, 2007 General Session
UT Code § 49-20-413 (2021)
2021 Utah Code|Title 49 - Utah State Retirement and Insurance Benefit Act|Chapter 20 - Public Employees' Benefit and Insurance Program Act|Part 4 - Insurance Program|Section 413 - Pilot program for on-site employee clinic.

 Effective 5/12/2015  49-20-413. Pilot program for on-site employee clinic.    (1) Within state premiums paid to the state risk pool from the Legislature, the program shall establish a primary care clinic:   (a) for state employees and their dependents;     (b) within a state building that is accessible to a large number of state employees; and     (c) in accordance with Subsection (2).       (2) The program shall:   (a) affiliate with an existing clinic:   (i) located in a building accessible to a large number of state employees; and     (ii) managed by a physician licensed in this state under Title 58, Chapter 67, Utah Medical Practice Act, or Chapter 68, Utah Osteopathic Medical Practice Act; or       (b) request bids from private entities to establish the on-site primary care clinic in accordance with criteria established by the program, which shall include at least the following:   (i) the entity's ability to establish a primary care clinic that is designed to:   (A) be convenient for employees and their dependents;     (B) increase health of employees;     (C) increase compliance with health care screening and management of chronic health care conditions; and     (D) dispense commonly used, pre-packaged drugs in a cost effective manner;       (ii) the entity's organizational and financial independence from any particular hospital network, network of clinics, or network of health care providers; and     (iii) management of the clinic by a physician licensed in the state under Title 58, Chapter 67, Utah Medical Practice Act, or Chapter 68, Utah Osteopathic Medical Practice Act.        Enacted by Chapter 68, 2015 General Session  Technically renumbered to avoid duplication of section number also used in SB265, Chapter 455.
UT Code § 49-20-414 (2021)
2021 Utah Code|Title 49 - Utah State Retirement and Insurance Benefit Act|Chapter 20 - Public Employees' Benefit and Insurance Program Act|Part 4 - Insurance Program|Section 414 - Telemedicine services -- Reimbursement -- Reporting.

 Effective 5/14/2019  49-20-414. Telemedicine services -- Reimbursement -- Reporting.    (1) As used in this section:   (a) "Network provider" means a health care provider who has an agreement with the program to provide health care services to a patient with an expectation of receiving payment, other than coinsurance, copayments, or deductibles, directly from the managed care organization.     (b) "Telemedicine services" means the same as that term is defined in Section 26-60-102.       (2) This section applies to the risk pool established for the state under Subsection 49-20-201(1)(a).     (3) The program shall, at the provider's request, reimburse a network provider for medically appropriate telemedicine services at a commercially reasonable rate.     (4) Before November 1, 2019, the program shall report to the Legislature's Public Utilities, Energy, and Technology Interim Committee and Health Reform Task Force on:   (a) the result of the reimbursement requirement described in Subsection (3);     (b) existing and potential uses of telehealth and telemedicine services;     (c) issues of reimbursement to a provider offering telehealth and telemedicine services;      (d) potential rules or legislation related to:   (i) providers offering and insurers reimbursing for telehealth and telemedicine services; and     (ii) increasing access to health care, increasing the efficiency of health care, and decreasing the costs of health care; and       (e) telemedicine services that the program declined to cover because the telemedicine services that were requested were not medically appropriate.      Amended by Chapter 249, 2019 General Session
UT Code § 49-20-415 (2021)
2021 Utah Code|Title 49 - Utah State Retirement and Insurance Benefit Act|Chapter 20 - Public Employees' Benefit and Insurance Program Act|Part 4 - Insurance Program|Section 415 - Prescribing policies for certain opioid prescriptions.

 Effective 5/9/2017  49-20-415. Prescribing policies for certain opioid prescriptions.  A plan offered to state employees under this chapter may implement a prescribing policy for certain opioid prescriptions in accordance with Section 31A-22-615.5. Enacted by Chapter 53, 2017 General Session  Technically renumbered to avoid duplication of section number also enacted in HB154, Chapter 241.
UT Code § 49-20-416 (2021)
2021 Utah Code|Title 49 - Utah State Retirement and Insurance Benefit Act|Chapter 20 - Public Employees' Benefit and Insurance Program Act|Part 4 - Insurance Program|Section 416 - Screening, Brief Intervention, and Referral to Treatment program reimbursement.

