Utah Admin. Code R590-167-2 - Purpose and Scope

(1) The purpose of this rule is to:

(a) enhance the availability of health insurance coverage to individuals and small employers;

(b) regulate and prevent abuse in insurer rating practices and establish limits on differences in rates between health benefit plans;

(c) ensure renewability of coverage;

(d) establish limitations on the use of preexisting condition exclusions;

(e) prescribe the way case characteristics may be used;

(f) regulate the use and establishment of separate classes of business;

(g) provide for portability;

(h) improve the overall fairness and efficiency of the individual and small employer health insurance market;

(i) promote broader spreading of risk in the individual and small employer marketplace; and

(j) regulate rating practices for all health benefit plans sold to an individual and a small employer, whether sold directly or through an association or another group of individuals and small employers.

(2)

(a) This rule applies to a health benefit plan that:

(i) meets one or more of the criteria in Subsections 31A-30-104(1) and 31A-30-104(2); and

(ii) provides coverage to a covered insured in Utah.

(b) A carrier that issues a health benefit plan to an individual or small employer is not subject to this rule solely because an individual or a small employer that was issued a health benefit plan in another state moves to Utah.

Notes

Utah Admin. Code R590-167-2

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