2011 Utah Code
Title 26 Utah Health Code
Chapter 40 Utah Children's Health Insurance Act
Section 106 Program benefits.

26-40-106. Program benefits.
(1) Until the department implements a plan under Subsection (2), program benefits may include:
(a) hospital services;
(b) physician services;
(c) laboratory services;
(d) prescription drugs;
(e) mental health services;
(f) basic dental services;
(g) preventive care including:
(i) routine physical examinations;
(ii) immunizations;
(iii) basic vision services; and
(iv) basic hearing services;
(h) limited home health and durable medical equipment services; and
(i) hospice care.
(2) (a) Except as provided in Subsection (2)(d), no later than July 1, 2008, the program benefits shall be benchmarked, in accordance with 42 U.S.C. 1397cc, to be actuarially equivalent to a health benefit plan with the largest insured commercial enrollment offered by a health maintenance organization in the state.
(b) Except as provided in Subsection (2)(d), after July 1, 2008:
(i) program benefits may not exceed the benefit level described in Subsection (2)(a); and
(ii) program benefits shall be adjusted every July 1, thereafter to meet the benefit level described in Subsection (2)(a).
(c) The dental benefit plan shall be benchmarked, in accordance with the Children's Health Insurance Program Reauthorization Act of 2009, to be equivalent to a dental benefit plan that has the largest insured, commercial, non-Medicaid enrollment of covered lives that is offered in the state.
(d) The program benefits for enrollees who are at or below 100% of the federal poverty level are exempt from the benchmark requirements of Subsections (2)(a) and (2)(b).