LegalFix

Section 201.2 - Evaluation of health insurance market.

UT Code § 31A-2-201.2 (2019) (N/A)
Copy with citation
Copy as parenthetical citation

(1) Each year the commissioner shall: (a) conduct an evaluation of the state's health insurance market; (b) report the findings of the evaluation to the Health and Human Services Interim Committee before December 1 of each year; and (c) publish the findings of the evaluation on the department website.

(a) conduct an evaluation of the state's health insurance market;

(b) report the findings of the evaluation to the Health and Human Services Interim Committee before December 1 of each year; and

(c) publish the findings of the evaluation on the department website.

(2) The evaluation required by this section shall: (a) analyze the effectiveness of the insurance regulations and statutes in promoting a healthy, competitive health insurance market that meets the needs of the state, and includes an analysis of: (i) the availability and marketing of individual and group products; (ii) rate changes; (iii) coverage and demographic changes; (iv) benefit trends; (v) market share changes; and (vi) accessibility; (b) assess complaint ratios and trends within the health insurance market, which assessment shall include complaint data from the Office of Consumer Health Assistance within the department; (c) contain recommendations for action to improve the overall effectiveness of the health insurance market, administrative rules, and statutes; (d) include claims loss ratio data for each health insurance company doing business in the state. (e) include information about pharmacy benefit managers collected under Section 31A-46-301; and (f) include information, for each health insurance company doing business in the state, regarding: (i) preauthorization determinations; and (ii) adverse benefit determinations.

(a) analyze the effectiveness of the insurance regulations and statutes in promoting a healthy, competitive health insurance market that meets the needs of the state, and includes an analysis of: (i) the availability and marketing of individual and group products; (ii) rate changes; (iii) coverage and demographic changes; (iv) benefit trends; (v) market share changes; and (vi) accessibility;

(i) the availability and marketing of individual and group products;

(ii) rate changes;

(iii) coverage and demographic changes;

(iv) benefit trends;

(v) market share changes; and

(vi) accessibility;

(b) assess complaint ratios and trends within the health insurance market, which assessment shall include complaint data from the Office of Consumer Health Assistance within the department;

(c) contain recommendations for action to improve the overall effectiveness of the health insurance market, administrative rules, and statutes;

(d) include claims loss ratio data for each health insurance company doing business in the state.

(e) include information about pharmacy benefit managers collected under Section 31A-46-301; and

(f) include information, for each health insurance company doing business in the state, regarding: (i) preauthorization determinations; and (ii) adverse benefit determinations.

(i) preauthorization determinations; and

(ii) adverse benefit determinations.

(3) When preparing the evaluation and report required by this section, the commissioner may seek the input of insurers, employers, insured persons, providers, and others with an interest in the health insurance market.

(4) The commissioner may adopt administrative rules for the purpose of collecting the data required by this section, taking into account the business confidentiality of the insurers.

(5) Records submitted to the commissioner under this section shall be maintained by the commissioner as protected records under Title 63G, Chapter 2, Government Records Access and Management Act.

LegalFix

Copyright ©2024 LegalFix. All rights reserved. LegalFix is not a law firm, is not licensed to practice law, and does not provide legal advice, services, or representation. The information on this website is an overview of the legal plans you can purchase—or that may be provided by your employer as an employee benefit or by your credit union or other membership group as a membership benefit.

LegalFix provides its members with easy access to affordable legal services through a network of independent law firms. LegalFix, its corporate entity, and its officers, directors, employees, agents, and contractors do not provide legal advice, services, or representation—directly or indirectly.

The articles and information on the site are not legal advice and should not be relied upon—they are for information purposes only. You should become a LegalFix member to get legal services from one of our network law firms.

You should not disclose confidential or potentially incriminating information to LegalFix—you should only communicate such information to your network law firm.

The benefits and legal services described in the LegalFix legal plans are not always available in all states or with all plans. See the legal plan Benefit Overview and the more comprehensive legal plan contract during checkout for coverage details in your state.

Use of this website, the purchase of legal plans, and access to the LegalFix networks of law firms are subject to the LegalFix Terms of Service and Privacy Policy.

We have updated our Terms of Service, Privacy Policy, and Disclosures. By continuing to browse this site, you agree to our Terms of Service, Privacy Policy, and Disclosures.
Section 201.2 - Evaluation of health insurance market.