Section R590-283-3 - DefinitionsTerms used in this rule are defined in Sections 31A-1-301 and 31A-30-103, and Rule R590-266. Additional terms are defined as follows:
(1) "Defrayal payment" means the amount payable to a carrier from the state for expenses incurred for a state-required benefit under: (b) Section 31A-30-118; and(2) "EHB" means essential health benefits.(3) "Exchange" means exchange as defined in 45 CFR 155.20.(4) "Member month" means a count of one for each month during a calendar year during which an individual has coverage under a plan subject to this rule where coverage is evaluated on the first of the month.(5) "Qualified health plan" means a qualified health plan as defined in 45 CFR 155.20.(6) "State-required benefit" means a benefit required by the state:(a) on or after January 1, 2012;(b) for a purpose other than compliance with a federal requirement;(c) that is in excess of the Utah Essential Health Benefits Package; and(d) that is eligible for a defrayal payment.Utah Admin. Code R590-283-3
Adopted by Utah State Bulletin Number 2020-02, effective 12/23/2019Amended by Utah State Bulletin Number 2022-04, effective 2/8/2022Amended by Utah State Bulletin Number 2022-21, effective 10/24/2022