Section R590-215-4 - Permissible Arbitration Provisions(1) Compulsory binding arbitration is not a permissible arbitration provision.(2) Compulsory non-binding arbitration is a permissible arbitration provision when used as an internal review of an adverse benefit determination under 29 CFR 2560.503-1(c)(4).(3) Voluntary binding arbitration, at the election of an insured, is a permissible arbitration provision, and may only be used as a voluntary level of review under 29 CFR 2560.503-1(c)(3)(iii).(4) A policy form containing a compulsory binding or a voluntary binding arbitration provision for the exclusive election of an insurer will be disapproved under Subsection 31A-21-201(3)(a)(iv), and these provisions in any previously filed form are declared not enforceable.(5)(a) Each application for an individual or group health benefit plan or income replacement insurance policy that contains a voluntary arbitration provision shall include or have attached a prominent statement substantially as follows: ANY MATTER IN DISPUTE BETWEEN YOU AND THE COMPANY MAY BE SUBJECT TO ARBITRATION AS AN ALTERNATIVE TO COURT ACTION PURSUANT TO THE RULES OF (THE AMERICAN ARBITRATION ASSOCIATION OR OTHER RECOGNIZED ARBITRATOR), A COPY OF WHICH IS AVAILABLE ON REQUEST FROM THE COMPANY. THE COMPANY SHALL BEAR THE COSTS OF ARBITRATION, FILING FEES, ADMINISTRATIVE FEES AND ARBITRATOR FEES. OTHER EXPENSES OF ARBITRATION, INCLUDING, BUT NOT LIMITED TO: ATTORNEY FEES, EXPENSES OF DISCOVERY, WITNESSES, STENOGRAPHER, TRANSLATORS, AND SIMILAR EXPENSES, WILL BE BORNE BY THE PARTY INCURRING THOSE EXPENSES. ANY DECISION REACHED BY ARBITRATION SHALL BE BINDING UPON BOTH YOU AND THE COMPANY. THE ARBITRATION AWARD MAY INCLUDE ATTORNEY'S FEES, IF ALLOWED BY STATE LAW, AND MAY BE ENTERED AS A JUDGMENT IN ANY COURT OF PROPER JURISDICTION.
(b) The statement described in Subsection (5)(a) shall be disclosed prior to the execution of the insurance contract between the insurer and the policyholder and shall be contained in the certificate of insurance or other disclosure of benefits.(6) A voluntary binding arbitration provision may not preclude a dispute from being resolved through any small claims court having jurisdiction.(7) Any arbitration provision contained in an insurance policy shall comply with Title 78B, Chapter 11, Utah Uniform Arbitration Act.(8) An agreement for arbitration may not obligate an insured to pay for the arbitration as part of the voluntary appeal in accordance with 29 CFR 2560.503-1(c)(3)(v).(9) An arbitration provision may not require that arbitration be held at a place further from the residence of the insured than the nearest location of a State Court of General Jurisdiction.Utah Admin. Code R590-215-4
Amended by Utah State Bulletin Number 2022-16, effective 7/27/2022