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Utah - Compensation & Benefit Legislation

UTAH - AASHOWME

Demonstrates www.BenefitsReview.com™ site. Illustrates insurance carriers' coverages within the State.

 

UTAH - ADOPTED CHILD HEALTH CARE MANDATE

OBRA 1993 (Federal) requires group health plans to honor medical and child support orders. Also, plans must treat adopted children like biological children covered by the plan, and plans are precluded from applying pre-existing condition exclusions to an adopted child where no such exclusion applies to a newborn biological child. Health plans that covered the cost of pediatric vaccines as of May 1, 1993, and fail to continue that level of coverage, will be subject to an excise tax penalty applicable to plans that fail to meet the health care continuation coverage requirements under OBRA 1993.

 

Mandatory coverage of birth of adopted children is included in state's newborn health care mandate.

 

Preventive care for children: No.

 

(Utah Code Ann. Sections 31A-22-610.5, 31A-22-611)

 

UTAH - ALCOHOLISM & DRUG ABUSE

Employer option.

 

Minimum yearly inpatient coverage: No statutory requirements.

 

Minimum yearly outpatient coverage: No statutory requirements.

 

Minimum lifetime coverage: No statutory requirements.

 

(Utah Code Ann. Section 31A-22-715)

 

UTAH - CAFETERIA PLAN TAX LAWS

State income tax, unemployment insurance tax on salary reduction: No. Follows FUTA.

 

UTAH - CONTINUATION OF COVERAGE CONVERSIONS

Events Triggering Continuation of Coverage:

 

UTAH - COORDINATION OF BENEFITS

Requires use of the birthday rule if coordinating benefits. Based on 1986 National Association of Insurance Commissioner Rules model. (Utah Insurance Reg. R590-131)

 

UTAH - COST-OF-LIVING

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian cost-of-living data and U.S. Automobile Cost Survey.

 

UTAH - DRUG TESTING AND EMPLOYEE ASSISTANCE BENEFITS

Who is Covered by Statute: All employers, employees, and applicants. Employer does not include the federal or state government or any local political subdivision. Written policy is required.

 

Applicant Testing: There is no restrictions to applicant testing.

 

Employee Testing: Employee testing is allowed for the following purposes: potential impairment of individual employee, investigations of workplace accidents or theft, maintenance or safety, or maintenance of productivity.

 

How Test Results are Used: Test results may be used to screen out drug-using applicants or to discharge or discipline employees. Employee referral to an EAP are at sole discretion of employer.

 

Enforcement of Statutes: Enforcement of statute is by private civil action. Cause of action available only if test result is false positive; employers enjoy rebuttable presumptions that test result is accurate if employer complied with statute; law bars damages if employer acted in good faith.

 

Employee Remedies: Employees may seek damages.

 

Employer Penalties: None.

 

Who Pays for Testing: Drug and alcohol testing shall be deemed work time for purposes of compensation and benefits for current employees. Employer shall pay all the costs of testing required by the employer.

 

Employee Assistance Benefits: State has no statutory requirements.

 

Other Requirements: In order to be able to test employees, employers and management must submit to testing on a periodic basis.

 

(Utah Code Ann. Sections 34-38-1 thru 34-8-15.)

 

UTAH - GROUP HEALTH CODE ADDITIONS (MANDATED)

Access to Health Care Providers: In cases where health insurers do not provide access to health care providers and health care facilities within 30 paved road miles of insured individuals' residences, such individuals may use the health care services of providers or facilities which are nearer to their residences. Insurers must reimburse individuals for health services rendered at the closer facilities if the alternate facilities are members of the same class of providers as covered under the plan, if illnesses are covered by the plan, and if pre-authorization or utilization requirements have been met. (H146, 1996) (Utah Code Ann. Section 31A-22-617.5.)

