No. 30508 (Amendment): R590-175. Basic Health Care Plan Rule

DAR File No.: 30508
Filed: 09/28/2007, 05:19
Received by: NL

RULE ANALYSIS

Purpose of the rule or reason for the change:

This rule is being changed to comply with changes made in the law during the 2007 Legislative Session by H.B. 295, Insurance Law Amendments. (DAR NOTE: H.B. 295 (2007) is found at Chapter 307, Laws of Utah 2007, and was effective as of 04/30/2007.)

Summary of the rule or change:

The rule removes mental health coverage as a general benefit but makes it available on conversion policies. The proposed lifetime maximum benefit is a maximum of $1,000,000 versus the current minimum of $1,000,000 now required. The maximum benefit per person will not be less than $300,000 where it is now $250,000. There will only be one optional deductible of $1,500. An additional deductible of $500 would be added for drugs. The copays for drugs and office visits have been changed. The term "specified plan" has been replaced with "basic health care plan." The term "carrier" has been replaced with "insurer."

State statutory or constitutional authorization for this rule:

Sections 31A-2-201 and 31A-22-613.5

Anticipated cost or savings to:

the state budget:

The changes to this rule will have no effect on the state budget. Neither expenses nor revenues will be affected. Health insurers will be required to refile their basic health plans and any other forms that may be affected by the changes to it. These filings will not bring in any added revenues and the increased workload will be handled as the normal course of business.

local governments:

Since this rule deals solely with the relationship between the department and its licensees it will have no fiscal impact on local governments.

small businesses and persons other than businesses:

Currently there are approximately 470 health insurers that would be required to change their basic health care plans and then refile them with the System for Electronic Rate and Form Filing (SERFF). This will cost them $15. The changes to the plans should be able to be done in-house. Insurers will need to redo their marketing materials to match the new benefits. These plans are not sold to consumers. They are used for comparison purposes only and should have little if any effect on them.

Compliance costs for affected persons:

Currently there are approximately 470 health insurers that would be required to change their basic health care plans and then refile them with the System for Electronic Rate and Form Filing (SERFF). This will cost them $15. The changes to the plans should be able to be done in-house. Insurers will need to redo their marketing materials to match the new benefits. These plans are not sold to consumers. They are used for comparison purposes only and should have little if any effect on them.

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

The changes to this rule were brought to the legislature by members of the insurance industry. They will require health insurers doing business in Utah to change their marketing materials and their basic health plans, then refile them. Except for the cost of filing, the financial impact will differ from insurer to insurer, mainly based on the amount of marketing materials that will need to be changed. 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

Interested persons may attend a public hearing regarding this rule:

11/01/2007 at 11:00 AM, State Office Building, 450 N Main St, Room 1112, Salt Lake City, UT

This rule may become effective on:

11/21/2007

Authorized by:

Jilene Whitby, Information Specialist

RULE TEXT

R590. Insurance, Administration.

R590-175. Basic Health Care Plan Rule.

R590-175-1. Authority.

This rule is issued pursuant to Subsection 31A-22-613.5(2) and the general rulemaking authority vested in the commissioner by Section 31A-2-201. Section 31A-22-613.5(2)(a) requires that the commissioner adopt a Basic Health Care Plan.

 

R590-175-2. Statement of Purpose and Scope.

(1) The purpose of [the]this rule is to [set standards for the Basic Health Care Plan which will be offered under the open enrollment provisions of Chapter 30. The commissioner has adopted the Basic Health Care Plan pursuant to Subsection 31A-22-613.5(2)(a) to be offered under those provisions. ]adopt a Basic Health Care Plan as:

(a) a conversion plan per Section 31A-22-723; or

(b) a basic coverage plan per Section 31A-30-109.

(2)(a) This rule applies to all insurers marketing health insurance policies subject to the open enrollment provisions of Chapter 30[.]; and

(b) to all insurers subject to 31A-22-723.

 

R590-175-3. General Requirements.

(1)[A.] Each insurer who is required to offer a health care plan under the open enrollment provisions of Chapter 30 shall file with the department at least one basic health care plan which is specified by the insurer as complying with the provisions of this rule and which must be offered for sale to anyone qualifying for open enrollment under Chapter 30.[

B. The specified plan may offer additional services or provide a greater level of benefits than the Basic Health Care Plan. However, the specified plan must contain at least those benefits set forth in the Basic Health Care Plan.]

