File No. 36703
This rule was published in the September 15, 2012, issue (Vol. 2012, No. 18) of the Utah State Bulletin.
Utah Essential Health Benefits Package
Notice of 120-Day (Emergency) Rule
DAR File No.: 36703
Filed: 08/30/2012 03:50:17 PM
Purpose of the rule or reason for the change:
The purpose of this rule is to designate an essential health benefits package in Utah as provided by Section 1302 of the Patient Protection and Affordable Care Act of 2010, as amended by the Health Care Education Reconciliation Act of 2010 (ACA).
Summary of the rule or change:
As outlined in Section 31A-30-116, Utah has chosen to designate its own essential health benefits rather than accept a federal determination. On 08/16/2012, the Chairmen of the Legislature's Health System Reform Task Force notified the Insurance Commissioner that the Task Force had voted to recommend the Public Employees Health Program's (PEHP) Utah Basic Plus Plan as Utah's Essential Health Benefit Package for the purposes of the ACA. (DAR NOTE: A corresponding proposed new Rule R590-266 is under DAR No. 36708 in this issue, September 15, 2012, of the Bulletin.)
Emergency rule reason and justification:
Regular rulemaking procedures would place the agency in violation of federal or state law.
Justification: In the 2012 General Session, the Legislature passed H.B. 144, Health System Reform Amendments, which requires the department to adopt via emergency rule, Subsection 31A-30-116(3)(b). The insurers need this information immediately so they can start development of the products and systems to manage the new requirements.
State statutory or constitutional authorization for this rule:
- Subsection 31A-30-116(3)(b)
This rule or change incorporates by reference the following material:
- Adds PEHP Utah Basic Plus 2012 Plan, published by Public Employees Health Plan, 2012
Anticipated cost or savings to:
the state budget:
The requirements of this rule will increase rate and form filings to the department from 65 health insurers offering comprehensive health insurance products. The increase in filings will not increase the department or state's revenues, just increase the workload of the department and since the department does not have the fiscal appropriation to hire anyone for the additional workload it will have to be assimilated among current employees.
This rule will have no impact on local governments since it deals solely with the relationship between the department and their licensees.
This rule will change the type of health insurance products agencies will offer to their clients. It may affect the cost of the health plan chosen by the small employers. If current plan does not meet the minimum requirements the premiums will more than likely increase to account for the increase in benefits.
persons other than small businesses, businesses, or local governmental entities:
This rule will impact 65 health insurers that sell insurance in Utah. Health insurers may need to develop new products, train their workforce and update their computer program. It may affect the cost of the health plan chosen by the large employer. If their current plan does not meet minimum requirements the premium of an approved plan will more than likely increase to account for the increase in benefits.
Compliance costs for affected persons:
This rule will impact 65 health insurers that sell insurance in Utah. Health insurers may need to develop new products, train their workforce, and update their computer program.
Comments by the department head on the fiscal impact the rule may have on businesses:
Utah has chosen to designate its own essential heath benefits rather than accept the federal determination. The benefits designated by the Health System Reform Task Force and myself were selected in order to maximize choice and minimize the premium impact on employers. Fiscal impacts for health insurers may be minimally dependent on their current plan designs.
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
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@example.com
This rule is effective on:
Jilene Whitby, Information Specialist
R590. Insurance, Administration.
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/2012/b20120915.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.
Text to be deleted is struck through and surrounded by brackets (e.g., [
example]). Text to be added is underlined (e.g., ). Older browsers may not depict some or any of these attributes on the screen or when the document is printed.
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 firstname.lastname@example.org.