What Employers Should Know About the Utah Health Exchange

By John Miers


In 2005, the state of Utah recognized the need for reforms in the health care industry, and began to make sweeping changes in the state's health-care system. Such initiative eventually led to the passing of the important legislation HB 133, also known as the Utah Health Exchange, in 2008.

The Exchange is designed to be a cloud-based marketplace where consumers can shop various health-care options and find what works best for their unique situation. Originally rolled out in January 2010 on a pilot program, January 2011 launched the first enrollment opportunity for most small employers. Based on information released from the State of Utah as of March 7th, the Exchange has successfully enrolled 83 employer groups and 2,534 covered lives.

Basically, the Health Exchange is a contribution program. Businesses enroll in the Exchange through a broker or tax advisor of their choice. The professional will guide the company's employees of the options they have and the benefits they choose under the program. You can enroll via an internet-based platform that's intended to make choosing and enrolling for health care plans easy.

Can My Business Participate? If you want to be qualified for the program, take note of these policies. Your business must have 2 to 50 employees, 75% of whom should be Utah residents. Then you need to complete the application form online and then submit the required documentation. Once an offer is established the group must have 75% participation of eligible employees. When your application is in, you can solicit the help of a broker or tax advisor to guide you with the implementation process.

Do you still need a Section 125 Plan? Availing of the Utah Health Exchange Program also requires payroll deduction using pre-tax dollars and this can only be done when the program is run under a Section 125 Plan. This document allows the employee portion of the premiums to be deducted completely pre-tax.

The major benefit of a Section 125 Plan (also known as a cafeteria plan) is its tax-advantage status. They are deducted pre-tax, meaning that the employee's taxable income is reduced by the amount of the premium. And once the taxable income goes down, so do the FICA and Medicare taxes. And the employers have their benefit as well: a decrease in the employee's taxable income can lead to a reduced employer share of FICA and Medicare taxes and even FUTA and state taxes.

The Default Plan Explained. The employer and advisor must choose a default health plan for his employees, and enroll them in the default plan, unless:

1. The employee opts for another health plan under the Exchange program. 2. The employee chooses to waive his right of availing of the plan and secures health coverage outside the company. 3. The employee specifically declines coverage in the health benefit plan.




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