(1) The purpose of this rule is to:
- (a) standardize and simplify the terms and coverage of a managed care health benefit plan;
- (b) facilitate public understanding and comparison of coverage;
- (c) prohibit use of a provision that is misleading or confusing in connection with the purchase of coverage or the settlement of a claim;
- (d) set minimum coverage requirements; and
- (e) provide for full disclosure in the sale of insurance.
- (2) This rule applies to a health benefit plan issued by a managed care organization.
- (3) This rule does not apply to short-term limited duration health insurance subject to Rule R590-286.
KEY: insurance, health insurance
Date of Last Change: June 10, 2025
Notice of Continuation: August 9, 2024
Authorizing, and Implemented or Interpreted Law: 31A-45-103; 31A-2-201(3)(a); 31A-23a-402(8); 31A-23a-412; 31A-2-202