Insurance, Administration

Rule R590-255

Utah NetCare Alternative Coverage Notification Rule

Notice of Proposed Rule

(New Rule)

DAR File No.: 33260
Filed: 12/10/2009 11:15:21 AM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The purpose of this rule is to adopt a model letter as required by Section 31A-22-724, for insurers to provide to employers as required by Section 31A-22-716 of the code to notify an employee of the employee's options for alternative health coverage.

Summary of the rule or change:

The purpose of this rule is to adopt a model letter as required by Section 31A-22-724, for insurers to provide to employers as required by Section 31A-22-716 of the code to notify an employee of the employee's options for alternative health coverage.

State statutory or constitutional authorization for this rule:

• Section 31A-22-724

Anticipated cost or savings to:

the state budget:

This rule will have no fiscal impact on the Insurance Department or the state since the requirement in the rule is for the insurer to provide a letter to employers they insure. It does not require that this letter be filed with the department so it will not impact the department's workload, nor will it impact the department's revenues or expenses.

local governments:

The only way this rule will affect local governments is if their health insurance is provided by a licensed health and accident insurer licensed to do business in Utah. The only way they would be affected is in the requirement to forward the alternative coverage notification letter to their employees, which could in most cases be done electronically with no mailing charges or paper costs.

small businesses:

The rule adopts a model alternative coverage letter that health and accident insurers are required to provide to employers they insure, whether large or small. The small business employer would be required to forward the Alternative Coverage Notification letter to their employees which could in most cases be done electronically resulting in no mailing charges or paper costs.

persons other than small businesses, businesses, or local governmental entities:

The rule adopts a model alternative coverage letter that health and accident insurers are required to provide to employers they insure, whether large or small. The employer would be required to forward the Alternative Coverage Notification letter to their employees which could in most cases be done electronically resulting in no mailing charges or paper costs.

Compliance costs for affected persons:

The insurers cost will be the letter they provide to employers they insure. Employers will have to provide a letter to employees, which could be provided via email and eliminate any cost.

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

This rule will create a cost in paper and mail expense to insurers and may or may not create a cost to the employers who have to forward it along to their employees.

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
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 [email protected]

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:

02/01/2010

Interested persons may attend a public hearing regarding this rule:

• 01/19/2009 09:00 AM, State Office Building, 450 N Main, Room 3112, Salt Lake City, UT

This rule may become effective on:

02/08/2010

Authorized by:

Jilene Whitby, Information Specialist

R590. Insurance, Administration.

R590-255. Utah NetCare Alternative Coverage Notification Rule.

R590-255-1. Authority.

This rule is promulgated pursuant to Section 31A-22-724 wherein the commissioner shall develop a model letter.

 

R590-255-2. Purpose and Scope.

(1) The purpose of this rule is to adopt a model letter for insurers to provide to employers as required by Section 31A-22-716 to notify an employee of the employee's options for alternative coverage.

(2) This rule applies to all accident and health insurers doing business in Utah that are required to offer alternative coverage pursuant to Section 31A-22-724.

 

R590-255-3. General Instructions.

(1) An insurer shall provide an employer:

(a) a letter that explains alternative coverage; or

(b) the Utah NetCare: Utah's Alternative Coverage letter.

(2) The letter required by this Subsection (1) shall be provided:

(a) to an employer at renewal;

(b) when requested by an employer; and

(c) when requested by an employee.

 

R590-255-4. Enforcement Date.

The commissioner will begin enforcing this rule 45 days from the rule's effective date.

 

R590-255-5. Penalties.

A person found, after a hearing or other regulatory process, to be in violation of this rule shall be subject to penalties as provided under 31A-2-308.

 

R590-255-6. Severability.

If any provision of this rule or its application to any person or situation is held to be invalid, that invalidity shall not affect any other provision or application of this rule which can be given effect without the invalid provision or application, and to this end the provisions of this rule are declared to be severable.

 

KEY: insurance alternative coverage, NetCare

Date of Enactment or Last Substantive Amendment: 2010

Authorizing, and Implemented or Interpreted Law: 31A-22-724