File No. 33843
This rule was published in the August 15, 2010, issue (Vol. 2010, No. 16) of the Utah State Bulletin.
Capitol Preservation Board (State), Administration
Health Reform -- Health Insurance Coverage in State Contracts -- Implementation
Notice of Proposed Rule
DAR File No.: 33843
Filed: 07/19/2010 06:16:41 PM
Purpose of the rule or reason for the change:
This rule is being amended to comply with H.B. 20 of the 2010 Utah Legislative Session which clarified and amended Section 63C-9-403. H.B. 20 amends provisions related to the requirement that contractors with certain state entities must provide qualified health insurance to their employees and the dependents of the employees who work or reside in the state. H.B. 20 clarified the waiting period; clarified that health insurance coverage must be offered to employees and dependents who work or reside in the state; clarified that the coverage that must be offered is a minimum standard and an employer may offer greater coverage; amended the definition of qualified health insurance coverage to clarify the standards; amended the enforcement provisions to provide protections for good faith compliance and clarified how an employer offering a defined contribution arrangement may comply with state contract requirements. Therefore, this rule change is being done to be consistent with state statute. (DAR NOTE: H.B. 20 (2010) is found at Chapter 229, Laws of Utah 2010, and was effective 05/11/2010.)
Summary of the rule or change:
The proposed changes clarify the applicability of the rule, add that an underwriter may determine actuarial equivalency, and include various grammatical and stylistic changes.
State statutory or constitutional authorization for this rule:
- Subsection 63C-9-301(3)(a)
- Section 63C-9-403
Anticipated cost or savings to:
the state budget:
There is no anticipated cost or savings to the state budget because compliance is already required and the changes only clarify the obligations of contractors, subcontractors, consultants, and subconsultants.
There is no anticipated cost or savings to local government because compliance is only required in state construction contracts and the changes only clarify the obligations of contractors, subcontractors, consultants, and subconsultants.
There is no anticipated cost or savings to small businesses because compliance is already required and the changes only clarify the obligations of contractors, subcontractors, consultants, and subconsultants.
persons other than small businesses, businesses, or local governmental entities:
There is no anticipated cost or savings to persons other than small businesses, businesses, or local government entities because compliance is already required and the changes only clarify the obligations of contractors, subcontractors, consultants, and subconsultants.
Compliance costs for affected persons:
There is no anticipated cost or savings to affected persons because compliance is already required and the changes only clarify the obligations of contractors, subcontractors, consultants, and subconsultants and make it easier to obtain a determination of actuarial equivalency.
Comments by the department head on the fiscal impact the rule may have on businesses:
There is no anticipated fiscal impact on businesses because compliance is already required and the changes only clarify the obligations of contractors, subcontractors, consultants, and subconsultants.
Allyson Gamble, Executive Director
The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:Capitol Preservation Board (State)
420 N STATE ST
SALT LAKE CITY, UT 84114-2110
Direct questions regarding this rule to:
- Alan Bachman at the above address, by phone at 801-538-3105, by FAX at 801-538-3313, or by Internet E-mail at firstname.lastname@example.org
- La Priel Dye at the above address, by phone at 801-538-3240, by FAX at 801-538-3313, or by Internet E-mail at email@example.com
- Allyson Gamble at the above address, by phone at 801-537-9156, by FAX at 801-538-3221, or by Internet E-mail at firstname.lastname@example.org
Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:
This rule may become effective on:
Allyson Gamble, Executive Director
R131. Capitol Preservation Board (State), Administration.
R131-13. Health Reform -- Health Insurance Coverage in State Contracts -- Implementation.
The purpose of this rule is to comply with the provisions of Section 63C-9-403.
This rule is authorized under Subsection 63C-9-301(3)(a) whereby the Capitol Preservation Board may make rules to govern, administer, and regulate the capitol hill complex, capitol hill facilities, and capitol hill grounds by following the procedures and requirements of Title 63G, Chapter 3, Utah Administrative Rulemaking Act, as well as Section 63C-9-403 that requires this rule related to health insurance provisions in certain design and construction contracts.
(1) Except as otherwise stated in this rule, terms used in this rule are defined in Section 63C-9-403.
(2) In addition:
(a) "Board" means the Capitol Preservation Board established pursuant to Section 63C-9-201.
(b) "Executive Director" means the executive director of the Capitol Preservation Board including, unless otherwise stated, the executive director's duly authorized designee.
(c) "Employee(s)" is as defined in Subsection 63C-9-403(1)(a) and includes only those employees that live and work in the state of Utah along with their dependents. "Employee" for purposes of this rule, shall not be construed as to be broader than the use of the term employee for purposes of state of Utah Workers' Compensation laws along with their dependents.
(d) "State" means the state of Utah.
R131-13-4. Applicability of Rule.
(1) Except as provided in
R131-13-4(2) below, R131-13 applies to all
contracts entered into by the Board
or the executive director, or on behalf of the Board, on or after
July 1, 2009, [
(a) the contract is for design and/or construction;
and (b)(i) the prime contract is in the amount of $1,500,000
or greater; or
(ii) a subcontract, at any tier, is in the amount of
$750,000 or greater.]
(2) R131-13 does not apply if:
(a) the application of R131-13 jeopardizes the receipt of federal funds;
(b) the contract is a sole source contract; or
(c) the contract is an emergency procurement.
(3) R131-13 does not apply to a change order as defined in Section 63G-6-103, or a modification to a contract, when the contract does not meet the initial threshold required by R131-13-4(1).
(4) A person who intentionally uses change orders or contract modifications to circumvent the requirements of Subsection R131-13-4(1) is guilty of an infraction.
