R590. Insurance, Administration.R590-239. Exemption of Student Health Centers From Insurance Code.
R590-239-1. Authority.
This rule is promulgated by the commissioner pursuant to Sections 31A-1-103 and 31A-2-201.
R590-239-2. Purpose and Scope.
(1) The purpose of this rule is to exempt a student health center established by an institution of higher education from regulation under Title 31A, Insurance Code.
(2)(a) This rule applies to a student health center established by an institution of higher education.
(b) This rule does not exempt health insurance from an insurer made available by an institution to its students from Title 31A, Insurance Code, under this rule, even if:
(i) use of the institution's student health center is an integral part of the health care coverage offered to the institution's students under the insurer's policy; or
(ii) the health insurance offered to the institution's students requires that initial treatment for any illness or injury be at the institution's student health center.
R590-239-3. Definitions.
Terms used in this rule are defined in Sections 31A-1-301 and 31A-8-101. Additional terms are defined as follows:
(1) "Board" means the Utah Board of Higher Education established in Section 53B-1-402.
(2) "Eligible recipient" means:
(a) an eligible student;
(b) a spouse of an eligible student;
(c) a child of, dependent of, or child placed for adoption with, an eligible student;
(d) an officer, faculty member, or employee of the institution; or
(e) upon application by the institution or the institution's student health center, a person approved by written order of the commissioner.
(3) "Eligible student" is as defined by each institution, but shall, at a minimum, require that the student be enrolled with the institution.
(4) "Institution" means an institution of higher education or postsecondary educational institute that consists of the following:
(a) an institution described in Section 53B-1-102; or
(b) an institution of higher education that has been accredited by the Northwest Commission on Colleges and Universities.
(8) "Student health center" means a facility that is operated to provide health care services to an eligible recipient:
(a) by that institution or pursuant to a contract with that institution;
(b) that employs a health care provider, or contracts with a health care provider, that may make a referral to another health care provider;
(c) that is funded, at least in part, by payment from one of the following sources, which payment grants access to the student health center during the period the eligible student is registered:
(i) a fee assessed to and paid by each eligible student at registration; or
(ii) the tuition paid by the eligible student;
(d) that may accept an insurance payment, or assist a user in completing a claim form for an insurance claim; and
(e) that may require an eligible recipient to pay;
(i) an additional fee for each time the student health center is visited;
(ii) an additional fee for a specialty service;
(iii) an additional fee for medical equipment; or
(iv) an additional fee for medication received at the student health center.
R590-239-4. Findings.
Pursuant to Subsection 31A-1-103(3)(d), the commissioner makes the following findings.
(1) Many institutions establish a student health center to provide limited health care to an eligible recipient. A student health center arranges for health care services to be provided by employing a health care provider at the student health center, or by contracting with a health care provider for health care services at the student health center or another facility that may be located in close proximity to the institution's campus. The student health center may also contract with a specialist to come to the student health center on a periodic basis, or to provide a service off-campus when the student health center provides a referral to that specialist.
(2) The operation of the student health center is paid at least in part from funds generated by the tuition of an eligible student or from a fee for that express purpose that each eligible student is required to pay. In return, the eligible student is entitled to limited health care services at the student health center during the ensuing quarter, semester, or school year. An eligible student usually pays a nominal fee each time they use the facility.
(3) A student health center does not provide all basic health care services required of a health maintenance organization but does enter into arrangements with some of the persons listed in the definition of a limited health plan to provide