(2)[C.] The [specified]basic health care plan shall not be designed or marketed in a manner [which]that [may ]tends to discourage its purchase by anyone [purchasing ]under the open enrollment provisions of Chapter 30.

(3)[D.] A plan having actuarial equivalence may be considered, at the sole discretion of the commissioner.

(4)[E.] Each insurer must use the language in this rule to present covered services, limitations and exclusions[;].

(5) [however, any]A plan offered in compliance with the open enrollment provisions of Chapter 30 must contain at least the benefits set forth in the Basic Health Care Plan as adopted by the commissioner.

(6) The [specified]basic health care plan is to be offered as a package, in its entirety, and is mutually exclusive of and not comparable on a line by line basis to an [carrier]insurer's other plans.

(7)[F.] [When]If the [specified]basic health care plan is offered by a preferred provider organization, PPO, the benefit levels shown in the [Basic Health Care Plan]plan are for contracting providers; benefit levels for non-contracting providers' services may be reduced in accordance with Section 31A-22-617.

(8)[G.] Each insurer is to include its usual contracting provisions in its [specified]basic health care plan including submission of claims, coordination of benefits, eligibility and coverage termination, grievance procedures general terms and conditions, etc.

(9) Each insurer who is required to offer a group conversion plan under Subsection 31A-33-723 shall file with the department at least one basic health care plan that complies with the provisions of this rule and must be offered for sale to anyone qualifying for conversion.

(10)[H.] The form to follow for the Basic Health Care Plan is as follows:

 

TABLE
BASIC HEALTH CARE PLAN

  1. MAXIMUM BENEFIT. The maximum benefit per person for the entire

period for which this policy coverage is in effect shall [not ]be

[ less than] $1,000,000.

  2.  ANNUAL MAXIMUM BENEFIT. The maximum annual benefit per person

shall not be less than [$250,000]$300,000.

  3. OUT OF POCKET MAXIMUM PER PERSON. The annual out of

pocket maximum per person shall be $5,000, including any

deductibles, copayments or coinsurances in the plan.

  4.[3.]  PREEXISTING CONDITION LIMITATION.

  (a)  Any preexisting condition limitation shall be in compliance

with Utah Code Subsection 31A-22-605.1(4)[30-107(5)]; and

  (b)  Any [the ]waiting period shall not exceed 12 months with

credit for prior coverage when applicable.

  5.[4.]  GENERAL COST-SHARING FOR MEDICAL BENEFITS.

  (a)  Cost-sharing shall be based on eligible expenses[.];

  (b)  The cost-sharing features of the plan shall be[ one of] the

following[, at the option of the carrier]:

  [(a)](i)  Annual Deductible[.  An annual deductible]

  (A)  The major medical deductible may not be less[greater] than

[$1,000]$1,500 per person [and only two deductibles per family

unit.  However, when the person has a medical savings account, the

deductible amount may be greater than $1,000.]

  (B)  An annual deductible for prescription benefits may not be

less than $500 per person.

[  (ii)  Copayment. See paragraph 6 for benefits applicable to

prescription drugs.

  (iii)  Coinsurance.  For all covered services other than mental

illness/substance abuse services and prescriptions, the person shall

pay not more than 20% coinsurance to an annual maximum of $3,000 per

person, $6,000 per family unit.

  (b)(i)  Deductible.  An annual deductible may not be greater

than $1,000 per person and only two deductibles per family unit.

  However, when the person has a medical savings account, the

deductible amount may be greater than $1,000. Preventive services

under a managed care plan; e.g., HMO, PPO, are not subject to the

deductible.]

  (ii)  Copayment.

  (A)  A copayment is not [to exceed]less than [$15]$25 per visit

for office visits, including preventive care[,] services.

[When a copayment is required, no coinsurance may be charged for

the same service. See paragraph 6 for benefits applicable to

prescription drugs.]

  (B)  A copayment is not less than $150 per visit to the emergency

room.

  (iii)  Coinsurance.  For all covered services other than [mental

illness/substance abuse services and ]prescriptions, the person shall

pay not [more]less than 20% coinsurance for office visits and 20%

per emergency room visits.[to an annual maximum of $3,000 per person,

$6,000 per family unit.

  (c)(i)  Deductible. None.

