Friday, April 27, 2012

Important Update Regarding PEHP Pilot Program

The Utah State employee's PEHP portion of the autism pilot program that recently passed the Utah State Legislature is currently open for enrollment for state employees eligible for PEHP health insurance plans. There have been several important clarifications provided recently regarding this plan:

  1. There is a one time enrollment opportunity that coincides with the standard open enrollment period for state employees. This window closes on July 1, 2012 and will not reopen to admit new participants during the duration of the program.
  1. The age range is from 2 to 6, inclusive of the endpoints. So any child with an autism spectrum disorder diagnosis that is 2 but not yet 7 by July 1st, 2012 is eligible for this program. *Note: This is an expanded interpretation/clarification of the bill. If your child is already 6 and does not turn 7 before July 1st, then they meet the age criteria for participation.
  1. Children will not be cut-off from the program if they exceed the age limit during the duration of the two year pilot period. As long as they are admitted into the program during open enrollment, they will remain eligible throughout the life of the program. *Note: This is a clarification on the program. If your child turns 7 during the life of the program, they will continue to receive services throughout the 2 year period.
  1. All state employees that are eligible for open enrollment and meet age and diagnostic requirement have equal eligibility for admittance into the autism pilot program. *Note: This is a clarification of the legislation. If you are not currently eligible for PEHP insurance as a state employee but will be eligible (either through new employment or increasing hours at an existing state employment position) sometime before July 1st you will still be able to apply. It is on a first-come first-serve basis, but the program is not full at this point.
  1. The pilot program caps at 50 children.

As mentioned previously, these clarifications apply only to state employees on PEHP insurance. This information has been provided as a courtesy to UAC members and is subject to change without notice. This information does not serve as any legal advice or recommendation. Check with PEHP for final interpretation on all aspects of the plan including eligibility, enrollment and services.