§ 63M-1-2506. Health benefit plan information on Health Insurance Exchange -- Insurer transparency.

(1)

(a) The office shall adopt administrative rules in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, that establish uniform electronic standards for insurers, employers, brokers, consumers, and vendors to use when transmitting or receiving information, uniform applications, waivers of coverage, or payments to, or from, the Health Insurance Exchange.

(b) The administrative rules adopted by the office shall:

(i) promote an efficient and consumer friendly process for shopping for and enrolling in a health benefit plan offered on the Health Insurance Exchange; and

(ii) if appropriate, as determined by the office, comply with standards adopted at the national level.

(2) The office shall assist the risk adjuster board created under Title 31A, Chapter 42, Defined Contribution Risk Adjuster Act, and carriers participating in the defined contribution market on the Health Insurance Exchange with the determination of when an employer is eligible to participate in the Health Insurance Exchange under Title 31A, Chapter 30, Part 2, Defined Contribution Arrangements.

(3)

(a) The office shall create an advisory board to advise the exchange concerning the operation of the exchange, the consumer experience on the exchange, and transparency issues.

(b) The advisory board shall have the following members:

(i) two health producers who are appointed producers with the Health Insurance Exchange;

(ii) two representatives from community-based, non-profit organizations;

(iii) one representative from an employer that participates in the defined contribution market on the Health Insurance Exchange;

(iv) up to four representatives from insurers who participate in the defined contribution market of the Health Insurance Exchange;

(v) one representative from the Insurance Department; and

(vi) one representative from the Department of Health.

(c) Members of the advisory board shall serve without compensation.

(4) The office shall post or facilitate the posting, on the Health Insurance Exchange, of the information required by this section and Section 31A-22-635 and links to websites that provide cost and quality information from the Department of Health Data Committee or neutral entities with a broad base of support from the provider and payer communities.

Amended by Chapter 400, 2011 General Session