 Effective 5/9/2017  49-20-416. Screening, Brief Intervention, and Referral to Treatment program reimbursement.    (1) As used in this section:   (a) "Controlled substance prescriber" means a controlled substance prescriber, as that term is defined in Section 58-37-6.5, who:   (i) has a record of having completed SBIRT training, in accordance with Subsection 58-37-6.5(2), before providing the SBIRT services; and     (ii) is a program enrolled controlled substance prescriber.       (b) "SBIRT" means the same as that term is defined in Section 58-37-6.5.       (2) The health program offered to the state employee risk pool under Section 49-20-202 shall reimburse a controlled substance prescriber who provides SBIRT services to a covered individual who is 13 years of age or older for the SBIRT services.    Enacted by Chapter 180, 2017 General Session  Technically renumbered to avoid duplication of section number also enacted in HB154, Chapter 241.
UT Code § 49-20-419 (2021)
2021 Utah Code|Title 49 - Utah State Retirement and Insurance Benefit Act|Chapter 20 - Public Employees' Benefit and Insurance Program Act|Part 4 - Insurance Program|Section 419 - Coverage of exome sequence testing.

 Effective 5/14/2019  49-20-419. Coverage of exome sequence testing.    (1) As used in this section, "exome sequence testing" means a genomic technique for sequencing the genome of an individual for diagnostic purposes.     (2) Beginning July 1, 2019, the program shall provide coverage for exome sequence testing:   (a) for a covered individual within the state risk pool who:   (i) is younger than 21 years of age; and     (ii) who remains undiagnosed after exhausting all other appropriate diagnostic-related tests;       (b) performed by a nationally recognized provider with significant experience in exome sequence testing;     (c) that is medically necessary; and     (d) at a rate set by the program.      Enacted by Chapter 320, 2019 General Session
UT Code § 49-20-420 (2021)
2021 Utah Code|Title 49 - Utah State Retirement and Insurance Benefit Act|Chapter 20 - Public Employees' Benefit and Insurance Program Act|Part 4 - Insurance Program|Section 420 - Coverage for in vitro fertilization and genetic testing.

 Affected by 63I-2-249 on 1/1/2030  Effective 5/12/2020  49-20-420. Coverage for in vitro fertilization and genetic testing.    (1) As used in this section:   (a) "Qualified condition" means:   (i) cystic fibrosis;     (ii) spinal muscular atrophy;     (iii) Morquio Syndrome;     (iv) myotonic dystrophy; or     (v) sickle cell anemia.       (b) "Qualified individual" means a covered individual who:   (i) has been diagnosed by a physician as having a genetic trait associated with a qualified condition; and     (ii) intends to get pregnant with a partner who is diagnosed by a physician as having a genetic trait associated with the same qualified condition as the covered individual.         (2) For a plan year that begins on or after July 1, 2020, the program shall provide coverage for a qualified individual for:   (a) in vitro fertilization services; and     (b) genetic testing of a qualified individual who receives in vitro fertilization services under Subsection (2)(a).       (3) Before November 1, 2022, and before November 1 of every third year thereafter, the program shall:   (a) calculate the change in state spending attributable to the coverage under this section; and     (b) report the amount described in Subsection (3)(a) to the Health and Human Services Interim Committee and the Social Services Appropriations Subcommittee.      Enacted by Chapter 187, 2020 General Session
UT Code § 49-20-421 (2021)
2021 Utah Code|Title 49 - Utah State Retirement and Insurance Benefit Act|Chapter 20 - Public Employees' Benefit and Insurance Program Act|Part 4 - Insurance Program|Section 421 - Prescription discount program.

 Effective 7/1/2021  49-20-421. Prescription discount program.    (1) As used in this section:   (a) "Diabetes" means:   (i) complete insulin deficiency or type 1 diabetes;     (ii) insulin resistant with partial insulin deficiency or type 2 diabetes; or     (iii) elevated blood glucose levels induced by pregnancy or gestational diabetes.       (b) "Discount program" means a process developed by the program that allows participants to purchase a qualified prescription at a discounted, post-rebate rate.     (c) "Epinephrine auto-injector" means the same as that term is defined in Section 26-41-102.     (d) "Individual with diabetes" means an individual who has been diagnosed with diabetes and who uses insulin to treat diabetes.     (e) "Insulin" means a prescription drug that contains insulin.     (f) "Participant" means a resident of Utah who:   (i) has a qualified condition;     (ii) does not receive health coverage under the program; and     (iii) enrolls in the discount program.       (g) "Prescription drug" means the same as that term is defined in Section 58-17b-102.     (h) "Qualified condition" means the individual:   (i) uses insulin to treat diabetes; or     (ii) has a prescription or a standing prescription drug order for an epinephrine auto-injector issued under Section 58-17b-1005.       (i) "Qualified prescription" means:   (i) insulin; or     (ii) epinephrine auto-injector.       (j) "Rebate" means the same as that term is defined in Section 31A-46-102.       (2) Notwithstanding Subsection 49-20-201(1), and for the purpose of the discount program only, the program shall offer a discount program that allows participants to purchase a qualified prescription at a discounted, post-rebate price when a rebate is available.     (3) The discount program described in Subsection (2) shall:   (a) provide a participant with a card or electronic document that identifies the participant as eligible for the discount on a qualified prescription related to the participant's qualified condition;     (b) provide a participant with information about pharmacies that will honor the discount;     (c) allow a participant to purchase a qualified prescription at a discounted, post-rebate price; and     (d) provide a participant with instructions to pursue a reimbursement of the purchase price from the participant's health insurer.       (4) The discount program shall charge a price for a qualified prescription that allows the program to retain only enough of any rebate for the qualified prescription to make the state risk pool whole for providing a discounted qualified prescription to participants.    Amended by Chapter 255, 2021 General Session
UT Code § 49-20-501 (2021)
2021 Utah Code|Title 49 - Utah State Retirement and Insurance Benefit Act|Chapter 20 - Public Employees' Benefit and Insurance Program Act|Part 5 - Pharmacy Benefits Manager Act|Section 501 - Title.

