Utah Admin. Code R590-220-3 - Definitions
Terms used in this rule are defined in Sections 31A-1-301 and 31A-30-103. Additional terms are defined as follows:
(1)
"Certification" means a statement that a submitted filing is
compliant.
(2) "Compliant" means a
filing that is complete and that complies with Title 31A, Insurance Code, and
this rule.
(3) "Discretionary
group" means a group that is authorized by the commissioner under Subsection
31A-22-701(1)(b).
(4) "Electronic filing" means a filing
submitted using SERFF.
(5)
"Eligible group" means a group that meets the requirements in Section
31A-22-701.
(6) "File and use"
means a filing is used, sold, or offered for sale after it is filed with the
department.
(7) "File before use"
means a filing is used, sold, or offered for sale after it is filed with the
department and a stated period of time elapses from the date filed.
(8) "File for acceptance" means a filing is
used, sold, or offered for sale after receiving written confirmation that the
filing is accepted.
(9) "File for
approval" means a filing is used, sold, or offered for sale after receiving
written confirmation that the filing is approved.
(10) "Filing objection letter" means a letter
issued by the commissioner when a review of the filing determines the filing is
not compliant and may require:
(a) correction
of non-compliant items;
(b)
clarification; or
(c) additional
information related to the filing.
(11) "Filing status information" means a list
of states a similar filing was submitted to, the date submitted, and the action
taken by each state, including their responses.
(12) "Letter of authorization" means a letter
signed by an officer of the insurer giving authority to a third party to submit
a filing on behalf of the insurer.
(13) "Market type" means a policy that
specifies a targeted market.
(14)
"NAIC Product Coding Matrix" means a numerical coding system developed by the
NAIC that provides uniform naming convention, uniform terminology, and uniform
description for a type of insurance product in a filing.
(15) "Non-2014 PPACA compliant health benefit
plan" means a health benefit plan that is:
(a)
a grandfathered health plan under
45 CFR
147.140(a); or
(b) a transitional health benefit plan, also
known as a grandmothered plan, under:
(i) the
letter from the Centers for Medicare and Medicaid Services dated November 14,
2013; and
(ii) Subsection
31A-30-117(3).
(16) "Order to prohibit use" means an order
issued by the commissioner prohibiting the use of a filing.
(17) "Change in rating methodology," for the
purposes of a non-2014 PPACA compliant health benefit plan, means a change in:
(a) the number of case characteristics used
by an insurer to determine premium rates in a class of business;
(b) the manner or procedures used to assign
an insured into categories for the purpose of applying a case characteristic to
determine premium rates in a class of business;
(c) the method of allocating expenses in a
class of business; or
(d) a rating
factor, with respect to any case characteristic, if the change would produce a
change in premium that exceeds 10% for an individual or small
employer.
(18) "Rejected"
means a filing is:
(a) not
compliant;
(b) returned to the
insurer stating the reason for rejection; and
(c) not considered filed with the
department.
(19)
"Resubmission" means a correction, modification, or replacement of a previously
rejected, withdrawn, or prohibited filing.
(20) "SERFF" means the System for Electronic
Rates and Form Filings.
(21)
"Stop-loss insurance" means insurance purchased by an employer for which the
stop-loss insurer assumes all loss amounts of the employer's plan in excess of
a stated amount, subject to the policy limit.
(22) "Type of insurance" or "TOI" means a
specific accident and health insurance product identified by the NAIC Product
Coding Matrix that can be selected in SERFF when submitting a filing in
Utah.
(23) "Utah filed date" means
the date the department indicates a paper filing is accepted.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.