	  (ii)  Copayment. A copayment is not to exceed $20 per visit

for office, including preventive care, services. When a copayment

is required, no coinsurance may be charged for the same service.

See paragraph 6 for benefits applicable to prescription drugs.

  (iii)  Coinsurance.  For all covered services other than mental

illness/substance abuse services and prescriptions, the person shall

pay not more than 30% coinsurance to an annual maximum of $3,000 per

person, $6,000 per family unit.]

  6.[5.]  PREVENTIVE SERVICES. Preventive services covered under a

managed care plan shall not be subject to the annual deductible.

[Preventive services under an indemnity or fee-for-service plan may

be subject to the annual deductible. ]Covered preventive services

shall consist of at least the following:

  (a)  childhood immunizations in accordance with guidelines as

recommended by the Centers for Disease Control, as directed and

modified from time to time;

  (b)  well-baby care through age five in accordance with

guidelines recommended by the American Academy of Pediatrics, as

directed and modified from time to time;

  (c)  for adults and adolescents, age, sex and risk appropriate

preventive and screening services in accordance with

Classification A guidelines recommended by the U.S. Preventive

Services Task Force, as directed and modified from time to time.

  7[6].  COST SHARING FOR PRESCRIPTION DRUGS. Benefits for

prescription drugs, other than self injectable drugs, except insulin,

shall be subject to either:

  (a)  a copayment of not more than:

  (i)  the lesser of the cost or $15 for the first tier of drugs;

[generic,]

  (ii)  the lesser of the cost or_$30[$25] for the middle tier of

drugs;[brand-name formulary prescription drugs,] and

  (iii)  the lesser of the cost or $60[$35] for the highest tier of

drugs[non-formulary prescription drugs]; or

  (b)  a coinsurance of not less than:

  (i)  the lesser of the cost or 25% for first tier drugs;

  (ii)  the lesser of the cost or 40% for middle tier drugs; and

  (iii)  the lesser of the cost or 60% for the highest tier of

drugs.[at the option of the carrier, benefits may be subject to

a 30% maximum coinsurance.

  Carriers may use formularies and may choose to not apply out-of-

pocket costs of prescription drugs to out-of-pocket maximums.]

  8.  COST SHARING FOR MENTAL HEALTH BENEFITS.  Benefits for

mental health services will be provided only on conversion policies

issued from group health plans offering mental health benefits and

at the same level of the group policy.

  9.[7.]  OUTPATIENT REHABILITATION SERVICES. Benefits for outpatient

rehabilitation services, [(]e.g., physical therapy, occupational

therapy, and speech therapy,[)] shall be limited to not less than 10

visits for each illness or injury.

[  8. MENTAL ILLNESS AND/OR SUBSTANCE ABUSE SERVICES. Benefits for

mental illness and/or substance abuse services may be subject to a

deductible. Coinsurance may not exceed 50% of eligible expenses and

may not apply toward the maximum. Benefits shall be one of the

following, at the option of the carrier:

  (a)  benefits for inpatient services shall be limited to not less

than ten days annually per person; benefits for outpatient services

shall be limited to not less than 20 visits annually per person;

  (b) 
mental health and/or substance abuse services for group

policies will be subject to 31A-22-625 and 31A-22-720.]

  10.[9.]  HOME HEALTH CARE. Benefits for home health
care shall be

limited to not less than 30 days in any 12 month period and shall

consist of services provided, in accordance with a plan of care, in

the home by a licensed community home health agency or an approved

hospital program for home health care when the person is physically

unable to obtain necessary medical care on an outpatient basis,

would otherwise be confined as an inpatient, and is under the care of

a physician. A "plan of care" means a written plan that:

  (a)  is approved by the physician prior to commencement of treatment,

unless it is continuity of care under the same physician;

  (b)  is based on the assessment data or physician orders; and

  (c)  identifies the patient's needs, who will provide needed

services, how often, treatment goals, and anticipated outcomes.

  Covered services shall not include health aide services furnished

when the person is not receiving professional services of a

registered nurse (RN), licensed practical nurse (LPN), or licensed

vocational nurse  (LVN), nor shall it  include housekeeping services.

  11.[10.]  DURABLE MEDICAL EQUIPMENT. Benefits for durable

medical equipment, rental or purchase, at the option of the

[carrier]insurer.  Prosthetics and orthotics shall be limited to

not less than $5,000 per person for the entire period for which

coverage is in effect.

