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

   1. (a) standardize and simplify the terms and coverage of a health benefit plan contract;
   2. (b) facilitate public understanding and comparison of coverage;
   3. (c) prohibit use of a provision that is misleading or confusing in connection with the purchase of coverage or the settlement of a claim;
   4. (d) set minimum coverage requirements; and
   5. (e) provide for full disclosure in the sale of insurance.

2. (2)(a) Except as excluded in Subsection (2)(b), this rule applies to a health benefit plan contract.

   1. (b) This rule does not apply to a:

      1. (i) health benefit plan issued to an employee group under Section 31A-22-502;
      2. (ii) health benefit plan subject to Rule R590-277; or
      3. (iii) short-term limited duration health insurance contract subject to Rule R590-286.

KEY: health insurance

Date of Last Change: March 24, 2025

Notice of Continuation: November 25, 2024

Authorizing, and Implemented or Interpreted Law: 31A-2-201; 31A-2-202; 31A-22-605; 31A-22-623; 31A-22-626; 31A-23a-402; 31A-23a-412; 31A-26-301