DAR File No. 41440

This notice was published in the May 1, 2017, issue (Vol. 2017, No. 9) of the Utah State Bulletin.


Insurance, Administration

Rule R590-203

Health Grievance Review Process

Five-Year Notice of Review and Statement of Continuation

DAR File No.: 41440
Filed: 04/04/2017 12:59:31 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(1) authorizes the commissioner to administer and enforce Title 31A. Subsection 31A-2-201(3)(a) authorizes the commissioner to make rules to implement the provisions of Title 31A. Section 31A-2-203 authorizes the commissioner to examine carrier records, files, and documentation. Section 31A-4-116 and Subsection 31A-22-629(4) require the commissioner to establish minimum standards for grievance review procedures.

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:

This rule clarifies statute and explains the difference between federal law and state statutes. The rule ensures that a carrier's grievance review procedures for individual and group health insurance and disability income insurance plans comply with federal law. Removing this rule would confuse insurers as to what is required of them in regards to their grievance procedures. This rule provides consumer protections. 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
Administration
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:

04/04/2017

Authorized by:

Steve Gooch, Information Specialist


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/2017/b20170501.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 Office of Administrative Rules.