Insurance, Administration

Section R590-263-3

Most Commonly Selected

Notice of Proposed Rule

(Amendment)

DAR File No.: 35483
Filed: 11/29/2011 11:49:36 AM

RULE ANALYSIS

Purpose of the rule or reason for the change:

This rule is being changed at the request of industry to make it easier for those health insurers that find the deadline in Section R590-263-3 impossible to comply with without changing their computer processes or for some other reason.

Summary of the rule or change:

The change to this rule is to accommodate allowances for insurer's internal processes. The change allows a licensed insurer to seek a date other than July 1 in Section R590-263-3 to comply with, if that date is burdensome. The focus of the rule and the Health Exchange is to provide more health benefit plans to choose from. The current date could result in fewer plans to choose from.

State statutory or constitutional authorization for this rule:

• Subsection 31A-30-205(1)(d)(iii)

Anticipated cost or savings to:

the state budget:

This change will not affect the State's budget positively or negatively. Employee workload will not be increased.

local governments:

This rule does not affect local government since it deals with the relationship between the department and its licensees.

small businesses:

The change could affect small employers if fewer plans are available on the Health Exchange.

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

The change to this rule is being made to make allowance to those health insurers that find the compliance date in Section R590-263-3 burdensome and expensive to comply with. There is also the possibility that without this change an insurer might withdraw their benefit plans from the state and the Health Exchange rather than incur this cost, thereby impacting the Exchange and consumers by reducing the number of benefit plans to choose from.

Compliance costs for affected persons:

The change to this rule is being made to make allowance to those health insurers that find the compliance date in Section R590-263-3 burdensome and expensive to comply with. There is also the possibility that without this change an insurer might withdraw their benefit plans from the state and the Health Exchange rather than incur this cost, thereby impacting the Exchange and consumers by reducing the number of benefit plans to choose from.

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

The change to this rule will have a positive financial impact on health insurers that find the deadline in Section R590-263-3 financially and physically burdensome. It could likely have a positive impact on the Health Insurance Exchange by encouraging more health insurers to participate.

Neal T. Gooch, Commissioner

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Insurance
Administration
Room 3110 STATE OFFICE BLDG
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:

01/17/2012

This rule may become effective on:

01/24/2012

Authorized by:

Jilene Whitby, Information Specialist

R590. Insurance, Administration.

R590-263. Commonly Selected Health Benefit Plans.

R590-263-3. Most Commonly Selected.

(1) As used in Subsection 31A-30-205(1)(d), the four most commonly selected small employer group health benefit plans to be offered as of January 1 each year are the carrier's four plans that are currently marketed to small employer groups that have the largest number of covered individuals as of the preceding July 1 or another date approved by the commissioner.

(2) If a carrier removes one of the four most commonly selected plans from the market, the carrier shall again determine the four most commonly selected small employer group health benefit plans currently marketed by the carrier so that there are four plans at all times.

(3) The carrier shall:

(a) maintain the documentation used to determine the four plans in Subsection (1) for a period of the current calendar year plus three years; and

(b) make the documentation available for review upon the commissioner's request.

 

KEY: insurance health benefit plans

Date of Enactment or Last Substantive Amendment: [October 27, 2011]2012

Authorizing, and Implemented or Interpreted Law: 31A-30-205(1)(d)(iii)