Utah Premium Parthnership for Health Insurance
UPP (Utah's Premium Partnership for Health Insurance) helps make health insurance more affordable for working individuals and families who do not currently have health insurance. UPP (pronounced ‘up’) helps you pay your monthly health insurance premiums through your employer’s health insurance plan.
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
   
   
  1. What's UPP?
  Utah’s Premium Partnership for Health Insurance (UPP) is a program of the Utah Department of Health. UPP (pronounced “up”) helps make health insurance more affordable for working individuals and families.
UPP is for adults and children who do not currently have health insurance
 

• UPP will help you pay your monthly premiums when you enroll in your employer’s health insurance plan
• You or your dependents may qualify for UPP based on family size, income, and if your employer’s health insurance plan meets basic guidelines
• If you or your dependents qualify, UPP will reimburse you up to $150 per adult and up to $100 per child in the family--every month!
 
 
 

2. How does UPP work?
 
UPP helps make health insurance more affordable for working individuals and families. Basically, here’s how it works:
 
• First, you must apply for UPP BEFORE the date that your health insurance coverage begins (your employer health plan).
• UPP will contact you within two weeks from receiving your application.
• Pay your monthly premiums. (Typically, the cost is withheld from every pay check.)
• If you qualify for UPP, they’ll ask you to send a copy of your paycheck stub to show that the premiums are being paid.
• Then, UPP will reimburse you up to $150 per adult and up to $100 per child every month to share in the cost of your monthly premiums.
• In addition, you may be eligible to receive an additional $20 per child if he/she is enrolled in dental coverage.
 
   
 
3. Who is eligible?
 
Utah adults and children are eligible—children age 18 and under, and adults ages 19-64 who fit within the income guidelines. See #4 “Do I qualify?”
 
 
 
4. Do I qualify?
 
There are several factors that are used to determine eligibility.
  Adults age 19-64 may qualify if:
 

• You are not covered by health insurance right now
• You or your spouse is employed
• The company you or your spouse works for offers health insurance
• You are eligible to get health insurance through your job or your spouse’s job
• You are a U.S. citizen or legal resident
• You fit within the income guidelines for adults
• The cost of the least expensive health insurance option is more than 5% of your total household income (before taxes)

You may also call your local office for more information.

 
 
 
5. Does my child qualify?
 
Children ages 0-18 may qualify if:
 

• Child is not covered by health insurance right now
• Child is a U.S. citizen or legal resident
• You or your spouse is employed
• Your company (or your spouse’s company) offers health insurance
• You are eligible to get health insurance through your job (or your spouse’s job) for your child
• Your family’s income fits within the income guidelines for insuring children
• The cost of the least expensive health insurance option is more than 5% of your total
household income (before taxes)

You may also call your local office for more information.

 
   
  6. What are the income guidelines?
 

To qualify for UPP, you must meet the income guidelines explained in the chart. Income includes the following: wages that you and your spouse earn, child support, alimony, Social Security, etc.

We know there are many rules regarding income, and it’s hard to remember them all. So just fill out your application the best you can and UPP will contact you if there are any questions. You may also call your local office for more information.

Maximum Income Per Month
(Before Taxes)*
Family Size
For an Adult
to Qualify

For a Child
to Qualify
1
$1,300
$1,734
2
$1,750
$2,334
3
$2,200
$2,934
4
$2,650
$3,534
5
$3,100
$4,134
6
$3,550
$4,734
7
$4,000
$5,334
For each additional family member
Add $450 per
adult
Add $600 per
child

*Effective March 1, 2008
 
   
 
7. How do I apply?
   
  1. Ask your employer if you are eligible to get health insurance through them.
2. Apply for UPP BEFORE the date that your health insurance coverage begins.
3. Follow these steps to apply:
 

• Apply for UPP. Apply online OR download and return the UPP Application.
• Have your employer fill out and return the Employer’s Health Insurance Form. (included in the application)

 

- The Employer’s Health Insurance Form must be
completed by your employer or your company’s
Human Resources representative.
- This form must be completed for each employed household member.
- If you need extra forms, you may download the Employer’s Health Insurance Form.
- Have your employer or Human Resources representative return the form as soon as possible.
Mail: UPP, PO Box 144102, SLC, UT 84114-4102
Fax: 801-538-6860.
 

• You will hear from UPP within two weeks. After UPP has received both your application and the Employer’s Health Insurance Form, your local office will contact you.
  Back
 
 
8. When is it time to get UPP?
 
It’s time to get UPP if you and/or your family are not currently enrolled in your employer-sponsored health insurance, or as soon as you begin a new job. Apply for UPP BEFORE the date that your health insurance coverage begins.

If you’re eligible to add your spouse or your child to your health insurance, then it’s time for them to get UPP for them, too.
 
 
 
9. What will my costs be?
 
If you are enrolled with UPP, you must make their monthly payment to their employer health plan. You are responsible for paying co-pays or co-insurance as required by the employer health plan. In return, UPP will reimburse you up to $150 per adult and up to $100 per child.

Example: Household has one parent and two children
Health Plan’s total premium = $400/month for the whole family
UPP reimbursement = $150 (1 adult) + $200 (2 children) = $350/month
Your total cost = $50 + any co-pays, co-insurance and deductibles
 
 
 
10. I have health insurance, but my spouse doesn’t. Can he/she qualify for UPP?
 
Yes, it is possible that your spouse may qualify for UPP if he/she can enroll in your employer’s health insurance.
 

• If your spouse is age 19-64, see See #4 Do I qualify?
• If your spouse is age 18 or younger, see See #4 Does my child qualify?
 
