UPP FAQ

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 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.

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 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.

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 for health insurance offered at work (employer sponsored health insurance only)
• Have a deductible of $4,000 per person (or less)
• A lifetime maximum of $1,000,000 (or more)
• Plan pays at least 70% of inpatient costs after the deductible

The plan does not cover any abortion services; or the plan only covers abortion services in the case where the life of the mother would be endangered if the fetus were carried to term or in the case of rape or incest.

Please visit the How to Apply page to see information on applying for UPP.

UPP helps make health insurance more affordable for 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). If you are already enrolled in COBRA you may apply at any time.
• UPP will contact you within two weeks from receiving your application.
• Pay your monthly premiums.
• If you qualify for UPP, you will need to provide proof you have enrolled and show how much you pay in premiums.
• Then, UPP will reimburse you up to $300 per adult and up to $120 per child every month to share in the cost of your monthly premiums. A check will be mailed to you each month.
• In addition, you may be eligible to receive an additional $20 per child if he/she is enrolled in dental coverage. (Every eligible child will receive an additional $20 each month to pay for dental coverage or be enrolled in the Children’s Health Insurance Program dental plan).

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.

*Effective March 2023

If you are enrolled with UPP, you must pay your monthly premium for your employer’s health plan or COBRA coverage. You are also responsible for paying co-pays or co-insurance as required by your health plan. In return, UPP will reimburse you up to $300 per adult and up to $120 per child.

Example: Household has one parent and two children
Health Plan’s total premium = $550/month for the whole family
UPP reimbursement = $300 (1 adult) + $240 (2 children) = $540/month
Your total cost = $10 + any co-pays, co-insurance and deductibles

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 individuals and families.

UPP is for adults and children who do not currently have health insurance or enroll in COBRA coverage.

• UPP will help you pay your monthly premiums when you enroll in your employer’s health insurance plan or COBRA
• You or your dependents may qualify for UPP based on family size, income, and if your employer’s health insurance plan or COBRA coverage meets basic guidelines
• If you or your dependents qualify, UPP will reimburse you up to $300 per adult and up to $120 per child in the family–every month!

It’s time to get UPP if:

• You and/or your family are not currently enrolled in your employer-sponsored health insurance,
• If you have begun a new job.
• If you are eligible for COBRA
• If you are already enrolled in COBRA coverage
• If you have health insurance offered at work and are not yet enrolled, you must apply for
• UPP BEFORE the date that your health insurance coverage begins.
• If you’re eligible to add your spouse or your child(ren) to your health insurance, then it’s time for them to get UPP, too.

As of July 1, 2008 approval for UPP is also considered a qualifying event for applicants to enroll in their employer-sponsored health insurance plan at any time. Applicants do not have to wait for the annual open-enrollment to enroll, if approved for UPP. For more information call 1-888-222-2542 or click here.

Utah adults and children are eligible—children age 18 and under, and adults ages 19-64 who fit within the income guidelines. See “Do I qualify?”