(1)

1. (a) After complying with the reporting requirements of Section 63M-1-2505.5, the commissioner may adopt administrative rules that change the rating and underwriting requirements of this chapter as necessary to transition the insurance market to meet federal qualified health plan standards and rating practices under PPACA.

2. (b) Administrative rules adopted by the commissioner under this section may include:

   1. (i) the regulation of health benefit plans as described in Subsections 31A-2-212(5)(a) and (b); and
   2. (ii) disclosure of records and information required by PPACA and state law.

3. (c)

   1. (i) The commissioner shall establish by administrative rule one statewide open enrollment period that applies to the individual insurance market that is not on the PPACA certified individual exchange.

   2. (ii) The statewide open enrollment period:

      1. (A) may be shorter, but no longer than the open enrollment period established for the individual insurance market offered in the PPACA certified exchange; and
      2. (B) may not be extended beyond the dates of the open enrollment period established for the individual insurance market offered in the PPACA certified exchange.

(2) A carrier that offers health benefit plans in the individual market that is not part of the individual PPACA certified exchange:

1. (a) shall open enrollment:

   1. (i) during the statewide open enrollment period established in Subsection (1)(c); and
   2. (ii) at other times, for qualifying events, as determined by administrative rule adopted by the commissioner; and
2. (b) may open enrollment at any time.

(3)

1. (a) The commissioner shall identify a new mandated benefit that is in excess of the essential health benefits required by PPACA.
2. (b) In accordance with 45 C.F.R. Sec. 155.170, the state shall make a payment to defray the cost of a new mandated benefit in the amount calculated under Subsection (3)(c) directly to the qualified health plan issuer on behalf of an individual who receives an advance premium tax credit under PPACA.

3. (c) The state shall quantify the cost attributable to each additional mandated benefit specified in Subsection (3)(a) based on a qualified health plan issuer's calculation of the cost associated with the mandated benefit, which shall be:

   1. (i) calculated in accordance with generally accepted actuarial principles and methodologies;
   2. (ii) conducted by a member of the American Academy of Actuaries; and
   3. (iii) reported to the commissioner and to the individual exchange operating in the state.
4. (d) The commissioner may require a proponent of a new mandated benefit under Subsection (3)(a) to provide the commissioner with a cost analysis conducted in accordance with Subsection (3)(c). The commissioner may use the cost information provided under this Subsection (3)(d) to establish estimates of the cost to the state for premium subsidies under Subsection (3)(b).