No. 32976 (5-year Review): Rule R590-76. Health Maintenance Organizations and Limited Health Plans

DAR File No.: 32976
Filed: 09/14/2009 05:07:12 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:

Title 31A, Chapter 8, of the Insurance Code regulates health maintenance organizations, their incorporation, licensure, solvency, securities standards, requirements regarding their operations, and access to health care providers. Subsection 31A-2-201(3) is the general rulemaking provision that allows the commissioner to make rules to implement the provisions of the code, which in this case is Chapter 8 of Title 31A.

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 has received no written comments regarding this rule within the past five years.

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

Health maintenance organizations are major players in our health insurance market. This rule, along with Title 31A, Chapter 8, of the Insurance Code have been developed to ensure the availability, accessibility, and quality of services provided by health maintenance organizations (HMOs); to provide standards for terms and provisions contained in HMO contracts and certificates; to provide standards for determining financial condition; and to provide other standards deemed necessary to protect the interests of the citizens of Utah. Therefore, this rule should be continued.

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Insurance
Administration
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]

Effective:

09/14/2009

Authorized by:

Jilene Whitby, Information Specialist

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