  12.[11.]  COVERED SERVICES. Subject to medical necessity,

provider network, and prior approval criteria established by the

[carrier]insurer, and subject to the limitations and exclusions and

other terms and conditions of the policy, the following shall be

covered services under the basic health care plan:

  (a)  inpatient hospital services:

  (i)  semi-private room accommodations;

  (ii)  ICU;

  (iii)  hospital services and supplies;

  (b)  ambulatory service facility services:

  (i)  birthing center services, when maternity care is covered;

  (ii)  surgical facility services;

  (c)  office preventive services;

  (d)  office medical services:

  (i)  diagnostic services; e.g., x-ray, lab tests;

  (ii)  therapeutic services; e.g., injection of medication;

  (e)  outpatient hospital services:

  (i)  emergency room services;

  (ii)  diagnostic services;

  (iii)  therapeutic services; e.g., chemotherapy, radiation therapy;

  (iv)  surgical facility services;

  (f)  inpatient medical services; e.g., physician visits;

  (g) surgery;

  (h)  assistant-at-surgery;

  (i)  anesthesia, including children's general anesthesia for

dental, if necessary;

  (j)  consultation;

  (k)  dental care for accidental injury to sound natural teeth;

  (l)  limited home health care;

  (m)  emergency ambulance transportation;

  (n)  prescription drugs;

  (o)  durable medical equipment, prosthetics and orthotics, as

limited; and medical supplies;

  (p)  maternity services:

  (i)  for employer group[s] conversion plans, maternity benefits

are provided on the same basis as benefits for sickness;

  (ii)  for individual[s] plans, there are no maternity benefits;

  (iii)  benefits for complications of pregnancy are provided on the

same basis as benefits for sickness. Complications of pregnancy

will not be excluded solely because the pregnancy is a preexisting

condition. "Complications of pregnancy" means diseases or conditions,

the diagnoses of which are[an illness,] distinct from pregnancy but

are adversely affected or caused by pregnancy and not associated

with a normal pregnancy[, affecting the mother and occurring during

pregnancy and requiring separate and specific medical or surgical

services for which separate and additional charges are incurred].

  Complications of pregnancy does not include false labor,

occasional spotting, doctor prescribed rest during the period

of pregnancy, morning sickness, and conditions of comparable

severity associated with management of a difficult pregnancy.

In no event will the presence of complications of pregnancy result

in benefits being provided for services normal to care and treatment

of pregnancy and childbirth. Such normal services include but are not

limited to hospitalization for childbirth or termination of pregnancy

by any means, anesthesia services, ultrasound examinations,

prenatal diagnostic laboratory services, antepartum and postpartum

care, vaginal or cesarean delivery, threatened premature termination,

premature termination, and routine nursery care of the newborn;

  (iv)  newborn and maternity inpatient time limits will conform

to Subsection 31A-22-610.2.  For conversion plans, maternity will be

covered with the lesser of benefits originally on plan prior to

conversion or the basic benefit plan.  This coverage benefit is only

for existing pregnancies, known or unknown at the time of conversion.

Additional premium for pregnancy is not allowed;

  (q)  limited outpatient rehabilitation services;

  (r)  limited mental illness/substance abuse services;

  (s)  diabetes as required by Section 31A-22-626.

  (t)  inborn metabolic errors, PKU, nutritional benefits as required

by Section 31A-22-623; and

  (u)  mastectomy as required by Sections 31A-22-630 and 31A-22-719.

  13[12].  EXCLUSIONS. Benefits will not be provided for any of the

following:

  (a)  services, supplies, or treatment provided prior to the

effective date or after the termination date of coverage;

  (b)  charges in connection with a work-related injury or sickness

for which coverage is provided under any state or federal worker[']s'

compensation, employer's liability, or occupational disease law;

  (c)  services, supplies, or treatment for which coverage is

provided under any motor vehicle no-fault plan. When the person is

required by law to have no-fault insurance in effect, this exclusion

applies to charges up to the minimum coverage required by law whether

or not such coverage is in effect[.];

  (d)  services, supplies, or treatment for injury or sickness

resulting from war or any act of war whether declared or undeclared;

  (e)  services, supplies, or treatment for injury or sickness

resulting from service in the military of any country;

