Utah Admin. Code R590-167-10 - Status of a Carrier as a Covered Carrier

(1)

(a) Before marketing a health benefit plan, a carrier shall file with the commissioner its intent to operate as a covered carrier in Utah under the terms of the act and of this rule.

(b) The filing shall state if the carrier intends to market to individuals, small employers, or both, and shall be signed by an officer of the company.

(2) Except as provided by Subsection (3), a carrier may not offer a health benefit plan to an individual or a small employer in Utah, or continue to provide coverage under a health benefit plan previously issued to an individual or a small employer in Utah, unless the filing under Subsection (1) indicates that the carrier intends to operate as a covered carrier in Utah.

(3)

(a) If a carrier does not intend to operate as a covered carrier in Utah, the carrier may continue to provide coverage under a health benefit plan previously issued to an individual or a small employer in Utah if:

(i) the carrier complies with the act with respect to each health benefit plan previously issued to an individual or a small employer;

(ii) the carrier provides coverage to each new entrant to a health benefit plan previously issued to an individual or a small employer;

(iii) the carrier complies with Sections 31A-30-106 and 31A-30-106.1 and this rule as they apply to an individual or a small employer whose coverage was terminated, limited, or restricted by the carrier; and

(iv) the carrier files a letter of intent indicating the carrier does not intend to operate as a covered carrier in Utah and will maintain the business in compliance with the act and this rule.

(b)

(i) If a filing made under Subsection (3) indicates that a carrier does not intend to operate as a covered carrier in Utah, the carrier is precluded from operating as a covered carrier in Utah, except as provided for in Subsection (3), for a period of five years from the date of the filing.

(ii) Upon written request from the carrier, the commissioner may reduce the five-year period if the commissioner finds that permitting the carrier to operate as a covered carrier would be in the best interests of the individuals and small employers in Utah.

Notes

Utah Admin. Code R590-167-10

Adopted by Utah State Bulletin Number 2024-05, effective 2/21/2024