2011 Utah Code
Title 63M Governor's Programs
Chapter 1 Governor's Office of Economic Development
Section 2504 Creation of Office of Consumer Health Services -- Duties.

63M-1-2504. Creation of Office of Consumer Health Services -- Duties.
(1) There is created within the Governor's Office of Economic Development the Office of Consumer Health Services.
(2) The office shall:
(a) in cooperation with the Insurance Department, the Department of Health, and the Department of Workforce Services, and in accordance with the electronic standards developed under Sections 31A-22-635 and 63M-1-2506, create a Health Insurance Exchange that:
(i) provides information to consumers about private and public health programs for which the consumer may qualify;
(ii) provides a consumer comparison of and enrollment in a health benefit plan posted on the Health Insurance Exchange; and
(iii) includes information and a link to enrollment in premium assistance programs and other government assistance programs;
(b) contract with one or more private vendors for:
(i) administration of the enrollment process on the Health Insurance Exchange, including establishing a mechanism for consumers to compare health benefit plan features on the exchange and filter the plans based on consumer preferences;
(ii) the collection of health insurance premium payments made for a single policy by multiple payers, including the policyholder, one or more employers of one or more individuals covered by the policy, government programs, and others; and
(iii) establishing a call center in accordance with Subsection (3);
(c) assist employers with a free or low cost method for establishing mechanisms for the purchase of health insurance by employees using pre-tax dollars;
(d) establish a list on the Health Insurance Exchange of insurance producers who, in accordance with Section 31A-30-209, are appointed producers for the Health Insurance Exchange; and
(e) report to the Business and Labor Interim Committee and the Health System Reform Task Force prior to November 1, 2011, and prior to the Legislative interim day in November of each year thereafter regarding the operations of the Health Insurance Exchange required by this chapter.
(3) A call center established by the office:
(a) shall provide unbiased answers to questions concerning exchange operations, and plan information, to the extent the plan information is posted on the exchange by the insurer; and
(b) may not:
(i) sell, solicit, or negotiate a health benefit plan on the Health Insurance Exchange;
(ii) beginning July 1, 2011, receive producer compensation through the Health Insurance Exchange; and
(iii) beginning July 1, 2011, be designated as the default producer for an employer group that enters the Health Insurance Exchange without a producer.
(4) The office:
(a) may not:
(i) regulate health insurers, health insurance plans, health insurance producers, or health insurance premiums charged in the exchange;
(ii) adopt administrative rules, except as provided in Section 63M-1-2506; or
(iii) act as an appeals entity for resolving disputes between a health insurer and an

insured;
(b) may establish and collect a fee in accordance with Section 63J-1-504 for:
(i) the transaction cost of:
(A) processing an application for a health benefit plan;
(B) accepting, processing, and submitting multiple premium payment sources; and
(C) providing a mechanism for consumers to filter and compare health benefit plans in the exchange based on consumer preferences; and
(ii) funding the call center established in accordance with Subsection (3); and
(c) shall separately itemize any fees established under Subsection (4)(b) as part of the cost displayed for the employer selecting coverage on the exchange.