For your spouse to apply:
Follow the same guidelines. See #7 How do I apply.
 
 
 
11. My child is on CHIP, can he/she get UPP?
 
Yes. It’s possible your child may qualify for UPP. If he/she qualifies, your child may switch from CHIP to UPP. Also, your employer’s health insurance plan must meet basic guidelines. See #14 Does my employer’s health insurance plan qualify for UPP?

We encourage you to compare the benefits, co-pays and health insurance premiums between CHIP and your employer’s health insurance plan. See the Comparison Chart to decide which option is best for you.

To get UPP, please contact your case worker. He/she will be able to give you the necessary forms.
 
 
 
12. I am on PCN. Can I get UPP?
 
Yes. It’s possible you may qualify for UPP. If you qualify (see #4 Do I qualify?) you may switch from PCN to UPP. Also, your employer’s health insurance plan must meet basic guidelines. (see #14 Does my employer’s health insurance plan meet UPP guidelines.)

To get UPP, contact your case worker. He/she will be able to give you the necessary forms you need to fill out.

 
 
 
13. Is there a limit to how many people in my family can use UPP?
 
No. There’s not a limit. If you qualify, you may receive up to $150 for each adult in your family and up to $100 for each child in your family, no matter how many people are in your family.

Example: Household has two adults and five children
Health Plan’s total premium = $825/month for the whole family
UPP reimbursement = $300 (2 adults) + $500 (3 children) = $800/month

 
 
 
14. Does my employer’s health insurance plan qualify for UPP?
 
Your health insurance plan must meet these guidelines:
• Cover physicians visits, well child exams, hospital inpatient services, child immunizations, and pharmacy
• Employer must pay at least 50% of the cost for the employee’s coverage
• Have a deductible of $1,000 per person or less
• A lifetime maximum of $1,000,000 or more
• Plan pays 70% of inpatient costs after the deductible
 
 
 
15. What about dental coverage?
 
There are two options for your children to get dental coverage:
• Get dental coverage through CHIP, or
• Get dental coverage through your employer and receive an additional reimbursement of $20 per child every month

Options for dental coverage are only for individuals age 18 and under.
 
 
 
16. I turned in my application. When will I know if I can get UPP?
 
A local eligibility worker will contact you within 2 weeks after you turn in your application. Beyond that, it may take 4-6 weeks to process your application. If there are parts of the application that are incomplete, the process will take longer as we try to contact you to get that information.
 
 
 
17. What should I expect now that I’m enrolled?
 
1. Send a copy of your paycheck stub. Once you are enrolled with UPP and your employer health plan, send UPP a copy of your paycheck stub showing that the cost of the health insurance coverage was withheld.
2. UPP will send you a reimbursement check. Your check will arrive in the mail during the first two weeks of each month. Make sure UPP always has your current address to avoid delays.
3. After six months, UPP will send you a follow-up form. Your employer or HR rep must fill out this form and return it to UPP in order for your benefits to continue.
If you have any questions, call 1-888-222-2542 or e-mail upp@utah.gov.
 
 
 
18. How do you verify that a person has health insurance?
 
Your employer sends UPP the verification form, which lists who is covered. Also, you will need to provide UPP with a copy of your paycheck stub. UPP contacts your health insurance company to ensure you remain covered.
 
   
 
19. How long can I be on UPP?
 
You can be on UPP, as long as you are employed, are insured, report all changes in your information to UPP, and continue paying your health insurance premium. You must also renew enrollment every year. See How do I renew?
 
 
 
20. Can I upgrade to a better insurance plan?
 
Yes. You can choose the plan you want to be reimbursed for, as long as you qualify for UPP using the least expensive plan that your employer offers.
 
   
 
21. How do I renew?
 
Every 12 months from the time you enrolled, UPP reviews your enrollment. At that time, UPP will mail you a renewal form. Fill out the form and return it to your eligibility worker as soon as possible.
 
   
 
22. How is UPP funded?
 
UPP is funded with state and federal money.
 
 
 
23. How do employers benefit from UPP?
 
Employers have an advantage to using UPP because it increases participation in group coverage. Health insurance carriers require a certain percentage of employees to participate in coverage in order for an employer to offer group coverage.

And, benefits help employees stay around longer. If an employee has health insurance through their job, they’re more likely to stay.

 
   
 
24. How can employers let their employees know about UPP?
 
Employers can provide new employees with an UPP brochure in their new-employee information packet. Employers can also include an UPP brochure with the information packet during the annual open enrollment period for the health insurance plan. If you’d like to order brochures or any other UPP materials, call 801-538-6847 or e-mail upp@utah.gov.

 
 
 
25. I am moving to another state. Do other states have a program like UPP?
 
Yes. So far, these states have a similar program: California, Georgia, Idaho, Illinois, Iowa, Louisiana, Maryland, Massachusetts, Missouri, Montana, New Jersey, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, Texas, Virginia, West Virginia, and Wisconsin.

However, eligibility rules are different for each state. Please refer to each state for more information.

 
   
 
26. I am a reporter. Who do I call if I have more questions?
 
Please be prepared to give us your full name, organization you are with, and media related questions you have.
801-538-6847
 
 
 
27. My question isn’t answered here. Who do I call if I have more questions?
 
If you have questions that are not answered on this Web site, call 1-888-222-2542 or e-mail upp@utah.gov
 
 
 
28. I want to order materials. Who should I contact?
 
To order materials (min. qty. 25) for your organization, please e-mail upp@utah.gov with your request and mailing address.