DAR File No. 38969
This notice was published in the December 15, 2014, issue (Vol. 2014, No. 24) of the Utah State Bulletin.
Insurance, Administration
Rule R590-232
Authorization for a Health Maintenance Organization to Provide Services as Third Party Administrator of Health Care Benefits
Five-Year Notice of Review and Statement of Continuation
DAR File No.: 38969
Filed: 11/21/2014 10:45:15 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:
Subsection 31A-8-103(2) allows the commissioner to waive provisions of Title 31A that may be considered inapplicable to health maintenance organizations. Section 31A-2-201 gives the commissioner authority to write rules to implement the provisions of Title 31A. The rule authorizes a health maintenance organization to provide services as a third party administrator of health care benefits without a license.
Summary of written comments received during and since the last five-year review of the rule from interested persons supporting or opposing the rule:
The department has not received any written comments regarding this rule in the past five years.
Reasoned justification for continuation of the rule, including reasons why the agency disagrees with comments in opposition to the rule, if any:
It is important that this rule remain in effect since it authorizes heath maintenance organizations (HMOs) to provide services as a third party administrator of health care benefits. As a third party administrator, an HMO would provide administrative services to employers and other associations having group insurance policies. They process claims, certify eligibility, etc. 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:
InsuranceAdministration
Room 3110 STATE OFFICE BLDG
450 N MAIN ST
SALT LAKE CITY, UT 84114-1201
Direct questions regarding this rule to:
- Steve Gooch at the above address, by phone at 801-538-3803, by FAX at 801-538-3829, or by Internet E-mail at sgooch@utah.gov
Effective:
11/21/2014
Authorized by:
Todd Kiser, Commissioner
Additional Information
More information about a Five-Year Notice of Review and Statement of Continuation is available online.
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/2014/b20141215.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.
For questions regarding the content or application of this rule, please contact Steve Gooch at the above address, by phone at 801-538-3803, by FAX at 801-538-3829, or by Internet E-mail at sgooch@utah.gov. For questions about the rulemaking process, please contact the Division of Administrative Rules.