No. 38087 (Change in Proposed Rule): Rule R590-268. Small Employer Stop-Loss Insurance

DAR File No.: 38087
Filed: 01/15/2014 03:38:40 PM

RULE ANALYSIS

Purpose of the rule or reason for the change:

Changes to the incorporated attachments to the rule were suggested during the latest comment period.

Summary of the rule or change:

Changes to the Disclosure form include: added a box for insurer's phone number; enrollment for the form and for the liability exposure section was changed to be requested based on enrollment expected at the coverage effective date. In the "Total Employer Outlay" section, the "Monthly Rate" was changed to "Monthly Cost." Added a third page of guidance language to help insurers fill out the Disclosure form. Changes made to the Application form include: removed "annual" from the "Annual Aggregate Attachment Point" to reflect that some contracts may be more than 12 months; removed the line "The Employer agrees to abide by the insurer's enrollment provisions;" added a version control date; and added brief guidance page to help small employers fill out the application. (DAR NOTE: This change in proposed rule has been filed to make additional changes to a proposed new rule that was published in the November 15, 2013, issue of the Utah State Bulletin, on page 142. 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 change in proposed rule and the proposed new rule 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:

• Section 31A-43-304

This rule or change incorporates by reference the following material:

• Updates Utah Stop-loss Disclosure, published by Utah Insurance Department, 01/15/2014
• Updates Utah Small Employer Stop-Loss Universal Application, published by Utah Insurance Department, 01/15/2014

Anticipated cost or savings to:

the state budget:

Changes to the rule are to provide clarification and instruction for the filling out the application and disclosure forms that are incorporated by reference in the rule. These forms are not filed with the department so they will not impact our workload or costs and revenues of the department or state.

local governments:

This rule has no impact on local governments since the rule deals with the relationship between the department, their licensees, and consumers of these licensees.

small businesses:

The changes to this rule are for clarification and instruction to help the small employer fill out the forms. There will be no fiscal impact to the small employer.

persons other than small businesses, businesses, or local governmental entities:

The changes to this rule are for clarification and instruction purposes. The forms being changed will be completed by small employer groups only so should not affect large groups or individuals.

Compliance costs for affected persons:

There will be no compliance costs to the changes made to these forms. They are strictly for clarification and instruction to assist in the completion of the forms.

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 in or outside of the State of Utah.

Todd E. Kiser, 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:

03/03/2014

This rule may become effective on:

03/10/2014

Authorized by:

Todd Kiser, Commissioner

RULE TEXT

R590. Insurance Administration.

R590-268. Small Employer Stop-Loss Insurance.

 

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R590-268-5. Standard Application.

(1) Stop-loss insurers marketing to small employers shall use the Utah Small Employer Stop-loss Universal Application.

(2) The Small Employer Stop-loss Universal Application shall not display the insurer's name, identifying logo or address.

(3) The Utah Small Employer Stop-loss Universal Application, published [November 15, 2013]January 15, 2014, is hereby incorporated by reference and is available on the Department's website at https://insurance.utah.gov/legal-resources/rules/current-rules.php.

(4) The Utah Small Employer Stop-loss Universal Application may be altered for:

(a) purposes of electronic application and submission, including electronic signature disclaimers;

(b) languages other than English; and

(c) reasons specifically approved by the commissioner.

 

R590-268-6. Stop-Loss Insurance Disclosure.

(1) Stop-loss insurers marketing to small employers shall use the Utah Small Employer Stop-loss Disclosure.

(2) The stop-loss insurer may display the insurer's name, identifying logo, and address on the disclosure.

(3) The Utah Small Employer Stop-loss Disclosure, published [November 15, 2013]January 15, 2014, is hereby incorporated by reference and is available on the Department's website at https://insurance.utah.gov/legal-resources/rules/current-rules.php.

(4) The disclosure may be altered for reasons specifically approved by the commissioner.

 

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KEY: small employer stop-loss

Date of Enactment or Last Substantive Amendment: [2013]2014

Authorizing, and Implemented or Interpreted Law: 31A-43-304; Title 31A, Chapter 43