 

Adopted Children: Disability policies providing family coverage must cover adopted children from the date of placement with the insured. (Utah Code Ann. Section 31A-22-610.) Policies which offer dependent coverage to newborn children of plan participants from the moment of birth also must provide dependent coverage on the same basis for adopted children of participants. Coverage for participant's adopted children must be available from the moment of birth if placement for adoption occurs within 30 days of a child's birth, or from the date of placement in a home if placement occurs 30 days or more after the child's birth. Benefits for adopted children are not subject to pre-existing conditions limitations and include any injury or sickness, including the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities or prematurity. (S194, 1997) (Utah Code Ann. Section 31A-22-610 - 610.1.)

 

Alcoholism and Drug Abuse Treatment: Insurers must offer group disability policyholders coverage for such treatment in approved facilities. (Utah Code Ann. Section 31A-22-715.)

 

Coverage Continuation and Conversion: Disability policies must provide continuation and conversion rights to employees whose coverage under the policy terminates for any reason (with exceptions) and to dependents who cease eligibility due to death of the insured or dissolution of marriage. (Utah Code Ann. Sections 31A-22-612, 31A-22-703, 31A-22-710, 31A-22-714.)

 

Dependents: Any insurer or HMO providing dependent coverage must cover unmarried dependents up to age 26, and cannot terminate coverage of a dependent by reason of age before the dependent is 26 years old. (Utah Code Ann. Section 31A-22-610.5.)

 

Handicapped Dependents: Disability policies cannot terminate coverage of handicapped children while the person is incapable of employment due to mental retardation or physical handicap and chiefly dependent on the insured. (Utah Code Ann. Section 31A-22-611.)

 

Health Maintenance Organizations: Under certain specified conditions, HMOs must pay for covered health care services rendered to participants by a independent hospital, to credentialed staff members at independent hospitals, to credentialed staff members at local practice locations, to participants at federally qualified health centers, or to participants of non-contracting providers which have referred insured individuals to another non-contracting provider. Also, HMOs may contract directly with an independent hospital, a federally qualified health center, or a credentialed staff member. (H216, 1997) (Utah Code Ann. Section 31A-8-501.)

 

Maternity: Health care providers (HMOs and managed care plans included) which cover maternity care, including any prenatal or maternity expenses of a birth mother or newborn child, must provide benefits for care of adopted children of a covered individual if a newborn child is placed for adoption within 30 days of birth. For the purpose of complying with the law and coordinating benefits, the insurance plan of an adoptive child's parent must be treated as a secondary plan. (S194, 1997) (Utah Code Ann. Section 31A-22-610 - 610.1.)

 

Newborns: Disability policies providing family coverage must provide benefits for newborns from the moment of birth for injury or sickness including treatment of medically diagnosed congenital defects, birth abnormalities, and prematurity. (Utah Code Ann. Section 31A-22-610.)

 

Policies for Small Employers: Small employer health insurance carriers, among others, must apply rating factors consistently with respect to all small employers in a class of business. Insurers may not, without prior approval from the insurance commissioner, use case characteristics for premium rating other than age, gender, industry, geographic area, family composition, and group size, and may not transfer involuntarily a small employer into or out of a class of business unless it offers to transfer all small employers in that class of business. Carriers also must disclose certain information regarding premium rates and pre-existing conditions as part of its sales material. "Small employer is defined as any person, firm, corporation, partnership, or association actively engaged in business that, on at least 50 percent of its working days during the preceding calendar quarter, employed at least one and not more than 50 eligible employees, the majority of whom were employed within the state. (Utah Code Ann. Sections 31A-22-101, 31A-22-610.5.)

 

UTAH - GROUP HEALTH FOR SMALL EMPLOYERS

For insurance plans offered to small employers:

 

UTAH - GROUP LIFE CODE ADDITIONS

Employer required to pay part of premium: No.

 

Percent of employees who must elect coverage (if employees pay part of premium): No statutory requirements.

 

Percent of employees who must be covered if employer pays all of premium: 100%.

 

Minimum number of employees in group plan: No statutory requirements.

