No. 28767 (Second): R590-220. Submission of Accident and Health Insurance Filings

DAR File No.: 28767
Filed: 12/01/2006, 07:52
Received by: NL

RULE ANALYSIS

Purpose of the rule or reason for the change:

These changes were requested during the last comment period.

Summary of the rule or change:

The changes to this rule require insurers to submit filing status information only when domiciliary approval has not been obtained. (DAR NOTE: This is the second change in proposed rule (CPR) for Rule R590-220. The original proposed amendment upon which the first CPR was based was published in the June 15, 2006, issue of the Utah State Bulletin, on page 27. The first CPR upon which this second CPR is based was published in the August 15, 2006, issue of the Utah State Bulletin, on page 30. Underlining in the rule below indicates text that has been added since the publication of the proposed rule mentioned above; strike out indicates text that has been deleted. You must view the first CPR, the second CPR, and the proposed amendment together to understand all of the changes that will be enforceable should the agency make this rule effective.)

State statutory or constitutional authorization for this rule:

Sections 31A-2-201, 31A-2-201.1, and 31A-2-202

Anticipated cost or savings to:

the state budget:

This procedural change will reduce an insurer's filing requirements by one page. This will save the department a little on storage. It will not reduce the workload of the department. The Department will still receive the same number of filings as before the rule changes.

local governments:

The amendments to this rule will not affect local governments since the rule deals only with the relationship between the department and their licensees, in this case, health and accident insurers.

other persons:

These changes will reduce the paperwork by one page for each filing made by the approximately 220 health and accident insurers actively engaged in selling insurance in Utah. The cost savings will be minimal in the way of paper saved but it will save the insurers time with one less page to fill out for each filing. Since there will be minimal cost savings to the insurers, there will be little or no cost savings to pass on to the consumer.

Compliance costs for affected persons:

These changes will reduce the paperwork by one page for each filing made by the approximately 220 health and accident insurers actively engaged in selling insurance in Utah. The cost savings will be minimal in the way of paper saved but it will save the insurers time with one less page to fill out for each filing. Since there will be minimal cost savings to the insurers, there will be little or no cost savings to pass on to the consumer.

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

The changes to this rule will have little or no fiscal impact on Utah 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:

01/15/2007

This rule may become effective on:

01/22/2007

Authorized by:

Jilene Whitby, Information Specialist

RULE TEXT

R590. Insurance, Administration.

R590-220. Submission of Accident and Health Insurance Filings.

 

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R590-220-6. Filing Submission Requirements.

A filing must be submitted by market type and type of insurance. A filing may not include more than one type of insurance, or request filing for more than one insurer. A complete filing consists of the following documents submitted in the following order:

(1) Transmittal. The NAIC Life, Accident and Health, Annuity, Credit Transmittal Document, as provided in R590-220-3(2), must be on the top of the filing. The transmittal form must be properly completed.

(a) Complete the transmittal by using the following:

(i) NAIC Instruction Sheet for Life, Accident and Health, Annuity, Credit Transmittal Document;

(ii) NAIC Instruction Sheet for Life, Accident and Health, Annuity, Credit Transmittal Document Form Filing Attachment and Rate Filing Attachment; and

(iii) NAIC Uniform Life, Accident and Health, Annuity and Credit Coding Matrix.

(b) Do not submit the document described in sections (a)(i),(ii), and (iii) with the filing.

(2) Filing Description. A cover letter should not be submitted. Instead, the following information must be included in the Filing Description on the transmittal and presented in the order shown below.

(i) Indicate if the filing is new, replacing a previous filing, or contains forms that have been previously filed and are included for informational purposes.

(ii) Provide a brief description of each component's purpose, benefits and provisions.

(iii) Identify any new, unusual, or controversial provision.

(iv) Identify any unresolved previously prohibited provision and explain why the provision is included in the filing.

(v) Explain any change in benefits or premiums that may occur while the contract is in force.

(vi) If the filing is replacing or modifying a previous submission, provide information that identifies the filing being replaced or modified, the Utah filed date, and a detailed description of the changes made.

(vii) If the filing includes forms for informational purposes, provide the dates the forms were filed.

(viii) If filing a certificate, outline of coverage, application, or endorsements, and the filing does not contain a policy, identify the affected policy form number, the Utah filed date, and describe the effect of the submitted forms on the base policy.

(b) Marketing Facts.

(i) List the issue ages, which means the range of minimum and maximum ages for which a policy will be issued;

(ii) Identify the intended market, such as senior citizens, nonprofit organizations, association members, etc; and

(iii) Describe marketing and advertising in detail, i.e., through a marketing association, mass solicitation, electronic media, financial institutions, internet, telemarketing, or individually through licensed producers.

(c) Underwriting Methods. Provide a general explanation of the underwriting applicable to the filing.

(3) Certification. The Utah Accident and Health Insurance Filing Certification must be properly completed and signed. A filing will be rejected if the certification is missing or incomplete. A certification that is inaccurate may subject the filer to administrative action.

(4) [Domicile]Domiciliary Approval and Filing Status Information. [A foreign insurer and filer must first submit filings to their domicile state. ]All filings for a foreign insurer must include[ domicile status and filing status information]:

(a) [Provide ]a stamped copy of the approval letter from the domicile state for the exact same filing[ and];

(b) [Filing]filing status information which includes[;]:

(i) a list of the states to which the filing was submitted[,];

(ii) the date submitted[,]; and

(iii) summary of the states' actions and their responses[,.]; or

(c) [If]if the filing is specific to Utah and only filed in Utah, then section 14 of the transmittal must be completed stating, "UTAH SPECIFIC - NOT SUBMITTED TO ANY OTHER STATE."

(5) Group Questionnaire or Discretionary Group Authorization Letter. A group filing must identify the type of group, and include either a signed and fully completed "Utah Accident and Health Insurance Group Questionnaire," or a copy of the "Utah Accident and Health Insurance Discretionary Group Authorization" letter.

(6) Letter of Authorization. When the filer is not the insurer, a letter of authorization from the insurer must be included. The insurer remains responsible for the filing being in compliance with Utah laws and rules.

(7) Items being submitted for filing. Refer to each applicable subsection of this rule for general procedures and additional procedures on how to submit forms, rates, and reports.

(8) Return Notification Materials.

(a) Return notification materials are limited to:

(i) a copy of the transmittal; and

(ii) a self addressed, stamped envelope.

(b) Any additional documents submitted for return will be discarded.

(c) Notice of filing will not be provided unless return notification materials are submitted.

. . . . . . .

 

KEY: health insurance filings

Date of Enactment or Last Substantive Amendment: [2006]2007

Authorizing, and Implemented or Interpreted Law: 31A-2-201; 31A-2-201.1; 31A-2-202; 31A-22-605; 31A-22-620; 31A-30-106