DAR File No. 43179

Governor, Economic Development, Consumer Health Exchange

Rule R358-1

Electronic Standards for Transmitting Information through the Health Insurance Exchange

Notice of Proposed Rule

(Repeal)

DAR File No.: 43179
Filed: 08/31/2018 02:37:40 PM

RULE ANALYSIS

Purpose of the rule or reason for the change:

H.B. 336 passed in the 2017 General Session amended the duties of the Office of Consumer Health Services within the Governor's Office of Economic Development to wind down the small employer health insurance exchange known as Avenue H by 07/01/2018. Therefore, this rule is no longer necessary.

Summary of the rule or change:

This rule is repealed in its entirety.

Statutory or constitutional authorization for this rule:

• Subsection 63N-11-107(1)(a)

Anticipated cost or savings to:

the state budget:

The repeal of this rule is to wind down the small employer health insurance exchange known as Avenue H as a result of H.B. 336 (2017), and costs or savings were included in the Legislature's consideration of the bill. A copy of this fiscal analysis is available from the Utah State Legislature website at: https://le.utah.gov/~2017/bills/static/hb0336.html.

local governments:

There is no aggregate anticipated cost or savings to local governments. The repeal of this rule is to wind down the small employer health insurance exchange known as Avenue H as a result of H.B. 336 (2017), and costs or savings were included in the Legislature's consideration of the bill. A copy of this fiscal analysis is available from the Utah State Legislature website at: https://le.utah.gov/~2017/bills/static/hb0336.html.

small businesses:

There is no aggregate anticipated cost or savings to small businesses. The repeal of this rule is to wind down the small employer health insurance exchange known as Avenue H as a result of H.B. 336 (2017), and costs or savings were included in the Legislature's consideration of the bill. A copy of this fiscal analysis is available from the Utah State Legislature website at: https://le.utah.gov/~2017/bills/static/hb0336.html.

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

There is no aggregate anticipated cost or savings to persons other than small businesses, businesses, or local government entities. The repeal of this rule is to wind down the small employer health insurance exchange known as Avenue H as a result of H.B. 336 (2017), and costs or savings were included in the Legislature's consideration of the bill. A copy of this fiscal analysis is available from the Utah State Legislature website at: https://le.utah.gov/~2017/bills/static/hb0336.html.

Compliance costs for affected persons:

There are no compliance costs for affected persons. The repeal of this rule is to wind down the small employer health insurance exchange known as Avenue H as a result of H.B. 336 (2017), and costs or savings were included in the Legislature's consideration of the bill. A copy of this fiscal analysis is available from the Utah State Legislature website at: https://le.utah.gov/~2017/bills/static/hb0336.html.

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

The repeal of this rule will not result in fiscal impact to businesses.

Val Hale, Director

The full text of this rule may be inspected, during regular business hours, at the Office of Administrative Rules, or at:

Governor
Economic Development, Consumer Health Exchange
60 E SOUTH TEMPLE
SALT LAKE CITY, UT 84111

Direct questions regarding this rule to:

• Dane Ishihara at the above address, by phone at 801-538-8865, by FAX at , or by Internet E-mail at dishihara@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:

10/15/2018

This rule may become effective on:

10/22/2018

Authorized by:

Val Hale, Executive Director

Appendix 1: Regulatory Impact Summary Table*

Fiscal Costs	FY 2019	FY 2020	FY 2021
State Government	$0	$0	$0
Local Government	$0	$0	$0
Small Businesses	$0	$0	$0
Non-Small Businesses	$0	$0	$0
Other Person	$0	$0	$0
Total Fiscal Costs:	$0	$0	$0
Fiscal Benefits
State Government	$0	$0	$0
Local Government	$0	$0	$0
Small Businesses	$0	$0	$0
Non-Small Businesses	$0	$0	$0
Other Persons	$0	$0	$0
Total Fiscal Benefits:	$0	$0	$0
Net Fiscal Benefits:	$0	$0	$0

 

*This table only includes fiscal impacts that could be measured. If there are inestimable fiscal impacts, they will not be included in this table. Inestimable impacts for State Government, Local Government, Small Businesses and Other Persons are described in the narrative. Inestimable impacts for Non-Small Businesses are described in Appendix 2.

 

Appendix 2: Regulatory Impact to Non-Small Businesses

There is no regulatory impact creating financial cost to non-small businesses because of the repeal of this rule.

 

 

[R358. Governor, Economic Development, Consumer Health Services.

R358-1. Electronic Standards for Transmitting Information through the Health Insurance Exchange.

R358-1-1. Purpose and Authority.

(1) The purpose of this rule is to establish electronic standards for data transmission and reception through the Health Insurance Exchange.

(2) This rule is enacted under the authority of Section 63M-1-2506.

 

R358-1-2. Definitions.

(1) Technology partner. A Health Insurance Exchange technology partner administers the technology on which the Exchange runs and supports the activities that take place on that technology.

(2) Financial partner. A Health Insurance Exchange financial partner administers the financial transactions that occur on the Exchange, including invoicing and collection of payments, and the disbursement of funds for services provided.

(3) Provider partner. A Health Insurance Exchange provider partner is any entity that offers goods or services to consumers through the Exchange system.

 

R358-1-3. Standards.

(1) The Office of Consumer Health Services requires that all Exchange technology, financial, and provider partners strive to keep consumer data secure at all times. All partners shall:

(a) transmit consumer data between the Exchange and all partners via secure file transfer protocol (SFTP);

(b) keep consumer data encrypted during transmission and while at rest on partner servers; and

(c) establish security profiles to provide leveled access to the minimum allowable data.

 

R358-1-4. HIPAA Compliance.

(1) The Office of Consumer Health Services requires that all Exchange technology and provider partners comply with the Health Insurance Portability and Accountability Act (HIPAA).

 

R358-1-5. Quality Control Process.

(1) Because security is integral to Health Insurance Exchange operations, the Office of Consumer Health Services shall:

(a) conduct periodic security audits to ensure the strength of the above standards as performed by all partners; and

(b) perform risk assessments across all partners, technologies, and platforms when implementing new enhancements or services.

 

KEY: data standards, Health Insurance Exchange, consumer health, health insurance

Date of Enactment or Last Substantive Amendment: October 10, 2012

Notice of Continuation: September 29, 2017

Authorizing, and Implemented or Interpreted Law: 63M-1-2506]