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UTAH CODE (Last Updated: January 16, 2015) |
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Title 31A. Insurance Code |
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Chapter 30. Individual, Small Employer, and Group Health Insurance Act |
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Part 1. Individual and Small Employer Group |
§ 31A-30-106.7. Surcharge for groups changing carriers. (Effective 5/13/2014)
Latest version.
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(1) (a) Except as provided in Subsection (1)(b), if prior notice is given, a covered carrier may impose upon a small group that changes coverage to that carrier from another carrier a one-time surcharge of up to 25% of the annualized premium that the carrier could otherwise charge under Section 31A-30-106.1. (b) A covered carrier may not impose the surcharge described in Subsection (1)(a) if: (i) the change in carriers occurs on the anniversary of the plan year, as defined in Section 31A-1-301; (ii) the previous coverage was terminated under Subsection 31A-30-107(3)(e); (iii) employees from an existing group form a new business; and (iv) the surcharge is not applied uniformly to all similarly situated small groups. (2) A covered carrier may not impose the surcharge described in Subsection (1) if the offer to cover the group occurs at a time other than the anniversary of the plan year because: (b) (i) the application for coverage is made prior to the anniversary date in accordance with the covered carrier's published policies; and (ii) additional underwriting or rating information requested by the covered carrier is not received until after the anniversary date. (3) If a covered carrier chooses to apply a surcharge under Subsection (1), the application of the surcharge and the criteria for incurring or avoiding the surcharge shall be clearly stated in the: (a) written application materials provided to the applicant at the time of application; and (b) written producer guidelines. (4) The commissioner shall adopt rules in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, to ensure compliance with this section.