R131-13-5. Contractor to Comply with Section 63C-9-403.
All contractors and subcontractors that are subject to the requirements of Section 63C-9-403 shall comply with all the requirements, penalties and liabilities of Section 63C-9-403.
R131-13-6. Not Basis for Protest or Suspend, Disrupt, or Terminate Design or Construction.
(1) The failure
to comply with] R131-13 or Section 63C-9-403:
(a) may not be the basis for a protest or other action from a prospective bidder, offeror, or contractor under Section 63G-6-801 or any other provision in Title 63G, Chapter 6, Part 8, Legal and Contractual Remedies; and
(b) may not be used by the procurement entity or a prospective bidder, offeror, or contractor as a basis for any action or suit that would suspend, disrupt or terminate the design or construction.
R131-13-7. Requirements and Procedures a Contractor Must Follow.
A contractor, including consultants and designers, must comply with the following requirements and procedures in order to demonstrate compliance with Section 63C-9-403.
(1) Demonstrating Compliance with Health
Insurance Requirements. The following requirements must be met by a
contractor, including consultants, designers and others under
contract with the Board or the executive director that is subject
to the requirements of
R131-13 no later than the time [
of execution of the contract]:
(a) demonstrate compliance by a written certification to the executive director that the contractor has and will maintain for the duration of the contract an offer of qualified health insurance coverage for the contractor's employees; and
(b) the contractor shall also provide such written certification prior to the execution of the contract, in regard to all subcontractors, including subconsultants, at any tier that are subject to the requirements of R131-13.
(2) Recertification. The executive director shall have the right to request a recertification by the contractor by submitting a written request to the contractor, and the contractor shall so comply with the written request within ten working days of receipt of the written request; however, in no case may the contractor 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 Subsections 63C-9-403(1)(c)(i) and (iii)
is met by the contractor if the contractor 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
For purposes of R131-13-7(3), actuarially equivalency is achieved by meeting or exceeding any of the following:
(a) In accordance with Section 26-40-106(2)(a), the largest
insured commercial enrollment offered by a health maintenance
organization in the State, which details of the plan are provided
on the website of the Division at
or (b) provides coverage that is actuarially equivalent to 75%
of the benefit plan determined under R131-13-7(3)(a) above and
employer premium contributions as required by statute.]
(4) The health insurance must be available
upon the first
month following the initial ninety days from the [
beginning of employment].
(5) Architect and Engineer Compliance Process. Architects and engineers that are subject to R131-13 must demonstrate compliance with R131-13 in any annual submittal. During the procurement process and no later than the execution of the contract with the architect or engineer, the architect or engineer shall confirm that their applicable subcontractors or subconsultants meet the requirements of R131-13.
(6) General (Prime) Contractors Compliance Process. Contractors that are subject to R131-13 must demonstrate compliance with R131-13 for their own firm and any applicable subcontractors, in any pre-qualification process that may be used for the procurement. At the time of execution of the contract, the contractor shall confirm that their applicable subcontractors or subconsultants meet the requirements of R131-13.
(7) Notwithstanding any prequalification process, any contract subject to R131-13 shall contain a provision requiring compliance with R131-13 from the time of execution and throughout the duration of the contract.
(8) Hearing and Penalties.
(a) Hearing. Any hearing for any penalty under R131-13 conducted by the Board or executive director shall be conducted in the same manner as any hearing required for a suspension or debarment.
(b) Penalties that may be Imposed by the Board or Executive Director. The penalties that may be imposed by the Board or executive director if a contractor, consultant, subcontractor or subconsultant, at any tier, intentionally violates the provisions of R131-13 may include:
(i) 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;
(ii) a six-month suspension of the contractor or subcontractor 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;
(iii) an action for debarment of the contractor or subcontractor in accordance with Section 63G-6-804 upon the third or subsequent violation; and
(iv) monetary penalties which may not exceed 50% of the amount necessary to purchase qualified health insurance coverage for an employee and dependents of an employee of the contractor or subcontractor who was not offered qualified health insurance coverage during the duration of the contract.
In addition to the penalties imposed above, a
contractor, consultant, subcontractor or subconsultant who
violates the provisions of
R131-13 shall be liable to the employee for health
care costs [
not covered by insurance].
R131-13-8. Not Create any Contractual Relationship with any Subcontractor or Subconsultant.
Nothing in R131-13 shall be construed as to create any contractual relationship whatsoever between the State, the Board, or the executive director with any subcontractor or subconsultant at any tier.
KEY: health insurance, contractors, contracts
Date of Enactment or Last Substantive Amendment: [
October 8, 2009]
Authorizing, and Implemented or Interpreted Law: 63C-9-403, 63C-9-301(3)(a)
The Portable Document Format (PDF) version of the Bulletin is the official version. The PDF version of this issue is available at http://www.rules.utah.gov/publicat/bull-pdf/2010/b20100815.pdf. The HTML edition of the Bulletin is a convenience copy. Any discrepancy between the PDF version and HTML version is resolved in favor of the PDF version.
Text to be deleted is struck through and surrounded by brackets (e.g., [
example]). Text to be added is underlined (e.g., ). Older browsers may not depict some or any of these attributes on the screen or when the document is printed.
For questions regarding the content or application of this rule, please contact Alan Bachman at the above address, by phone at 801-538-3105, by FAX at 801-538-3313, or by Internet E-mail at email@example.com; La Priel Dye at the above address, by phone at 801-538-3240, by FAX at 801-538-3313, or by Internet E-mail at firstname.lastname@example.org; Allyson Gamble at the above address, by phone at 801-537-9156, by FAX at 801-538-3221, or by Internet E-mail at email@example.com.