Utah Admin. Code R590-199-4 - Plan of Orderly Withdrawal

(1) A carrier and each affiliate of a carrier that elects to withdraw or nonrenew coverage under a health benefit plan must file a plan of orderly withdrawal with the commissioner.

(2)

(a) The plan of orderly withdrawal must be filed with the commissioner no later than 30 working days before the notice given under Subsection 31A-22-618.6(5)(e)(ii) or 31A-22-618.7(3)(e)(ii).

(b) The plan of orderly withdrawal shall be accompanied by:

(i) a $50,000 withdrawal fee; or

(ii) proof of placement or assumption of all business to another carrier.

(c) The fee shall be made payable to the Utah Insurance Department.

(3) The plan of orderly withdrawal shall include the following information:

(a) the name and telephone number of the company representative to contact regarding the withdrawal;

(b) a list of all policy forms affected by the withdrawal;

(c) the number of group or individual policies, or both, that are currently in force;

(d) the number of covered lives, including the insured, spouse, and dependents, under each health benefit plan policy form;

(e) the number of COBRA or Utah mini-COBRA policies and the number of covered lives for each policy form;

(f) a copy of the notice required by Section 31A-22-618.6 or 31A-22-618.7, as applicable;

(g) the service or coverage areas, indicating the withdrawal area, within the state;

(h) a list of all types of insurance coverage offered in Utah in the prior year, by line of business, and the premium volume generated ;

(i) any reinsurance ceding arrangements relating to the health benefit plans being withdrawn;

(j) a list of all affiliated carriers described in Subsection 31A-30-104(4);

(k) if more than 100 covered individuals are being nonrenewed:

(i) a certified actuarial analysis from a qualified actuary of the impact that the withdrawal will have on the individual and employer market in Utah; and

(ii) an actuarial certification from a qualified actuary certifying to the level of liability related to the health benefit plans being nonrenewed;

(l) any proposal to withdraw or nonrenew any other line of business in Utah in the next 12 months;

(m) a statement that the nonrenewal of any coverage under a health benefit plan will occur on the annual renewal date of each policy or plan;

(n) proof that all liabilities relating to the policies that will be nonrenewed are fully satisfied or adequately reserved; and

(o) an acknowledgement that the company is prohibited from writing new business in the health benefit plan market withdrawn from for a period of five years beginning on the date of discontinuation of the last coverage nonrenewed.

(4) If both the written notice and a complete plan of orderly withdrawal are not received, the partial submission will be returned and considered not received by the commissioner.

(5) Availability of coverage through a special enrollment period or open enrollment under Section 31A-30-117 is not considered assumption or placement with another carrier.

Notes

Utah Admin. Code R590-199-4

Amended by Utah State Bulletin Number 2014-21, effective 10/10/2014 Amended by Utah State Bulletin Number 2022-12, effective 6/7/2022