1. (1) A contract may not include a definition regarding a matter defined in Section R590-277-3 unless the definition complies with that section.

2. (2) Except for an employer-sponsored health benefit plan, a contract:

   1. (a) may not provide for termination of coverage of the spouse or a dependent solely because of the occurrence of an event specified for termination of coverage of the contract holder, other than for nonpayment of premium; and
   2. (b) shall provide that in the event of the contract holder's death, the spouse shall become the contract holder.
3. (3) A contract providing coverage for the recipient in a transplant operation shall also provide reimbursement of medically necessary transplant expenses of a live donor.
4. (4) A premium change notice shall be given no less than 45 days before the renewal date.

5. (5)(a) Except under Subsection (5)(b), a completed application:

   1. (i) is made part of the contract; and

      1. (ii) shall be provided to the applicant before, or at delivery, of the contract.

   2. (b) Subsection (5)(a) does not apply to:

      1. (i) an employer-sponsored health benefit plan; or
      2. (ii) an individual if the application was submitted through the health insurance exchange.

6. (6) A managed care organization offering an individual health benefit plan shall issue with an individual policy:

   1. (a)(i) an outline of coverage; or

      1. (ii) a benefit summary; and
   2. (b) a summary of benefits and coverage.

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