No. 43520 (5-year Review): Rule R590-220. Submission of Accident and Health Insurance Filings

DAR File No.: 43520
Filed: 02/13/2019 02:45:31 PM

NOTICE OF REVIEW AND STATEMENT OF CONTINUATION

Concise explanation of the particular statutory provisions under which the rule is enacted and how these provisions authorize or require the rule:

Subsection 31A-2-201(3) authorizes the Insurance Commissioner to write rules to implement the provisions of the Insurance Code, Title 31A. Section 31A-2-201.1 authorizes the Insurance Commissioner to write rules regarding rates, forms, binders, and reports. Subsection 31A-2-202(2) authorizes the Insurance Commissioner to perform the duties imposed by Title 31A. Subsection 31A-22-605(4) authorizes the Insurance Commissioner to write rules regarding the contents of policy provisions and minimum benefit standards; the content and format of the outline of provisions; the method of identifying policies and contracts; and rating practices. Subsection 31A-22-620(3)(f) authorizes the Insurance Commissioner to adopt rules to prohibit policy provisions that would be unjust, unfair, or unfairly discriminatory under a Medicare Supplement policy or certificate. Subsection 31A-30-106(1) sets standards for health benefit plans for individuals in individual and small employer groups; and Subsection 31A-30-106(4) requires carriers that offer health benefit plans to individuals to maintain, at the carrier's principal place of business, a description of their rating practices and renewal underwriting practices. Subsection 31A-30-106.1(13) requires small employer carriers to maintain, at their principal place of business, a complete and detailed description of its rating practices and renewal underwriting practices; Subsection 31A-30-106.1(14) authorizes the Insurance Commissioner to write rules regarding rates and rating practices used by small employer carriers and rates charged for health benefit plans, as well as case characteristics used by small employer and individual carriers.

Summary of written comments received during and since the last five-year review of the rule from interested persons supporting or opposing the rule:

The Department of Insurance (Department) amended this rule in 2015, and received industry comment from one insurer at that time. The comment requested the ability to include a range of deductibles under Subsection R590-220-6(f), the ability to sign documents electronically, and asks about an outdated reference in the rule. All comments were accepted and included in the final submitted version of the amended rule.

Reasoned justification for continuation of the rule, including reasons why the agency disagrees with comments in opposition to the rule, if any:

This rule is important in requiring that the Department receive policy rate and form information from insurers. Such information is necessary to make sure there is no unfair discrimination in the coverage that health insurers provide and the rates they charge. Therefore, this rule should be continued.

The full text of this rule may be inspected, during regular business hours, at the Office 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:

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

Effective:

02/13/2019

Authorized by:

Steve Gooch, Information Specialist

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