Title 31A, Title 31A: Insurance Code

31A-30-105. Establishment of classes of business. Effective January 1, 2014, a covered carrier may establish up to four separate classes of business: (1) one class of business for individual health benefit plans that are not grandfathered under PPACA; (2) one class of business fo…

31A-30-106. Individual premiums -- Rating restrictions -- Disclosure. (1) Premium rates for health benefit plans for individuals under this chapter are subject to this section. The index rate for a rating period for any class of business may not exceed the index rate for any othe…

31A-30-106.1. Small employer premiums -- Rating restrictions -- Disclosure. (1) Premium rates for small employer health benefit plans under this chapter are subject to this section. (2) The index rate for a rating period for any class of business may not exceed the index rate for…

31A-30-106.5. Conversion policy -- Premiums -- Rating restrictions. (1) Sectionapplies to conversion policies. 31A-30-106 (2) Conversion policy premium rates may not exceed by more than 35% the index rate for small employers with similar case characteristics for any class of busi…

31A-30-106.7. Surcharge for groups changing carriers. (1) Except as provided in Subsection, 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 pre…

31A-30-107.5. Preexisting condition exclusion -- Condition-specific exclusion riders -- Limitation periods. (1) A health benefit plan may impose a preexisting condition exclusion only if the provision complies with Subsection. 31A-22-605.1(4) (2) In accordance with Subsection, an…

31A-30-108. Eligibility for small employer and individual market. (1) A small employer carrier shall accept a small employer that applies for small group coverage as set forth in the Health Insurance Portability and Accountability Act, Sec. 2701(f) and 2711(a), and PPACA, Sec. 27…

31A-30-112. Employee participation levels. (1) For purposes of this section, "participation" means the same as that term is defined in Section. 31A-1-301 Except as provided in Subsection, a requirement used by a covered carrier in determining whether to provide coverage to a smal…

31A-30-114. Disclosure. (1) A covered carrier shall make the information described in Subsectionavailable: (2) to: a small employer; or an individual; and at the time of solicitation; or upon the request of: a small employer; or an individual; as part of the covered carrier's sol…

31A-30-115. Actuarial review of health benefit plans. (1) The department shall conduct an actuarial review of rates submitted by a carrier that offers a small employer plan and a carrier that offers an individual plan under this chapter: to verify the validity of the rates, risk …

31A-30-117. Patient Protection and Affordable Care Act -- Market transition. (1) The commissioner may adopt administrative rules in accordance with, that change the rating and underwriting requirements of this chapter as necessary to transition the insurance market to meet federa…

31A-30-118. Patient Protection and Affordable Care Act -- State insurance mandates -- Cost of additional benefits. (1) The commissioner shall identify a new mandated benefit that is in excess of the essential health benefits required by PPACA. The state shall quantify the cost at…