Utah Admin. Code R590-146-18 - Requirements for Application Forms and Replacement Coverage
(1)
(a) An
application form shall include questions designed to elicit information as to
whether, as of the date of the application, the applicant:
(i) has Medicare supplement insurance,
Medicare Advantage coverage, Medicaid coverage, or other accident and health
insurance currently in force; or
(ii) intends to replace any other accident
and health insurance policy or certificate currently in force.
(b) A supplementary application or
other form to be signed by the applicant and producer containing the questions
and statements in the Application Supplementary Statements and Questions may be
used.
(2) A producer
shall list all other health insurance policies they have sold to the applicant,
including a list of each policy sold:
(a) that
is still in force; and
(b) in the
past five years, that is no longer in force.
(3) In the case of a direct response issuer,
a copy of the application or supplemental form, signed by the applicant and
acknowledged by the issuer, shall be returned to the applicant by the issuer at
policy delivery.
(4)
(a) Upon determining a sale will involve
Medicare supplement insurance coverage replacement, an issuer, other than a
direct response issuer or its producer, shall provide to the applicant, prior
to issuance or delivery of the policy or certificate, the Notice to Applicant
Regarding Replacement of Medicare Supplement Insurance or Medicare
Advantage.
(b) One copy of the
notice signed by the applicant and the producer, except when the coverage is
sold without a producer, shall be provided to the applicant and an additional
signed copy shall be retained by the issuer.
(c) A direct response issuer shall deliver to
the applicant when issuing the policy the Notice to Applicant Regarding
Replacement of Medicare Supplement Insurance or Medicare Advantage.
(d) The notice shall be provided in
substantially the same format in no less than 12-point font.
(5) Paragraphs one and two of the
notice may be deleted by an issuer if the replacement does not involve
application of a new preexisting condition limitation.
Notes
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