Utah Admin. Code R590-286-7 - Outline of Coverage and Disclosure Requirements

(1) An insurer shall deliver to an applicant the Short-Term Limited Duration Health Insurance Disclosure at the time of application.

(2) The outline of coverage in Table 1 shall be issued with a contract.

TABLE 1 Short-Term Limited Duration Outline of Coverage

(COMPANY NAME) SHORT-TERM LIMITED DURATION HEALTH INSURANCE COVERAGE THIS (POLICY)(CERTIFICATE) PROVIDES LIMITED BENEFITS BENEFITS ARE SUPPLEMENTAL AND ARE NOT INENDED TO COVER ALL MEDICAL EXPENSES OUTLINE OF COVERAGE Read Your (Policy)(Certificate) Carefully - This outline of coverage provides a very brief description of the important features of your policy. This is not the insurance contract and only the actual policy provisions will control. The policy itself sets forth in detail the rights and obligations of both you and your insurance company. It is, therefore, important that you READ YOUR (POLICY)(CERTIFICATE) CAREFULLY! Short-term limited duration health insurance coverage is designed to provide, to persons insured, limited or supplemental coverage. A brief specific description of the benefits, including dollar amounts. A description of any provisions that exclude, eliminate, restrict, reduce, limit, delay, or in any other manner operate to qualify payment of the benefits. A description of provisions respecting renewability or continuation of coverage, including age restrictions or any reservation of right to change premiums.

(3) A policy delivered to a person eligible for Medicare by reason of age shall include the following language printed on or attached to the first page of the outline of coverage, "THIS IS NOT A MEDICARE SUPPLEMENT POLICY. If you are eligible for Medicare, review the Guide to Health Insurance for People With Medicare available from the company."

(4) An application for short-term limited duration health insurance shall include a statement by the applicant attesting and acknowledging the following:

(a) the insured has received the Short-Term Limited Duration Health Insurance Disclosure;

(b) coverage does not meet minimum essential coverage;

(c) benefits do not comply with the Patient Protection and Affordable Care Act;

(d) exclusions or limitations, including a preexisting condition exclusion or limitation, may apply;

(e) lifetime dollar limits may apply; and

(f) annual dollar limits may apply.

(5) An insurer shall, upon request from the commissioner, file for use a copy of any short-term limited duration health insurance advertisement intended for written, radio, electronic, or television use in this state.

Notes

Utah Admin. Code R590-286-7

Adopted by Utah State Bulletin Number 2021-07, effective 3/11/2021 Adopted by Utah State Bulletin Number 2025-07, effective 3/24/2025