Vol. 2010, No. 11 (06/01/2010) PDF - Administrative Rules - Utah.gov

DAR File No. 33649
NOTICES OF PROPOSED RULES
(2) Recertification. The Executive Director shall have
the right to request a recertification by the contractor or consultant
by submitting a written request to the contractor or consultant, and
the contractor or consultant shall so comply with the written request
within ten (10) working days of receipt of the written request;
however, in no case may the contractor or consultant be required to
demonstrate such compliance more than twice in any 12-month
period.
(3) Demonstrating Compliance with Actuarially
Equivalent Determination. The actuarially equivalent determination
required by Subsection (1) of 72-6-107.5 is met by the contractor or
consultant if the contractor or consultant provides the Executive
Director with a written statement of actuarial equivalency from
either the Utah Insurance Department[ or], an actuary selected by
the contractor or the contractor's insurer[ or], an actuary selected by
the consultant or the consultant's insurer, or an underwriter who is
responsible for developing the employer groups premium rates.
(a) [f]For purposes of this,[R]rule, [R916-5,] actuar[y]ial
equivalency, or greater is achieved by meeting or exceeding the
requirements of qualified health insurance coverage as defined in
Subsection 72-6-107.5(1)(c).[a federally qualified health care plan.]
The benchmark plan referred to in Subsection 72-6-107.5(1)(c), [is
the Children's Health Insurance Program. The insurance program
]may be found at: http://dfcm.utah.gov/downloads/Health
%20Insurance%20Benchmark.pdf.[ The plan may be used for
evaluating the offered health plan to determine if it is actuarial
equivalent or superior.]
(4) [Time Frame Availability for Health Insurance. ]The
health insurance must be available upon the first day of the calendar
month following the initial [ninety (]90[)] days from the [beginning
of employment]date of hire.
(5) Consultant Compliance Process. Consultants who are
subject to this [R]rule must demonstrate compliance with this
[R]rule in their initial Financial Screening Application. The
consultant's will then be required to demonstrate the offer of health
insurance that meets the requirements outlined in Section
72-6-107.5. During the procurement process and no later than the
execution of the contract with the consultant, the consultant will
confirm the prime is still in compliance with this [R]rule and the
subconsultants of the consultant will certify through their prime
consultant they meet the requirements of this [R]rule. The written
contract will contain a provision where the consultant confirms
compliance with this [R]rule by both the consultant and applicable
subconsultants.
(6) Contractor[s] Compliance Process. Contractors who
are subject to this [R]rule must demonstrate compliance with this
[R]rule. The contractor will indicate in the Pre-qualification
Application that the contractor will offer health insurance which
meets the requirements outline[s]d in Section 72-6-107.5. When a
contract is written, contractors [may]will confirm the prime
contractor is still in compliance with this [R]rule and their
subcontractors will certify through their contractor that they meet
the requirements of this [R]rule. The written contract shall contain
a provision where the contractor confirms compliance with this
[R]rule by both the contractor and applicable subcontractors.
(7) Must be in Compliance at the Time the Contract is
executed. Notwithstanding any prequalification of a contractor,
subcontractor, consultant or subconsultant that is subject to this
[R]rule, the contractor subcontractor, consultant or subconsultant
must agree to the language in the executed contract that requires the
contractor to be in compliance with this [R]rule at the time of the
execution of the contract and throughout the duration of the
contract.
R916-5-8. Department Hearing and Penalties.
(1) Hearing. Any hearing regarding the failure to comply
with this [R]rule shall be held in accordance with the Utah
Administrative Procedures Act and Rule 907-1 unless specifically
stated otherwise in a governing statute.
(2) Penalties. The penalties that may be imposed if a
contractor, consultant, subcontractor or subconsultant, at any tier
intentionally violates [the provisions of ]this [R]rule[. May]
include:
(a) a three-month suspension of the contractor or
subcontractor from entering into future contracts with the state upon
the first violation, regardless of which tier the contractor or
subcontractor is involved[ with the future design and/or
construction contract];
(b) a six-month suspension of the contractor,
subcontractor, consultant or subconsultant from entering into future
contracts with the state upon the second violation, regardless of
which tier the contractor or subcontractor is involved[ with the
future design and/or construction contract];
(c) an action for debarment of the contractor,
subcontractor , consultant or subconsultant in accordance with
Section 63G-6-804 upon the third or subsequent violation; and
(d) monetary penalties which may not exceed 50% of the
amount necessary to purchase qualified health insurance coverage
for an employee and the dependents of an employee of the
contractor, subcontractor, consultant or subconsultant who was not
offered qualified health insurance coverage during the duration of
the contract.
(e) [a]A prime contractor or consultant will not be subject
to penalties for the failure of a subcontractor or subconsultant to
meet the requirement of maintaining their offer of qualified health
care coverage.
R916-5-9. Does Not Create Any Contractual Relationship With
Any Subcontractor or Subconsultant.
Nothing in this [R]rule shall be construed as to create any
contractual relationship whatsoever between the Department or the
State with any subcontractor or subconsultant at any tier.
KEY: contracts, health insurance, health insurance in state
contracts, health reform
Date of Enactment or Last Substantive Amendment:
[September 21, 2009]2010
Authorizing, and Implemented or Interpreted Law: 72-6-107.5
End of the Notices of Proposed Rules Section
UTAH STATE BULLETIN, June 01, 2010, Vol. 2010, No. 11 127