No. 32491 (Amendment): R590-146-20. Standards for Marketing

DAR File No.: 32491
Filed: 04/01/2009, 03:25
Received by: NL

RULE ANALYSIS

Purpose of the rule or reason for the change:

Subsection R590-146-20(D) is being added to comply with the Genetic Nondiscrimination Act (GINA) of 2008. States are required to comply with GINA no later than 07/01/2009. H.B. 52 passed during this year's Legislative session (2009) which revised Section 31A-22-620 to allow for compliance with GINA. (DAR NOTE: H.B. 52 (2009) is found at Chapter 349, Laws of Utah 2009, and will be effective 05/12/2009.)

Summary of the rule or change:

Subsection R590-146-20(D) has been added to the section requiring compliance with the GINA of 2008.

State statutory or constitutional authorization for this rule:

Section 31A-22-620

This rule or change incorporates by reference the following material:

This rule incorporates by reference the Genetic Nondiscrimination Act of 2008, enacted May 21, 2008, 29 CFR Part 1635

Anticipated cost or savings to:

the state budget:

Neither the state nor the Insurance Department will be impacted financially by the change in this rule. The state is currently required to comply with the Utah Genetic Testing Privacy Act which provides similar requirements pursuant to Section 31A-22-1602, Genetic testing restrictions.

local governments:

The changes to this rule will have no fiscal impact on local governments since it deals with Medicare Supplement insurance standards regulated by the department and required to be followed by their licensed health insurers.

small businesses and persons other than businesses:

The changes to this rule will have no fiscal impact on small businesses since the change applies to health insurers who are large employers.

Compliance costs for affected persons:

There will be no compliance costs for health insurers since this law is already essentially in place under Section 31A-22-1602.

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

Utah businesses will incur no fiscal impact as a result of the changes to this rule since the state already has a similar law. 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:

05/15/2009

This rule may become effective on:

05/22/2009

Authorized by:

Jilene Whitby, Information Specialist

RULE TEXT

R590. Insurance, Administration.

R590-146. Medicare Supplement Insurance Standards.

R590-146-20. Standards for Marketing.

A. An issuer, directly or through its producers, shall:

(1) establish marketing procedures to assure that any comparison of policies by its producers will be fair and accurate;

(2) establish marketing procedures to assure excessive insurance is not sold or issued.

(3) display prominently by type, stamp or other appropriate means, on the first page of the policy the following:

"Notice to buyer: This policy may not cover all of your medical expenses"

(4) inquire and otherwise make every reasonable effort to identify whether a prospective applicant or enrollee for Medicare supplement insurance already has accident and sickness insurance and the types and amounts of any such insurance; and

(5) establish auditable procedures for verifying compliance with this Subsection A.

B. In addition to the practices prohibited in Section 31A-23-302, the following acts and practices are prohibited:

(1) Twisting. Knowingly making any misleading representation or incomplete or fraudulent comparison of any insurance policies or insurers for the purpose of inducing, or tending to induce, any person to lapse, forfeit, surrender, terminate, retain, pledge, assign, borrow on, or convert an insurance policy or to take out a policy of insurance with another insurer.

(2) High pressure tactics. Employing any method of marketing having the effect of or tending to induce the purchase of insurance through force, fright, threat, whether explicit or implied, or undue pressure to purchase or recommend the purchase of insurance.

(3) Cold lead advertising. Making use directly or indirectly of any method of marketing which fails to disclose in a conspicuous manner that a purpose of the method of marketing is solicitation of insurance and that contact will be made by an insurance producer or insurance company.

C. The terms "Medicare Supplement," "Medigap," "Medicare Wrap-Around" and words of similar import shall not be used unless the policy is issued in compliance with this rule.

D. An issuer shall comply with the Genetic Nondiscrimination Act of 2008, enacted May 21, 2008, 29 CFR Part 1635. This document is incorporated by reference and available for inspection at the Insurance Department and the Department of Administrative Rules.

 

KEY: insurance

Date of Enactment or Last Substantive Amendment: [August 25, 2005]2009

Notice of Continuation: April 16, 2007

Authorizing, and Implemented or Interpreted Law: 31A-22-620