  (f)  services, supplies, or treatment for which benefits are

provided under Medicare or any other government program except

Medicaid;

  (g)  services, supplies, or treatment for which no charge is made

or for which the person is not required to pay;

  (h) services or supplies not incident to or necessary for the

treatment of injury or sickness or which are not medically necessary,

as determined by the [carrier]insurer;

  (i)  treatment or prevention of an injury or sickness,

including mental illness, by means of treatments, procedures,

techniques, or therapy outside generally accepted health care

practice;

  (j)  services, supplies, or treatment required as a result of an

injury or sickness sustained while committing a felony or engaging

in an illegal occupation;

  (k)  services to the extent benefits are provided by any

governmental unit except as required by federal law for treatment

of veterans in Veterans Administration or armed forces facilities

for non-service related medical conditions;

  (l)  examinations, reports, or appearances in connection with

legal proceedings; and services, supplies, or accommodations

pursuant to a court order, whether or not injury or sickness is

involved;

  (m)  investigative/experimental technology, treatment, procedure,

facility, equipment, drug, device or supply, "technology," which does

not, as determined by the [carrier]insurer on a case by case basis,

meet all of the following criteria:

  (i)  the technology must have final approval from appropriate

governmental regulatory bodies, if applicable;

  (ii)  the technology must be available in significant number

outside the clinical trial or research setting;

  (iii)  the available research regarding the technology must

be substantial. For purposes of this definition, "substantial" means

sufficient to allow the [carrier]insurer to conclude that:

  (A)  the technology is both medically necessary and appropriate

for the person's treatment;

  (B)  the technology is safe and efficacious; and

  (C)  more likely than not, the technology will be beneficial to the

person's health;

  (iv)  the regional medical community as a whole must generally

recognize the technology as appropriate;

  (n)  services in connection with any transplant of any whole

organ or part thereof, live or cadaver, bone marrow, either as donor

or recipient, or any artificial organ, except for the following:

  (i)  cornea transplants;

  (ii)  kidney transplants;

  (iii)  liver transplants for children under age 18 years;

  (iv)  bone marrow transplants for children under age 18 years; and

  (v)  evaluation, treatment and therapy involving the use of

myeloablative chemotherapy with autologous hematopoietic stem cell

and/or colony stimulating factor support for children under age 18

years;

  (o)  custodial care;[.]

  (i)  "Custodial care" means:

  [(i)](A)  institutional care, consisting mainly of room and board,

which is for the primary purpose of controlling the person's

environment; and

  (B)[(ii)]  professional or personal care, consisting mainly

of non-skilled nursing services with or without medical supervision,

which is for the primary purpose of managing the person's

disability or maintaining the person's degree of recovery already

attained without reasonable expectation of significant further

recovery.

  (ii)  "Custodial care" does not mean outpatient palliative

and supportive care provided by a hospice program to a person

who is terminally ill with a life expectancy of not more than six

months and is in lieu of institutional or inpatient hospital care;

  (p)  services, supplies, or treatment in connection with cosmetic

or reconstructive procedures which alter appearance but do not

restore or improve impaired physical function or which are performed

for psychological or emotional purposes, except when performed while

a person is covered under this policy for the following:

  (i)  repair of defects resulting from an accident occurring within

90 days of the effective date of this policy under creditable

coverage or occurring during this policy;

  (ii)  replacement of diseased tissue surgically removed for illness

occurring within 90 days of this policy under creditable coverage or

occurring during this policy;

  (iii)  treatment of a birth defect in a child who has met the

pre-existing conditions requirement since birth or date of placement

for adoption; and

  (iv)  mastectomy reconstruction as required by Sections 31A-22-630

and 31A-22-719;

  (q)  dental services. This exclusion will not apply if dental

services are required as a result of an accidental injury which

occurs while coverage is in force, dental services are received

within two years following the accidental injury, and the person

has been continuously covered from the date of the accidental injury

through the date the dental services are provided;

  (r)  eyeglasses, contact lenses and/or servicing of eyeglasses

and/or contact lenses. This exclusion does not apply to contact

lenses in the case of keratoconus or post-cataract surgery when the

contact lenses are medically necessary in the treatment of the

condition;

