Zane Benefits Publishes New Information on Utah Health Insurance Exchange

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Federal Government to Run Individual Exchange and Utah to Run SHOP Exchange

Today, Zane Benefits, Inc. published new information on Utah Health Insurance Exchange. Zane Benefits, which provides comprehensive and flexible alternatives to traditional employer sponsored health benefits, is the leader in defined contribution health plans and health reimbursement arrangement plans.

According to Zane Benefits’ website, beginning in 2014 as part of the Affordable Care Act (ACA), health insurance coverage for individuals and small businesses will become available through new state health insurance exchanges (also called health insurance marketplaces). Most importantly, the key tax credits (e.g. the small business healthcare tax credits) and tax subsidies (e.g. individual health insurance tax subsidies) will only be available for coverage purchased through a state health insurance exchanges.

All states have three options for setting up a state health insurance exchange for 2014:

  • Build a State-Based Exchange
  • Enter into a State-Federal Partnership Exchange
  • Default to a Federally-Facilitated Exchange

Utah will enter into a unique state-federal partnership: Utah will run the small business "SHOP" exchange, and the federal government will run the individual health insurance exchange. The Utah Health Insurance Exchange will open October 1, 2013, with coverage beginning January 1, 2014.

History of the Utah Health Insurance Exchange

According to Zane Benefits’ website, Utah has one of the more unique histories in developing their Health Insurance Exchange. Prior to federal health care reform, former Governor Jon Huntsman signed HB 133 in 2008 and HB 188 in 2009 which created the Utah Health Exchange. Additional legislation (HB 294 and HB 128) was signed into law in 2010 and 2011, respectively, by current Governor Gary Herbert amending provisions related to health care reform in 2010. These later pieces of legislation reauthorized the Health System Reform Task Force to evaluate options for bringing the state’s already existing exchange into compliance with the Affordable Care Act.

These laws, along with HB 144 introduced in February 2012, allowed small businesses to participate in a type defined contribution or "employee choice" model where small businesses and employees could compare, select, and enroll in commercial health insurance online. In 2012 the Utah Exchange was rebranded Avenue H.

According to Zane Benefits’ website, the biggest question over the last few months has been, would the federal government certify Avenue H as Utah's small business "SHOP" exchange while also allowing Utah to default to the federally-run individual health insurance exchange?

On May 10, 2013, Utah announced they reached an agreement with the US Department of Health and Human Services (HHS) for Utah to run Avenue H, the small business "SHOP" health exchange, without a competing federal solution or interjection from the federal government, and that the federal government would run the individual health insurance exchange.

In a press release by Avenue H, Governor Herbert said "The only way this was going to work was if we were granted flexibility. Fortunately for all, HHS proved to be flexible, concurring with everything we proposed to be able to operate an exchange that meets the needs of Utah residents," said the Governor. "The new model clearly outlines what Utah will do and what HHS will do. We are sticking with our exchange and moving forward."

With Utah's Health Insurance Exchange, Utah will maintain oversight over qualified health plans, including certification, re-certification, decertification and compliance. Utah will also continue to administer the Medicaid program through existing Medicaid structure.

The federal government will be responsible for operating the individual health insurance exchange, conducting pre-certification for Medicaid and CHIP eligibility, and managing tax credits through the individual exchange.

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About Zane Benefits
Zane Benefits was founded in 2006 to provide a revolutionized SaaS (Software-as-a-Service) administration platform ("ZaneHRA") for Health Reimbursement Arrangements (HRAs) and defined contribution health care. The flagship software provides a 100% paperless administration experience to employers and insurance professionals that want to offer better health benefits without a traditional group health insurance plan at lower costs. For more information about ZaneHRA, visit

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Christina Merhar
Zane Benefits
800-391-9209 6725
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