 

Employer prohibited as beneficiary: Yes.

 

Grace period (days): 30.

 

Mandatory conversion: Yes.

 

Other provisions: None.

 

(Utah Code Ann. Section 31-A-22-502, 31A-22-513, 31A-22-517, 31A-22-518)

 

UTAH - HOLIDAYS

January 1, Washington's Birthday (or 3rd Monday in February), Memorial Day (or last Monday in May), July 4, Labor Day (or 1st Monday in September), Veterans Day, and December 25 are state holidays in all 50 states and in the District of Columbia. Other holidays under State law include: Martin Luther King's birthday (or 3rd Monday in January), Columbus Day (or 2nd Monday in October), Thanksgiving, Sunday. Other: All days set apart by the Governor or President. If any holiday falls on Sunday, following Monday is a holiday; if any holiday falls on Saturday, preceding Friday is a holiday.

 

UTAH - IMMIGRATION (PREVAILING WAGE POLICY)

See U.S. Federal General Administrative Letter 1-2000

 

UTAH - JURY DUTY & WITNESS TIME OFF

Employer Restriction For Discharging Employee For Taking Leave For Jury Service: Yes.

 

Remedies and Penalties: Violator is guilty of criminal contempt, punishable by a fine of not more than $500, or imprisonment for not more than 6 months, or both. Employee may bring civil action within 30 days of violation for lost wages, reinstatement, and reasonable attorney fees. Damages may not exceed 6 month's wages.

 

Other Requirements: None reported. (Utah Code Ann. Section 78-46-21.)

 

Employer Restriction For Discharging Employee For Taking Leave to be a Witness: State reports no statutory requirements.

 

Remedies and Penalties: State reports no statutory requirements.

 

Other Requirements: State reports no statutory requirements.

 

UTAH - LEAVES OF ABSENCE

Employers Subject to Leave Laws: All state agencies.

 

Criteria for Eligibility: Employed for at least 2 full pay periods (full time employees) or for at least 40 hours per pay period (part time employees).

 

Maximum length of leave: Half time status up to 6 weeks. Temporary disability up to 12 months.

 

Paid Leave: For half time leave: paid leave is required. For long term leave: paid leave is not required.

 

Acceptable Reasons for Leave: Maternity/adoption of a child or to care for spouse or dependents.

 

Employment Guarantees After Leave: Entitled to reinstatement in a position with the same pay and seniority as the position held prior to leave.

 

Use of Vacation or other Time-off Benefits: Employee may use sick leave or other annual time off benefits to offset or extend leave benefits.

 

Certification Required: Employer may required certification of illness if leave is taken to care for children or spouse.

 

Effect Of Leave on Other Benefits: Sick leave accrues at rate of 4 hours per pay period without limit. Employee may pay premiums for continued health benefits.

 

Effect of Seniority Accrual During Leave: Seniority benefits do not accrue during leave.

 

Minimum Requirements for Notification to Employer: Employee must apply for leave in writing.

 

Conditions for Denial of a Request For Leave: Employee must plan to return to work to have leave approved. Leave must be beneficial to both employee and the state.

 

(Utah Admin. R. 468-8-5.3, 468-8-5.9)

 

See U.S. Federal Family and Medical Leave Act

 

UTAH - LONG TERM DISABILITY CODE ADDITIONS

State does not require employer to provide long term disability benefits; although many employers do in order to remain competitive in hiring/retention of employees.

 

See LEAVES OF ABSENCE (above), WORKERS' COMPENSATION (below) and U.S. Federal Americans With Disabilities Act

 

UTAH - MANDATED PROVIDERS

Optometrists, chiropractors, dentists, psychologists, podiatrists, social workers, nurse practitioners and midwives. Mandatory coverage for all licensed health care providers. Direct access to gynecologist/obstetrician. (Utah Code Ann. 31A-22-618, 31 A-22-624)

 

UTAH - MENTAL HEALTH CARE

State reports no statutory requirements.

