R590-126-2. Purpose and Scope

  (1) Purpose. The purpose of this rule is to provide reasonable standardization and simplification of terms and coverages of insurance policies in order to facilitate public understanding and comparison and to prohibit provisions which may be misleading or confusing in connection either with the purchase of such coverages or with the settlement of claims, and to provide for full disclosure in the sale of such insurance.

  (2) Scope.

  (a) This regulation applies to:

  (i) all individual accident and health insurance policies and group supplemental health policies and certificates, delivered or issued for delivery in this state on and after January 1, 2006, that are not specifically exempted from this regulation, regardless of:

  (A) whether the policy is issued to an association; a trust; a discretionary group; or other similar grouping; or

  (B) the situs of delivery of the policy or contract; and

  (ii) all dental plans and vision plans.

  (b) This rule shall not apply to:

  (i) employer accident and health insurance, as defined in Section 31A-22-502;

  (ii) policies issued to employees or members as additions to franchise plans in existence on the effective date of this regulation;

  (iii) Medicare supplement policies subject to Section 31A-22-620;

  (iv) civilian Health and Medical Program of the Uniformed Services, Chapter 55, title 10 of the United States Code, CHAMPUS supplement insurance policies; or

  (v) a health benefit plan that complies with R590-277, Managed Care Health Benefit Plan Policy Standards.

  (3) The requirements contained in this regulation shall be in addition to any other applicable regulations previously adopted.