Utah Administrative Code
Topic - Insurance
Title R590 - Administration
Rule R590-261 - Health Benefit Plan Adverse Benefit Determinations
Section R590-261-2 - Purpose and Scope
Universal Citation: UT Admin Code R 590-261-2
Current through Bulletin 2024-06, March 15, 2024
(1) The purpose of this rule is to provide a uniform standard for the establishment and maintenance of an independent review procedure to assure that a claimant has the opportunity for an independent review of a final adverse benefit determination.
(2)
(a) This rule applies to a carrier offering a
health benefit plan.
(b) This rule
does not apply to a grandfathered health plan.
(c) If all grandfathered health benefit plans
are administered consistently, a carrier may voluntarily comply with the
independent review process outlined in this rule.
(d) A self-funded health plan may voluntarily
comply with the independent review process outlined in this rule.
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