DAR File No. 41061
This notice was published in the January 1, 2017, issue (Vol. 2017, No. 1) of the Utah State Bulletin.
Accident and Health Insurance Standards
Five-Year Notice of Review and Statement of Continuation
DAR File No.: 41061
Filed: 12/12/2016 03:49:55 PM
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-2-201(3)(a) authorizes rules to implement the Insurance Code. Sections 31A-2-202 and 31A-23a-412 authorize the commissioner to request reports, conduct examinations, and inspect records of any licensee. Subsection 31A-22-605(4) requires the commissioner to adopt rules to establish standards for disclosure in the sale of and benefits provided by the individual and franchise accident and health policies. Section 31A-22-623 authorizes the commissioner to establish by rule minimum standards of coverage for dietary products for inborn metabolic errors. Section 31A-22-626 authorizes the commissioner to establish by rule minimum standards of coverage for diabetes for accident and health insurance. Subsection 31A-23a-402(8) authorizes the commissioner to define by rule acts and practices that are unfair and unreasonable. Subsection 31A-26-301(1) authorizes the commissioner to set standards for timely payment of claims. The rule provides reasonable standardization and simplification of terms and coverages of insurance policies in order to facilitate public understanding and comparison, to prohibit provisions that may be misleading or confusing in connection with the purchase of accident and health insurance or with the settlement of claims, and to provide full disclosure in the sale of such insurance.
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 received no written comments regarding this rule during 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:
Products in the individual market require closer regulation since there is not an employer entity who can bargain for an equitable contract on behalf of the individual. The rule sets forth benefits to be offered for certain products, yet still allows products with lesser benefits to be offered if marketed as "limited benefits." This helps individuals assess what type of product is being offered. Therefore, this rule should be continued.
The full text of this rule may be inspected, during regular business hours, at the Office 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:
- Steve Gooch 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
Steve Gooch, Information Specialist
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/2017/b20170101.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 email@example.com. For questions about the rulemaking process, please contact the Office of Administrative Rules.