Utah Admin. Code R590-233-2 - Purpose and Scope
(1) The purpose of
this rule is to:
(a) standardize and simplify
the terms and coverage of a health benefit plan contract;
(b) facilitate public understanding and
comparison of coverage;
(c)
prohibit use of a provision that is misleading or confusing in connection with
the purchase of coverage or the settlement of a claim;
(d) set minimum coverage requirements;
and
(e) provide for full disclosure
in the sale of insurance.
(2)
(a)
Except as excluded in Subsection (2)(b), this rule applies to a health benefit
plan contract.
(b) This rule does
not apply to a:
(i) health benefit plan issued
to an employee group under Section
31A-22-502;
(ii) health benefit plan subject to Rule
R590-277; or
(iii) short-term
limited duration health insurance contract subject to Rule R590-286.
Notes
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(1) Purpose. The purpose of this rule is to provide reasonable standardization and simplification of terms and coverages of insurance policies in order to facilitate public understanding and comparison and to prohibit provisions which may be misleading or confusing in connection either with the purchase of such coverages or with the settlement of claims, and to provide for full disclosure in the sale of such insurance.
(2) Scope.
(a) Except as excluded under (b), this regulation applies to all individual and group health benefit plan policies, including policies issued to associations, trusts, discretionary groups, or other similar groupings.
(b) This rule shall not apply to employer group health benefit plans.
(c) This rule does not apply to a health benefit plan subject to R590-277, Managed Care Health Benefit Plan Policy Standards.
(3) The requirements contained in this regulation shall be in addition to any other applicable regulations previously adopted.