DAR File No. 43428

Insurance, Administration

Section R590-126-2

Purpose and Scope

Notice of Proposed Rule

(Amendment)

DAR File No.: 43428
Filed: 12/07/2018 04:28:08 PM

RULE ANALYSIS

Purpose of the rule or reason for the change:

This change is being made to recognize the new standards proposed in Rule R590-277 as a result of H.B. 336, Health Reform Amendments, passed during the 2017 General Session. The effective date for applicable provisions had had a delayed effective date of 01/01/2018. (EDITOR'S NOTE: The proposed new Rule R590-277 is under Filing No. 43427 in this issue, December 15, 2018, of the Bulletin.)

Summary of the rule or change:

This change adds a citation to recognize health benefit plans that comply with the proposed new Rule R590-277.

Statutory or constitutional authorization for this rule:

• Section 31A-23a-412
• Subsection 31A-2-201(3)(a)
• Section 31A-2-202
• Section 31A-22-623
• Subsection 31A-22-605(4)
• Subsection 31A-23a-402(8)
• Section 31A-22-626
• Subsection 31A-26-301(1)

Anticipated cost or savings to:

the state budget:

There is no anticipated cost or savings to the state budget. This rule only adds a citation to recognize health benefit plans that comply with the proposed new Rule R590-277.

local governments:

There is no anticipated cost or savings to local governments. This rule only adds a citation to recognize health benefit plans that comply with the proposed new Rule R590-277.

small businesses:

There is no anticipated cost or savings to small businesses. This rule only adds a citation to recognize health benefit plans that comply with the proposed new Rule R590-277.

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

There is no anticipated cost or savings to any other persons. This rule only adds a citation to recognize health benefit plans that comply with the proposed new Rule R590-277.

Compliance costs for affected persons:

There are no anticipated compliance costs for affected persons. This rule only adds a citation to recognize health benefit plans that comply with the proposed new Rule R590-277.

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

After conducting a thorough analysis, it was determined that this proposed rule change will not result in a fiscal impact to businesses.

Todd E. Kiser, Commissioner

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 [email protected]

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:

01/31/2019

This rule may become effective on:

02/07/2019

Authorized by:

Steve Gooch, Information Specialist

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

This rule is not expected to have any fiscal impact on non-small businesses revenues or expenditures, because this rule merely adopts standards that are currently required under an administrative rule that applies not only to managed care contracts, but also other types of health insurance contracts.

 

The head of the Insurance Department, Todd E. Kiser, has reviewed and approved this fiscal analysis.

 

 

R590. Insurance, Administration.

R590-126. Accident and Health Insurance Standards.

R590-126-2. Purpose and Scope.

(1) Purpose. The purpose of this rule is to provide reasonable standardization and simplification of terms and coverages of insurance policies in order to facilitate public understanding and comparison and to prohibit provisions which may be misleading or confusing in connection either with the purchase of such coverages or with the settlement of claims, and to provide for full disclosure in the sale of such insurance.

(2) Scope.

(a) This regulation applies to:

(i) all individual accident and health insurance policies and group supplemental health policies and certificates, delivered or issued for delivery in this state on and after January 1, 2006, that are not specifically exempted from this regulation, regardless of:

(A) whether the policy is issued to an association; a trust; a discretionary group; or other similar grouping; or

(B) the situs of delivery of the policy or contract; and

(ii) all dental plans and vision plans.

(b) This rule shall not apply to:

(i) employer accident and health insurance, as defined in Section 31A-22-502;

(ii) policies issued to employees or members as additions to franchise plans in existence on the effective date of this regulation;

(iii) Medicare supplement policies subject to Section 31A-22-620;[or]

(iv) civilian Health and Medical Program of the Uniformed Services, Chapter 55, title 10 of the United States Code, CHAMPUS supplement insurance policies; or

(v) a health benefit plan that complies with R590-277, Managed Care Health Benefit Plan Policy Standards.

(3) The requirements contained in this regulation shall be in addition to any other applicable regulations previously adopted.

 

KEY: health insurance

Date of Enactment or Last Substantive Amendment: [March 12, 2009]2019

Notice of Continuation: December 12, 2016

Authorizing, and Implemented or Interpreted Law: 31A-2-201; 31A-2-202; 31A-21-201; 31A-22-605; 31A-22-623; 31A-22-626; 31A-23a-402; 31A-26-301