R590-277-5. General Requirements

  (1) Policy definitions. No policy subject to this rule may contain definitions respecting the matters defined in R590-277-3 unless such definitions comply with the requirements of that section.

  (2) Rights of spouse and dependents. Except for an employer sponsored health plan, a policy;

  (a) may not provide for termination of coverage of the spouse or a dependent solely because of the occurrence of an event specified for termination of coverage of the policyholder, other than for nonpayment of premium; and

  (b) shall provide that in the event of the policyholder's death the spouse of the insured shall become the insured.

  (3) Cancellation, renewability, and termination. A policy cancellation, renewability and termination provision shall comply with Sections 31A-22-618.6 or 31A-22-618.7.

  (4) Transplant donor coverage. A policy providing coverage for the recipient in a transplant operation shall also provide reimbursement of any medically necessary transplant expenses of a live donor.

  (5) Notice of premium change. A notice of change in premium shall be given no fewer than 45 days before the renewal date.

  (6)(a) Except as provided in Subsection (b), a completed application shall be made part of the policy. A copy of the completed application shall be provided to the applicant prior to, or upon delivery, of the policy.

  (b) Subsection (6)(a) does not apply to:

  (i) an employer sponsored health benefit plan; or

  (ii) an individual policy where application was effectuated directly through heathcare.gov.

  (7) A managed care organization offering a health benefit plan to an individual or small employer:

  (a) shall offer coverage to all individuals and eligible employees on a guaranteed basis without regard to health status;

  (b) may modify coverage at the time of renewal to the extent that such modification is consistent with federal and state law and effective on a uniform basis among all individuals in the health benefit plan; and

  (c) must renew or continue coverage at the option of the policyholder, subject to Subsections 31A-22-618.6 and 618.7.