R590-270-4. Definitions

  In addition to the definitions in Sections 31A-1-301 and 26-33a-102, and R428 rules, the following definitions apply for the purpose of this rule.

  (1) "Non-grandfathered health plan" means a health benefit plan issued to an individual or small employer:

  (a) after March 23, 2010; or

  (b) on or before March 23, 2010 that lost grandfather status at a renewal that occurred after March 23, 2010.

  (2) "Risk adjustment covered plan" means a plan as defined by 45 CFR 155.20.

  (3) "Subscriber premium" means the monthly premium for the subscriber and associated dependents that correspond to the carrier's rate data template filed with the Utah Insurance Department.

  (4) "Transitional plan" means a non-grandfathered health plan issued to an individual or small employer prior to January 1, 2014, that is renewed after January 1, 2014 pursuant to guidance issued by the United States Department of Health and Human Services Office for Consumer Information and Insurance Oversight dated November 14, 2013 and March 5, 2014.

  (5) "APCD Carrier" means a carrier that is required to submit data to the APCD based on parameters outlined in R428 rules.

  (6) "RA Carrier" means a carrier that is not required to submit data to the APCD based on parameters outlined in R428 rules, but issues risk adjustment covered plans where that plan is subject to risk adjustment in Utah.