No. 30462 (Amendment): R590-167-11. Actuarial Certification and Additional Filing Requirements

DAR File No.: 30462
Filed: 09/18/2007, 08:53
Received by: NL

RULE ANALYSIS

Purpose of the rule or reason for the change:

The purpose of the rule amendments are to change the year-end date of the small employer index premium rate report of the current and previous year and the date the reports are to be filed with the department.

Summary of the rule or change:

The purpose of the rule amendments are to change the year-end date of the small employer index premium rate report of the current and previous year and the date the reports are to be filed with the department.

State statutory or constitutional authorization for this rule:

Sections 31A-2-201 and 31A-30-106

Anticipated cost or savings to:

the state budget:

Since the changes being made deal only with the date filings are to be made, the work-load will not change, only shift.

local governments:

The changes to this rule will have no fiscal impact on local governments since they deal solely with the relationship between the department and their licensees.

small businesses and persons other than businesses:

The changes to this rule will not change what is required, just when it is required. Since most of the information can be downloaded from a computer program, it should not require additional work just a change in scheduling by the staff of each insurer.

Compliance costs for affected persons:

The changes to this rule will not change what is required, just when it is required. Since most of the information can be downloaded from a computer program, it should not require additional work just a change in scheduling by the staff of each insurer.

Comments by the department head on the fiscal impact the rule may have on businesses:

The changes to this rule will have no fiscal impact on businesses. D. Kent Michie, Commissioner

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Insurance
Administration
Room 3110 STATE OFFICE BLDG
450 N MAIN ST
SALT LAKE CITY UT 84114-1201

Direct questions regarding this rule to:

Jilene Whitby at the above address, by phone at 801-538-3803, by FAX at 801-538-3829, or by Internet E-mail at [e-mail]

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

11/14/2007

This rule may become effective on:

11/21/2007

Authorized by:

Jilene Whitby, Information Specialist

RULE TEXT

R590. Insurance, Administration.

R590-167. Individual, Small Employer, and Group Health Benefit Plan Rule.

R590-167-11. Actuarial Certification and Additional Filing Requirements.

(1) Actuarial Certification.

(a) An actuarial certification shall be filed annually and meet the requirements of Section 31A-30-106(4)(b) and the following:

(i) the actuarial certification shall be a written statement that meets the requirements of Title 31A Chapter 30, R590-167, and the applicable standards of practice as promulgated by the Actuarial Standards Board;

(ii) the actuary must state that he or she meets the qualifications of Subsection 31A-30-103(1);

(iii) the actuarial certification shall contain the following statement: "I, (name), certify that (name of covered carrier) is in compliance with the provisions of Title 31A Chapter 30, and R590-167, based upon the examination of (name of covered carrier), including review of the appropriate records and of the actuarial assumptions and methods utilized by (name of covered carrier) in establishing premium rates for applicable health benefit plans;" and

(iv) the actuarial certification shall list and describe each written demonstration used by the actuary to establish compliance with Title 31A Chapter 30 and R590-167.

(b) The actuarial certification shall be filed no later than April 1 of each year.

(2) Rating Manual.

(a) For every health benefit plan subject to the Act and this rule, the carrier shall file with the commissioner a copy of the applicable rating manual, for both new business and renewal rates, which includes:

(i) signed certification by an actuary that to the best of the actuary's knowledge and judgment the rate filing is in compliance with the applicable laws and rules of the State of Utah;

(ii) a complete and detailed description of how the final premium, including any fees, is calculated from the rating manual;

(iii) all changes and updates, which includes a complete and detailed description of how the final premium, including any fees, is calculated from the rating manual; and

(iv) a description of the carrier's classes of business as described in Subsection R590-167-4(1).

(b) The rate manual shall be filed:

(i) with an initial product filing; or

(ii) within 30 days prior to use for an existing health benefit plan

(3) Index Premium Rates.

(a) A small employer carrier shall file annually the index premium rate information required by Section 31A-29-117(2). The report shall include:

(i) the small employer index premium rate as of [March]January 1 of the previous year;

(ii) the small employer index premium rate as of [March]January 1 of the current year; and

(iii) the average percentage change in the index premium rate as of March 1 of the current and preceding year.

(b) The information described in Subsection R590-167-11(3)(a) shall be filed no later than [April]February 1 of each year.

 

KEY: health insurance

Date of Enactment or Last Substantive Amendment: [October 7, 2004]2007

Notice of Continuation: September 28, 2004

Authorizing, and Implemented or Interpreted Law: 31A-30-106