(1)
Authority.
This rule is intended to implement the provisions of Chapter
30, Title 31A, the Individual and Small Employer Health Insurance Act, referred
to in this rule as the Act. The commissioner's authority to enforce this rule
is provided under Subsections
31A-2-201(3)(a),
31A-30-106(1)(k),
and
31A-30-106.1(10).
(2) Purpose.
(a) The general purposes of the Act and this
rule are:
(i) to enhance the availability of
health insurance coverage to individuals and small employers;
(ii) to regulate and prevent abuse in insurer
rating practices and establish limits on differences in rates between health
benefit plans;
(iii) to ensure
renewability of coverage;
(iv) to
establish limitations on the use of preexisting condition exclusions;
(v) to prescribe the manner in which case
characteristics may be used;
(vi)
to regulate the use and establishment of separate classes of
business;
(vii) to provide for
portability; and
(viii) to improve
the overall fairness and efficiency of the individual and small employer health
insurance market.
(b)
The Act and this rule are intended to:
(i)
promote broader spreading of risk in the individual and small employer
marketplace; and
(ii) regulate
rating practices for all health benefit plans sold to individuals and small
employers, whether sold directly or through associations or other groupings of
individuals and small employers.
(3) Scope.
Carriers that provide health benefit plans to individuals and
small employers are intended to be subject to all of the provisions of this
rule.