 

UTAH - MINIMUM WAGE

Refer to the Federal minimum wage: $5.15 per hour (effective September 1, 1997).

 

Exemptions: Certain agriculture workers, domestics, outside sales, students, and apprentices. Handicapped workers in special environments may be paid lower wages (set by Commission). (Utah Code Ann. Sections 34-40-103, 34-40-104)

 

See U.S. Minimum Wage

 

UTAH - NEW HIRE REPORTING

Who is required to report: All employers.

 

Who must be reported: All new employees and rehires.

 

Exempt from reporting: No exemptions.

 

Form(s) to file: State form or W-4.

 

Filing deadline: Within 20 days of hire.

 

Employer information to be included: Name, address, and federal tax identification number.

 

Employee information to be included: Name, address, and SSN. Employer may , but is not required to, provide date of hire, occupational title, and whether employee is full-time or part-time.

 

Penalty for failure to report: Fines from $25 to $500 may be imposed.

 

(Utah Code Ann. Section 35A-11-101)

 

UTAH - NEWBORN CARE MANDATE

Mandated coverage.

 

Preventive care for children: No.

(Utah Code Ann. Sections 31A-22-610.5, 31A-22-611)

 

UTAH - PARENTAL LEAVE

See U.S. Federal Family and Medical Leave Act

 

UTAH - PRE-EXISTING CONDITIONS

For insurance plans offered to small employers, plan shall not exclude losses incurred more than 12 months following coverage due to pre-existing conditions. (Utah Code Ann. Sections 31A-30-103., 31A-30-106, 31A-30-107)

 

See U.S. Federal Health Insurance Portability & Accountability Act

 

UTAH - PROTECTED CLASSIFICATIONS

Age:  Yes, older than 40.

Race:  Yes.

Color:  Yes.

National Origin:  Yes.

Ancestry:  Yes.

Religion:  Yes.

Sex: Yes.

Pregnancy: Yes.

Sexual Harassment: Yes.

 

(Utah Code Ann. Sections 34-35-2, 34-35-6, 67-19-4.)

 

UTAH - SALARY SURVEY

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian wages & salaries (covering 3,000 positions).

 

UTAH - SHORT TERM DISABILITY CODE ADDITIONS

State does not require employer or employee participation in short term disability plans.

 

UTAH - TERMINATION & SEVERANCE PAY

Date pay is due if employee is discharged: Within 24 hours.

 

Date due if employee resigns: Next regular payday.

 

Wages: Yes.

 

Vacation Pay: No.

 

Holiday: No.

 

Sick leave: No.

 

Severance:

 

(Utah Code Ann. Section 34-28-5)

 

UTAH - UNEMPLOYMENT TAX

Employer Contributions:

 

 

Voluntary Contribution Provision: No.

 

(Utah Code Ann. Sections 35.4-7.2, 35.4-11. 35.4-15.)

 

UTAH - VACATION PAY

State reports no statutory requirements.

 

UTAH - VOTING TIME OFF

2 hours, if employee does not have 3 hours away from work while the polls are open. (Utah Code Ann. Sections 20A-1-601, 20A-3-103.)

 

UTAH - WORKERS' COMPENSATION

Private Employers: Mandatory as to all employments. Elective as to partners, sole proprietors, corporate officers and directors.

 

Public Employers: Mandatory coverage to all public employments, including community service volunteers. (Note: Volunteers are eligible only for workers' compensation medical benefits, not indemnity benefits.)

 

Exceptions: Casual employees. Farm employers who employ 5 or fewer persons for 40 hours per week for 13 weeks or less during the year; or employer/owner's family. Domestics who work less than 40 hours per week for a single employer. Real estate salesperson or broker.

 

Special Coverage Provisions: Voluntary for sole proprietors and their families when supervising or engaging in their business for farm.

 

(U.S. Chamber of Commerce, 1994 Analysis of Workers' Compensation Laws.)