R590. Insurance, Administration.R590-250. Professional Employer Organization License Procedure and Assurance Organization Designation.
R590-250-1. Authority.
This rule is promulgated by the commissioner pursuant to Sections 31A-2-201, 31A-40-103, 31A-40-302, and 31A-40-303.
R590-250-2. Purpose and Scope.
(1) The purpose of this rule is to:
(a) define terms used in Title 31A, Chapter 40, Professional Employer Organization Licensing Act;
(b) establish a licensing process; and
(c) establish a process to designate an assurance organization to certify qualifications of a PEO.
(2) This rule applies to:
(a) a PEO;
(b) an unlicensed person doing the business of a PEO; and
(c) an assurance organization certifying qualifications of a PEO.
R590-250-3. Definitions.
Terms used in this rule are defined in Sections 31A-1-301 and 31A-40-102. Additional terms are defined as follows:
(1) "Fully insured," as used in Title 31A, Chapter 40, Professional Employer Organization Licensing Act, and described in Section R590-250-4 means a health benefit plan where 100% of the liability is assumed by an insurer authorized to conduct business in Utah.
(2) "PEO" means a professional employer organization.
R590-250-4. Fully Insured Health Benefit Plan.
(1) A fully insured health benefit plan may include financial responsibility for claims assumed by the PEO if the insurer is responsible for 100% of the PEO's liability for non-payment by the PEO.
(2) A covered individual in a fully insured health benefit plan may make a claim for payment directly to the insurer.
(3) A fully insured health benefit plan may have co-pay or deductible requirements as required by contract.
R590-250-5. Initial and Renewal Licensing Process.
(1) A PEO shall complete and submit an initial or a renewal license application form together with supporting documents to the commissioner electronically.
(2) A PEO shall complete the appropriate PEO license application:
(a) Professional Employer Organization - Not Certified Through an Assurance Organization;
(b) Professional Employer Organization - Certified Through an Assurance Organization; or
(c) Professional Employer Organization - Small Operation License.
(3) PEO application forms are available on the department's website, https://insurance.utah.gov.
R590-250-6. Assurance Organization Designation Process.
The commissioner may designate an assurance organization that submits a request containing:
(1) an explanation of how the assurance organization will certify the qualification criteria under Subsection 31A-40-303(3); and
(2) evidence that the assurance organization is licensed by one or more states to certify the qualifications of a PEO.
R590-250-7. Severability.
If any provision of this rule, Rule R590-250, 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: insurance, assurance organization designation
Date of Last Change: January 10, 2023
Notice of Continuation: August 1, 2023
Authorizing, and Implemented or Interpreted Law: 31A-40-303(3)