49-20-501. Title.  This part is known as the "Pharmacy Benefits Manager Act."  Enacted by Chapter 83, 2011 General Session
UT Code § 49-20-502 (2021)
2021 Utah Code|Title 49 - Utah State Retirement and Insurance Benefit Act|Chapter 20 - Public Employees' Benefit and Insurance Program Act|Part 5 - Pharmacy Benefits Manager Act|Section 502 - Definitions.

 Effective 5/5/2021  49-20-502. Definitions.  As used in this part:  (1) "Health benefit plan" means:   (a) a health benefit plan as defined in Section 31A-1-301; or     (b) a health, dental, medical, Medicare supplement, or conversion program offered under Title 49, Chapter 20, Public Employees' Benefit and Insurance Program Act.       (2) "Pharmacist" is as defined in Section 58-17b-102.     (3) "Pharmacy" is as defined in Section 58-17b-102.     (4) "Pharmacy benefits management service" means the same as that term is defined in Section 31A-46-102.     (5) "Pharmacy benefits manager" means a person that provides a pharmacy benefits management service to the program.     (6) "Pharmacy service" means a product, good, or service provided by a pharmacy or pharmacist to an individual.    Amended by Chapter 340, 2021 General Session
UT Code § 49-20-503 (2021)
2021 Utah Code|Title 49 - Utah State Retirement and Insurance Benefit Act|Chapter 20 - Public Employees' Benefit and Insurance Program Act|Part 5 - Pharmacy Benefits Manager Act|Section 503 - Request for proposals for pharmacy benefits manager for Public Employees' Benefit and Insurance Program.

49-20-503. Request for proposals for pharmacy benefits manager for Public Employees' Benefit and Insurance Program.    (1) When the board issues a request for proposals for a pharmacy benefits manager to provide pharmacy benefits management services for the program, the request for proposals shall:   (a) require each responder to comply with the pharmacy audit provisions of Section 58-17b-622; and     (b) provide each responder with the option to include, among the billing options proposed, a billing option that complies with the requirements described in this section.       (2) The billing option described in Subsection (1) shall require the pharmacy benefits manager to, on at least a monthly basis, submit to the board an invoice for all pharmacy services paid by the pharmacy benefits manager on behalf of the program since the last request for payment or reimbursement.     (3) The invoice described in Subsection (2) shall state, as a separate item from any other amount:   (a) the total amount due to the pharmacy benefits manager for all pharmacy services billed in the invoice; and     (b) the total amount paid by the pharmacy benefits manager for the same pharmacy services for which payment is sought in that invoice.      Amended by Chapter 265, 2012 General Session
UT Code § 49-21-101 (2021)
2021 Utah Code|Title 49 - Utah State Retirement and Insurance Benefit Act|Chapter 21 - Public Employees' Long-Term Disability Act|Part 1 - General Provisions|Section 101 - Title.

49-21-101. Title.  This chapter is known as the "Public Employees' Long-Term Disability Act."  Renumbered and Amended by Chapter 250, 2002 General Session
UT Code § 49-21-103 (2021)
2021 Utah Code|Title 49 - Utah State Retirement and Insurance Benefit Act|Chapter 21 - Public Employees' Long-Term Disability Act|Part 1 - General Provisions|Section 103 - Creation of program.

49-21-103. Creation of program.  There is created for eligible employees the "Public Employees' Long-Term Disability Program."  Renumbered and Amended by Chapter 250, 2002 General Session