utah health exchange program    

About Utah Health Exchange

The Exchange creates two portals where health insurance can be purchased. The first portal deals with individual or personal plans and provides an easy link to carriers and marketers of health plans. The second and most publicized portal provides a unique avenue to purchase group health plans. There are three carriers providing coverage: Humana, Selecthealth and Regence Blue Cross Blue Shield of Utah. An employer wishing to purchase a plan for its employees through the Exchange will have the choice of all three carriers…under one roof. In addition, each carrier is required to offer at least two plans but all three have far exceeded this minimum creating an exceptional amount of choice for even the smallest employer. The Exchange also contains a feature referred to as “defined contribution”. As the concept infers, an employer can define their contribution to the health plan without the normal minimums imposed by an insurance carrier. Keep in mind, however that there will still be minimum participation requirements which will be difficult to meet without some level of employer participation. There is also a banking entity involved who helps to commingle funds from the employer, employee, spouse’s employer perhaps and even contributions from the employer of a second job.

What’s So Unique About Utah?

Utah has some of the lowest per capita health care costs in the country, yet has historically maintained an unexpectedly high rate of uninsured population. This was vexing for former governor John Huntsman Jr. as well as then house majority leader David Clark. Certainly cost is always an issue when observing the causes of the uninsured rate, however studies showed that other factors were involved. Too many individuals eligible for government programs such as Medicaid and Chip failed to sign up. There was also a large group of “young immortals� who certainly had the health history and financial means to purchase plans but elected not to do so. Most alarming was the number of individuals working for small businesses who were uninsured, even when there was a plan available. When queried as to the reason for not offering coverage, many times it was the restrictive nature of health insurance company underwriting guidelines placed on these businesses.

What Needed To Happen?

HB188 was sponsored by Representative Clark during the 2009 legislative session and easily passed the house and senate, eventually being signed into law by Governor Huntsman. Although the bill was quite comprehensive, it included two main facets. First, it created a new program called Utah NetCare. This is a much needed alternative to COBRA and conversion plans that provides more affordable continuation coverage. Many individuals become COBRA eligible by being displaced from employment and the cost certainly leads to a high rate of refusal. The NetCare benefits are rather stripped down and free of many state mandates, however it provides rate relief at a time that the eligible recipient needs it most. The second major component of HB188 created what is now referred to as the Utah Health Exchange.

How Does It All Work?

The employer portal is virtual and the enrollment data as well as health history is entered online by each eligible employee. Bswift is the administrator of the Exchange and provides this data to each carrier who then return rates for each plan. The employees make their selection and then the enrollment is finalized. The employer will work with a local authorized agent to help explain the processes and keep the company in compliance with state and federal laws including a required Section 125 document. The banking and billing function will be handled by Health Equity, the Exchange’s designated banking administrator. Initially, the Exchange is limited to employers with fewer than 50 employees but that is expected to change in the not so distant future.

What Sets Utah’s Exchange Apart?

Unlike Massachusetts’ program, Utah relies on a virtual world rather bricks and mortar. As opposed to high overhead costs passed on to the tax payer, Utah’s Exchange has a very small full time staff and relies on local agents to handle the majority of the “grunt” work that otherwise would be handled by a state employee. The Utah Exchange was also formed with a tremendous amount of input from the business and insurance carrier community who were allowed to build this from the ground up with the state government serving an advisory role in the background. This is opposed to Massachusetts where their program was established almost entirely by government officials.

How Do I Join?

The Exchange is closed until after the first of the year as the early adopter companies that were part of a limited launch go through the enrollment process. However, the Exchange is expected to reopen for all interested parties with fewer than 50 employees in March. Now is the time to contact us if you would be interested in knowing more.

How Do I Get More Information?

Click on the information service box and provide the requested data. We will contact you on how to receive rate and benefit information on the available programs for health coverage in Utah as mentioned is this site.

  • The professionally licensed and certified health insurance producer or field underwriter have undergone monthly continual education requirements as well as intensive training with all types of health insurance programs. Specifically Utah Health Exchange programs.
  • We believe it is in your best interest to obtain assistance in choosing a health insurance plan that is right for you. The complexities of coverage and differences between such requires assistance to avoid underinsured or over insured coverage's. Our services currently do not add to the cost of the program.





    • UAHU works closely with http://www.benefitsmanager.net on Utah Health Insurance ethical options.

Related resources