Utah Admin. Code R590-220-10 - Additional Procedures for Individual, Small Employer, and Group Health Benefit Plan Filings

(1) An insurer filing a health benefit plan filing shall comply with:
(a) Title 31A, Chapter 30, Individual, Small Employer, and Group Health Insurance Act;
(b) Title 31A, Chapter 45, Managed Care Organizations;
(c) Rule R590-167; and
(d) Rule R590-277.
(2) Form Filing.
(a) A non-2014 PPACA compliant health benefit plan form filing shall include the SERFF tracking number for the form's applicable rate manual filing.
(b) A grandfathered or transitional plan shall be filed separate from a 2014 PPACA compliant health benefit plan.
(3) Rate Manual Filing for a Non-2014 PPACA Compliant Health Benefit Plan.
(a) A rate manual filing that does not request a change in rating methodology is a file before use filing.
(b) A change in a rating methodology filing is a file for approval filing.
(c) A new or revised rate manual shall:
(i) include an actuarial certification signed by a qualified actuary; and
(ii) be filed 30 days before use.
(d) The company rate information on the rate/rule schedule tab shall be compliant.
(4) Rate Filing for a 2014 PPACA Compliant Health Benefit Plan.
(a) A rate filing shall be filed according to the department's annual bulletin to insurers.
(b) Quarterly changes to a rate filing shall be filed according to Bulletin 2015-3.

Notes

Utah Admin. Code R590-220-10
Amended by Utah State Bulletin Number 2015-20, effective 9/23/2015 Adopted by Utah State Bulletin Number 2023-12, effective 3/23/2016 Adopted by Utah State Bulletin Number 2023-13, effective 6/9/2023

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