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H.B. 44

             1     

INSURANCE DEPARTMENT - HEALTH

             2     
POLICY RESPONSIBILITIES

             3     
2001 GENERAL SESSION

             4     
STATE OF UTAH

             5     
Sponsor: Rebecca D. Lockhart

             6      This act modifies the Insurance Code to require the insurance commissioner to prepare an
             7      annual evaluation of the state's health insurance industry.
             8      This act affects sections of Utah Code Annotated 1953 as follows:
             9      AMENDS:
             10          31A-2-201, as last amended by Chapter 316, Laws of Utah 1994
             11      Be it enacted by the Legislature of the state of Utah:
             12          Section 1. Section 31A-2-201 is amended to read:
             13           31A-2-201. General duties and powers.
             14          (1) The commissioner shall administer and enforce this title.
             15          (2) The commissioner has all powers specifically granted, and all further powers that are
             16      reasonable and necessary to enable him to perform the duties imposed by this title.
             17          (3) (a) The commissioner may make rules to implement the provisions of this title
             18      according to the procedures and requirements of Title 63, Chapter 46a, Utah Administrative
             19      Rulemaking Act.
             20          (b) In addition to the notice requirements of Section 63-46a-4 , the commissioner shall
             21      provide notice under Section 31A-2-303 of hearings concerning insurance department rules.
             22          (4) (a) The commissioner shall issue prohibitory, mandatory, and other orders as necessary
             23      to secure compliance with this title. An order by the commissioner is not effective unless the
             24      order:
             25          (i) is in writing; and
             26          (ii) is signed by the commissioner or under the commissioner's authority.
             27          (b) On request of any person who would be affected by an order under Subsection (4)(a),


             28      the commissioner may issue a declaratory order to clarify the person's rights or duties.
             29          (5) (a) The commissioner may hold informal adjudicative proceedings and public
             30      meetings, for the purpose of investigation, ascertainment of public sentiment, or informing the
             31      public.
             32          (b) No effective rule or order may result from informal hearings and meetings unless the
             33      requirement of a hearing under Section 31A-2-301 is satisfied.
             34          (6) The commissioner shall inquire into violations of this title and may conduct any
             35      examinations and investigations of insurance matters, in addition to examinations and
             36      investigations expressly authorized, that he considers proper to determine:
             37          (a) whether or not any person has violated any provision of this title; or
             38          (b) to secure information useful in the lawful administration of any provision of this title.
             39          (7) (a) Each year, the commissioner shall:
             40          (i) conduct an evaluation of the state's health insurance h [ industry ] MARKET h ; h [ and ] h
             41          (ii) report the findings of the evaluation to the Health and Human Services Interim
             42      Committee before July 31 h ; AND
             42a          (iii) PUBLISH THE FINDINGS OF THE EVALUATION ON THE DEPARTMENT WEBSITE h .
             43          (b) The evaluation shall:
             44          (i) analyze the effectiveness of the insurance regulations and statutes in promoting a
             45      healthy, competitive health insurance h [ industry ] MARKET THAT MEETS THE NEEDS OF UTAHNS h
             45a      by assessing such things as the h AVAILABILITY AND h marketing of
             46      individual and group products, rate charges, h COVERAGE AND DEMOGRAPHIC CHANGES,
             46a      BENEFIT TRENDS, h market share S [ charges ] CHANGES s , and accessibility;
             47          (ii) assess complaint ratios and trends within the health insurance h [ industry ] MARKET
             47a      ,WHICH ASSESSMENT SHALL INTEGRATE COMPLAINT DATA FROM THE OFFICE OF CONSUMER
             47b      HEALTH ASSISTANCE WITHIN THE DEPARTMENT h ; h [ and ] h
             48          (iii) contain recommendations for action to improve the overall effectiveness of the health
             49      insurance market, administrative rules, and statutes h ; AND
             49a          (iv) INCLUDE CLAIMS LOSS RATIO DATA FOR EACH INSURANCE COMPANY DOING
             49b      BUSINESS IN THE STATE.
             49c          (c) WHEN PREPARING THE EVALUATION REQUIRED BY THIS SECTION, THE
             49d      COMMISSIONER MAY SEEK THE INPUT OF INSURERS, EMPLOYERS, INSURED PERSONS,
             49e      PROVIDERS, AND OTHERS WITH AN INTEREST IN THE HEALTH INSURANCE MARKET h .



Legislative Review Note
    as of 11-28-00 1:43 PM

A limited legal review of this legislation raises no obvious constitutional or statutory concerns.

Office of Legislative Research and General Counsel


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