Utah Admin. Code R590-199-5 - Plan of Orderly Withdrawal

Current through Bulletin No. 2021-18, September 15, 2021

(1) A covered carrier and each affiliate of a covered carrier that elects to nonrenew coverage under a health benefit plan in Utah must file a plan of orderly withdrawal with the commissioner explaining the process of nonrenewal. The plan must be filed with the commissioner at the time advance notice is given under Subsection 31A-30-107(3)(e) and 31A-30-107.1.(3)(e) and must be accompanied by a $50,000 withdrawal fee or proof of placement or assumption of all business to another carrier. This fee is to be made payable to the Utah Insurance Department. The plan of orderly withdrawal is to include the following information:
(a) name and telephone number of company representative to contact regarding the nonrenewal;
(b) list of all policy forms affected by the withdrawal;
(c) number of group or individual policies, or both, that are currently in force;
(d) number of covered lives, include insured, spouse and dependents, under individual health benefit plan policies;
(e) number of covered lives, include insured, spouse and dependents, under small employer health benefit plans;
(f) number of COBRA or Utah mini-COBRA policies and the number of covered lives for each;
(g) copy of notice required by Subsections 31A-30-107(3)(e) or 31A-30-107.1(3)(e);
(h) service or coverage areas within the state, which indicates withdrawal areas;
(i) list of all types of all insurance coverages offered in Utah by line of business and the premium volume generated in the prior year;
(j) any reinsurance ceding arrangements relating to the health benefit plans being nonrenewed;
(k) list of all affiliated carriers as described in Section 31A-30-104(4);
(l) certification of compliance executed by the president of the company stating that the withdrawing company is in compliance with 31A-30, as applicable, at the time the election to withdraw is filed;
(m) loss ratios for each form issued in Utah calculated in compliance with PPACA standards, including a description of all assumptions made;
(n) certified actuarial analysis from a qualified actuary of the impact that the withdrawal or nonrenewal will have on the individual and small employer market in Utah;
(o) actuarial certification from a qualified actuary certifying to the level of liability related to the policies;
(p) any plans to nonrenew any other line of business in Utah in the future;
(q) copy of the certificate of authority of the company and all affiliates involved in the withdrawal; and
(r) demonstrate that all liabilities relating to the policies that will be nonrenewed are fully satisfied or adequately reserved.
(2) Submit two copies of the plan of orderly withdrawal, one copy to be filed and a second set to be returned to you, and a self-addressed return envelope.
(3) If both the written notice and a complete plan of orderly withdrawal are not received, the partial submission will be returned and not considered to have been received by the department.
(4) Availability of coverage through a special enrollment period or a PPACA exchange is not considered assumption or placement with another carrier.

Notes

Utah Admin. Code R590-199-5
Amended by Utah State Bulletin Number 2014-21, effective 10/10/2014

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