  (s)  medical, non-surgical, care of weak, strained, flat,

unstable or unbalanced feet routine foot care. The exclusion of

routine foot care does not apply to cutting or removal of corns,

calluses, or nails when provided to a person who has a systemic

disease, such as diabetes with peripheral neuropathy or circulatory

insufficiency, of such severity that unskilled performance of the

procedure would be hazardous;

  (t)  orthopedic or corrective shoes, foot orthotics, or any other

supportive devices for the feet;

  (u)  drugs and medicines which do not bear the legend "Caution -

federal law prohibits dispensing without a prescription" and/or which

are not dispensed by a licensed pharmacist;

  (v)  charges in connection with jaw realignment procedures

including, but not limited to, osteotomy, upper or lower jaw

augmentation or reduction procedures, and orthognathic surgery;

charges in connection with treatment of temporomandibular joint (TMJ)

dysfunction, including surgical procedures and injections of the TMJ,

physical therapy, splints, and orthodontic appliances. This exclusion

will not apply to:

  (i)  the initial diagnostic evaluation of TMJ dysfunction;

  (ii) surgical correction of the TMJ required as a result of an

accidental injury which occurs while this coverage is in force; and

  (iii)  physical therapy services related to and subsequent to

covered TMJ surgery;

  (w)  treatment of obesity by means of surgical, medical or

medication services and regardless of associated medical, emotional,

or psychological conditions;

  (x)  services or supplies in connection with genetic studies;

  (y)  implantable contraceptives (hormonal or other);

  (z)  reversal of a sterilization procedure;

  (aa)  any treatment for or diagnosis of infertility, artificial

insemination, in vitro fertilization, and any other male or female

dysfunction, except as required by Section 31A-8-101;

  (bb)  vision testing, vision training;

  (cc)  radial keratotomy, laser and any surgical correction of

errors of refraction;

  (dd)  educational service or counseling, including weight

control clinics, stop smoking clinics, cholesterol counseling,

exercise programs or other types of physical fitness training,

except for those benefits required by Section 31A-22-626;

  (ee)  marriage counseling; family counseling; counseling

for educational, social, occupational, religious, or other

similar maladjustment; behavior modification, biofeedback, or rest

cures as treatment for mental disorders; sensitivity or stress-

management training; self-help training; and residential treatment;

  (ff)  treatment for mental disorders which are irreversible or

for which there is little or no reasonable expectation for

improvement, including mental retardation, personality disorders,

and chronic organic brain disease. This exclusion does not apply to

the initial assessment for diagnosis of the condition;

  (gg)  psychotherapy, counseling, or other services in

connection with learning disabilities, disruptive behavior disorders,

conduct disorders, psychosexual disorders, or transexualism. This

exclusion does not apply to the initial assessment for diagnosis of

the condition;

  (hh)  vitamins, special formulas, special diets, and food

supplements except as provided by a hospital or skilled nursing

facility during a confinement for which benefits are available,

except as outlined in Section 31A-22-623;

  (ii)  any devices used to aid hearing, including cochlear

implants, the fitting of such devices and any routine hearing tests;

  (jj)  acupuncture or acupressure;

  (kk)  speech therapy for psychosocial speech delays;

  (ll)  all shipping, handling, or postage charges except as

incidentally provided, without a separate charge, in connection with

covered services or supplies;

  (mm)  interest or finance charges except as specifically required

by law;

  (nn)  charges for missed appointments, telephone consultations,

and clerical services for completion of special reports or claim

forms;

  (oo)  travel expenses, whether or not prescribed;

  (pp)  care, except urgent or emergency care, rendered outside

the United States;

  (qq)  services provided by a member of the person's immediate

family or household; and

  (rr)  autopsy procedures.

 

(11)[I.] The [specified]basic health care plan is to be filed with the department before use.

(12)[J.] Conversion coverage provided pursuant to Section 31A-22-[708]723, may provide additional benefits in addition to the Basic Health Care Plan.

 

R590-175-4. Enforcement Date.

The commissioner will begin enforcing the revised provisions of this rule 45 days from the rule's effective date.

 

R590-175-5. Severability.

If a provision of this rule or its application to any person or circumstance is for any reason held to be invalid, the remainder of the rule and the application of these provisions shall not be affected.

 

KEY: insurance

Date of Enactment or Last Substantive Amendment: [August 23, 2001]2007

Notice of Continuation: November 8, 2005

Authorizing, and Implemented or Interpreted Law: 31A-22-613.5