DAR File No. 38798

Insurance, Administration

Rule R590-167

Individual, Small Employer, and Group Health Benefit Plan Rule

Five-Year Notice of Review and Statement of Continuation

DAR File No.: 38798
Filed: 08/20/2014 11:43:50 AM

NOTICE OF REVIEW AND STATEMENT OF CONTINUATION

Concise explanation of the particular statutory provisions under which the rule is enacted and how these provisions authorize or require the rule:

This rule obtains general rulemaking authority from Subsection 31A-2-201(3)(a), which authorizes the commissioner to write rules implementing the insurance code, Title 31A. More specific rulemaking authority comes from Subsection 31A-30-106(1)(k) which is now Subsection 31A-30-106(1)(h) and authorizes the commissioner to revise rules written for Sections 31A-22-602 and 31A-22-605 regarding individual accident and health policy rates that allow rating in accordance with Section 31A-30-106. Subsection 31A-30-106.1(10) gives direction in the rating of new health benefit plans into which new enrollees are enrolling. This rule is being amended now and should be filed for formal rulemaking within the next one - two months.

Summary of written comments received during and since the last five-year review of the rule from interested persons supporting or opposing the rule:

In the past five years, this rule went through several rulemaking changes to make the rule comply with legislative changes made in 2010 and 2011. During these changes, one comment was received requesting changes be made to the definition of "Risk Characteristics". These changes were made in DAR No. 33874.

Reasoned justification for continuation of the rule, including reasons why the agency disagrees with comments in opposition to the rule, if any:

This rule, along with Title 31A, Chapter 30, regulates and prevents abuse in insurer rating practices, assures consumers receive credit for previous coverage, and limits the use of restrictive riders. Therefore, this rule should be continued.

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]

Effective:

08/20/2014

Authorized by:

Todd Kiser, Commissioner