File No. 33328

This rule was published in the February 1, 2010, issue (Vol. 2010, No. 3) of the Utah State Bulletin.


Insurance, Administration

Rule R590-253

Utah Mini-COBRA Notification Rule

Notice of Proposed Rule

(Amendment)

DAR File No.: 33328
Filed: 01/14/2010 01:41:02 PM

RULE ANALYSIS

Purpose of the rule or reason for the change:

The changes to this rule are being made to comply with the Department of Defense Appropriation Act, 2010, extending the American Recovery and Reinvestment Act (ARRA) Subsidies from 9 months to 15 months. The change extends the COBRA premium reduction benefit for persons involuntarily terminated through February 28, 2010.

Summary of the rule or change:

In Section R590-253-2, the Department of Defense Appropriations Act of 2010 has been added; and in Section R590-253-3, the date for the eligibility of Utah mini-COBRA was changed to February 28, 2010.

State statutory or constitutional authorization for this rule:

  • Section 31A-2-201

Anticipated cost or savings to:

the state budget:

Changes to this rule will not impact department revenues, expenses, or workload. Insurers will not be required to file forms with the department nor will additional duties be required of department staff. As a result of the change in the federal law, the department has received an increased number of calls from consumers wanting to know how this will affect them.

local governments:

Local governments will not be affected by the changes in this rule since the rule affects the relationship between the department and their health insurance licensees and their consumers only.

small businesses:

The change in the federal law and our regulation only affect individuals who have been impacted by a reduction-in-force on the part of small employer groups. These small employer groups consist of 2 - 19 people. The employee has lost their health insurance coverage as a result of the reduction-in-force and as a result has turned to Utah mini-COBRA for coverage. The federal government has allowed premiums for the mini-COBRA coverage to be reduced by 35% for the individual with the insurer covering 65% of the premium, which is then subsidized by the federal government.

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

This rule only applies to individuals who were on small employer group health insurance plans.

Compliance costs for affected persons:

The change in the federal law and our regulation only affect individuals who have been impacted by a reduction-in-force on the part of small employer groups. These small employer groups consist of 2 - 19 people. The employee has lost their health insurance coverage as a result of the reduction-in-force and as a result has turned to Utah mini-COBRA for coverage. The federal government has allowed premiums for the mini-COBRA coverage to be reduced to 35% for the individual with the insurer covering 65% of the premium, which is then subsidized by the federal government.

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

This rule will have a positive fiscal impact on employees of small businesses who have been affected by a reduction-in-force and as a result lost their health insurance coverage. If they qualify, the cost of their mini-COBRA coverage will be reduced to 35% of the total premium. Insurers will then be required to cover the rest of the premium. That amount will then be subsidized by the federal government. The individual purchasing the mini-COBRA will have reduced premium costs and the insurer will be reimbursed by the federal government.

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 jwhitby@utah.gov

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:

03/03/2010

This rule may become effective on:

03/10/2010

Authorized by:

Jilene Whitby, Information Specialist

RULE TEXT

R590. Insurance, Administration.

R590-253. Utah Mini-COBRA Notification Rule.

R590-253-2. Purpose and Scope.

(1) The purpose of this rule is to ensure that all persons who are eligible for health insurance continuation coverage under the American Recovery and Reinvestment Act of 2009, ARRA, Section 3001(a)(7) , and the Department of Defense Appropriations Act of 2010, receive the necessary information and forms that will assist them in making a decision to elect continuation coverage of their health insurance coverage under Utah's mini-COBRA law.

(2) This rule applies to all accident and health insurers doing business in Utah that are required to provide continuation coverage pursuant to Sections 31A-22-722 and 722.5.

 

R590-253-3. General Instructions.

(1) An accident and health insurer shall provide the Utah mini-COBRA Continuation Coverage Election Notice for individuals eligible for Utah mini-COBRA. The notice can be downloaded from the Department's website at www.insurance.utah.gov.

(2) For individuals eligible for Utah mini-COBRA from February 17, 2009 , through February 28, 2010,[December 31, 2009,] an accident and health insurer shall:

(a) mail the notices required by R590-253-3(1) to an individual:

(i) within seven days after being contacted by an individual or the individual's employer on or after April 6, 2009; or

(ii) no later than April 10, 2009 for an insured whose employer or the individual contacted the insurer prior to April 1, 2009; or

(b) mail the notices required by R590-253-3(1) to all employers whose coverage is subject to 31A-22-722:

(i) no later than April 10, 2009;

(ii) on the plan's anniversary renewal; and

(iii) shall include a statement of the employer's obligation on the monthly notice of premium payments.

(c) An accident and health insurer who elects to provide notification under R590-253-3(2)(b) is responsible to assure the employer has provided notification to its employees who are eligible as provided by Section 31A-22-722 and the American Recovery and Reinvestment Act of 2009, Pub. S. 111-5.

(3)(a) For individuals eligible for Utah mini-COBRA from September 1, 2008 through February 16, 2009, the notices in R590-253-3(1) shall be mailed after being contacted by an individual or the individual's employer that the individual wants to take advantage of the second election period to extend the health insurance coverage provided by the employer Section 31A-22-722.5.

(b) The notice shall be mailed:

(i) within one business day after being contacted by an individual or the individual's employer on or after April 6, 2009; or

(ii) no later than April 9, 2009 for an insured whose employer or the individual contacted the insurer prior to April 6, 2009.

 

KEY: mini-COBRA insurance

Date of Enactment or Last Substantive Amendment: [July 1, 2009]2010

Authorizing, and Implemented or Interpreted Law: 31A-2-201

 


Additional Information

The Portable Document Format (PDF) version of the Bulletin is the official version. The PDF version of this issue is available at https://rules.utah.gov/publicat/bull-pdf/2010/b20100201.pdf. The HTML edition of the Bulletin is a convenience copy. Any discrepancy between the PDF version and HTML version is resolved in favor of the PDF version.

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For questions regarding the content or application of this rule, please contact Jilene Whitby at the above address, by phone at 801-538-3803, by FAX at 801-538-3829, or by Internet E-mail at jwhitby@utah.gov.