02-09-24 8:42 AM 1st Sub. (Green) S.B. 166
57 (g) "Qualified child" means an individual:
58 (i) who is under 18 years old;
59 (ii) whose household adjusted gross income is at or less than 300% of the federal
60 poverty level;
61 (iii) is a United States citizen;
62 (iv) is a Utah resident;
63 (v) has been diagnosed with juvenile rheumatoid arthritis; and
64 (vi) is not eligible for Medicaid or the Children's Health Insurance Program.
65 (2) (a) Subject to appropriation and Subsection (2)(b), the department shall create a
66 program to provide premium assistance to a qualified child.
67 (b) The department may not provide premium assistance to a qualified child if the
68 qualified child has access to an optimal drug through a health benefit plan provided by the
69 employer of the child's parent or guardian.
70 (3) An applicant for the premium assistance shall provide the department any
71 information the department deems necessary to determine whether a child qualifies for the
72 premium assistance.
73 (4) Each year, the department may not provide premium assistance to more than 150
74 qualified children.
75 (5) (a) The department shall provide the assistance directly to the eligible health benefit
76 plan.
77 (b) The department may provide the premium assistance in the form of a lump sum
78 payment.
79 (6) If a qualified child disenrolls from the eligible health benefit plan, the eligible
80 health benefit plan shall return any funds provided by the department for the months that the
81 qualified child was not enrolled in the eligible health benefit plan.
81a º (7) If a qualified child has the option to enroll in one of several eligible health benefit
81b plans, the department shall, to the extent that is practicable, ensure that the number of
81c qualified children receiving assistance under this section are divided evenly among eligible
81d health benefit plans. »
82 º [(7)] (8) » In accordance with Title 63G, Chapter 3, Utah Administrative
82a Rulemaking Act, the
83 department may make rules to implement this section.
84 Section 2. Section 31A-22-660 is enacted to read:
85 31A-22-660. Health benefit plan procedures related to prescription drugs.
86 (1) As used in this section, "long-term drug" means an enrollee's prescription drug
87 where the prescription has been active for at least 180 days with the health benefit plan.
-3- House Committee Amendments 2-26-2024 ho/cw1
Statutes affected: S.B. 166 1st Substitute : 26B-4-326, 26B-5-112.5, 26B-5-120
Amended: 26B-4-326, 26B-5-112.5, 26B-5-120
S.B. 166 1st Substitute (Not Adopted) Text: 26B-4-326, 26B-5-112.5, 26B-5-120