DAR File No. 38726

Insurance, Administration

Rule R590-263

Commonly Selected Health Benefit Plans

Notice of Proposed Rule

(Repeal)

DAR File No.: 38726
Filed: 08/01/2014 05:25:27 PM

RULE ANALYSIS

Purpose of the rule or reason for the change:

This rule is being repealed because the requirement to provide the required plans has been eliminated from the law during the 2013 General Legislative Session in H.B. 47 due to the provisions of the Affordable Care Act.

Summary of the rule or change:

This rule is being repealed because Subsection 31A-30-205(1)(d)(iii) requiring the department to set a standard for carriers to determine the most commonly selected small employer group health benefit plan, has been deleted from the law. Therefore, this rule is repealed in its entirety.

State statutory or constitutional authorization for this rule:

• Subsection 31A-30-205(1)(d)(iii)

Anticipated cost or savings to:

the state budget:

There will be no fiscal impact on the department or the state's budget with the repeal of this rule. The rule did not require any action on the part of the department in regard to the maintenance of the standard or files by insurers, so there will be no change in the work load of the department.

local governments:

The rule had no effect on local government since it deals with state insurance law and the relationship between the department and their licensees.

small businesses:

There will be an insignificant reduction in the amount of administrative dollars for insurers because they will no longer need to identify the plans and make the required offerings.

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

There should be no impact on individuals and large businesses. Large insurers were never impacted by this law and employers of small groups will still have health insurance plans to choose from to cover their employees.

Compliance costs for affected persons:

Any savings from the withdrawal of the requirement to maintain files will vary from insurer to insurer. In any case the saving will be insignificant.

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

The fiscal savings from the repeal of this rule will be negligible.

Todd E. Kiser, 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 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:

09/15/2014

This rule may become effective on:

09/22/2014

Authorized by:

Todd Kiser, Commissioner

R590. Insurance, Administration.

[R590-263. Commonly Selected Health Benefit Plans.

R590-263-1. Authority.

This rule is promulgated pursuant to Subsection 31A-30-205(1)(d)(iii) wherein the commissioner is directed to adopt a rule.

 

R590-263-2. Purpose and Scope.

(1) The purpose of this rule is to provide the standard for a carrier to determine the most commonly selected small employer group health benefit plans.

(2) This rule applies to all carriers that offer a health benefit plan to a small employer in the defined contribution market.

 

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.

 

R590-263-4. Penalties.

A person found to be in violation of this rule shall be subject to penalties as provided under Section 31A-2-308.

 

R590-263-5. Enforcement Date.

The commissioner will begin enforcing this rule January 1, 2012.

 

R590-263-6. Severability.

If any provision of this rule or its application to any person or circumstances is for any reason held to be invalid, the remainder of the rule and the application of the provision to other persons or circumstances shall not be affected thereby.

 

KEY: insurance health benefit plans

Date of Enactment or Last Substantive Amendment: January 25, 2012

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