R590. Insurance, Administration.R590-247. Universal Health Insurance Application Rule.
R590-247-1. Authority.
This rule is promulgated by the commissioner pursuant to Sections 31A-2-201, 31A-2-212, 31A-22-635, 31A-30-102, and 31A-30-117.
R590-247-2. Purpose and Scope.
(1) The purpose of this rule is to establish a universal application for all insurers offering a health benefit plan.
(2) This rule applies to:
(a) an individual health benefit plan offered outside the Federally Facilitated Marketplace; and
(b) a small employer health benefit plan.
R590-247-3. Definitions.
Terms used in this rule are defined in Sections 31A-1-301 and 31A-22-635.
R590-247-4. General Instructions.
(1) An insurer or producer shall use the Utah Individual Health Insurance Application and the Utah Small Employer Health Insurance Application.
(2) The Utah Individual Health Insurance Application and Utah Small Employer Health Insurance Application shall be used without insurer identifying logos or addresses to facilitate multiple insurer submissions using a single application.
(3) The Utah Individual Health Insurance Application and Utah Small Employer Health Insurance Application are available on the department's website, https://insurance.utah.gov.
(4) The Utah Individual Health Insurance Application and Utah Small Employer Health Insurance Application may be altered for:
(a) electronic application and submission, including electronic signature disclaimers;
(b) languages other than English; and
(c) reasons specifically approved by the commissioner.
(5) An insurer shall offer compatible systems for electronic submission of the Utah Individual Health Insurance Application and the Utah Small Employer Health Insurance Application.
(6) If an employee chooses to waive coverage, an insurer shall not require the employee to complete any section of the Utah Small Employer Health Insurance Application other than the Waiver of Coverage section.
(7) An insurer offering an individual health benefit plan shall use the Utah Health Insurance Application dated June 2016 for coverage outside of the Federally Facilitated Marketplace.
(8) An insurer offering a small employer health benefit plan shall use the Utah Small Employer Health Insurance Application dated January 2014 for an application with a coverage effective date on or after January 1, 2014.
R590-247-5. Severability.
If any provision of this rule, Rule R590-247, or its application to any person or situation is held invalid, such invalidity does not affect any other provision or application of this rule that can be given effect without the invalid provision or application. The remainder of this rule shall be given effect without the invalid provision or application.
KEY: universal health insurance application
Date of Last Change: August 8, 2022
Notice of Continuation: June 9, 2023
Authorizing, and Implemented or Interpreted Law: 31A-30-102
