1. (1) The purpose of this rule is to:

   1. (a) enhance the availability of health insurance coverage to individuals and small employers;
   2. (b) regulate and prevent abuse in insurer rating practices and establish limits on differences in rates between health benefit plans;
   3. (c) ensure renewability of coverage;
   4. (d) establish limitations on the use of preexisting condition exclusions;
   5. (e) prescribe the way case characteristics may be used;
   6. (f) regulate the use and establishment of separate classes of business;
   7. (g) provide for portability;

   8. (h) improve the overall fairness and efficiency of the individual and small employer health insurance market;

      1. (i) promote broader spreading of risk in the individual and small employer marketplace; and
   9. (j) regulate rating practices for all health benefit plans sold to an individual and a small employer, whether sold directly or through an association or another group of individuals and small employers.

2. (2)(a) This rule applies to a health benefit plan that:

   1. (i) meets one or more of the criteria in Subsections 31A-30-104(1) and 31A-30-104(2); and

      1. (ii) provides coverage to a covered insured in Utah.
   2. (b) A carrier that issues a health benefit plan to an individual or small employer is not subject to this rule solely because an individual or a small employer that was issued a health benefit plan in another state moves to Utah.

KEY: health insurance

Date of Last Change: February 21, 2024

Notice of Continuation: August 9, 2024

Authorizing, and Implemented or Interpreted Law: 31A-30-106; 31A-30-106.1