Section R590-235-4 - Licensure and Regulatory Requirements(1) A stand-alone Medicare PDP sponsor shall be licensed as a risk-bearing entity in the jurisdiction where the sponsor proposes to serve Medicare Part D beneficiaries.(2) A stand-alone Medicare PDP may be licensed and regulated as either a Utah domiciled health maintenance organization (HMO), a limited health plan, or a Utah domiciled or foreign indemnity insurer.(a) Regulatory requirements for a Utah domiciled standalone Medicare PDP organized as an HMO or limited health plan are established by Title 31A, Chapter 8, Health Maintenance Organizations and Limited Health Plans.(b) Regulatory requirements for a Utah domiciled standalone Medicare PDP organized as an indemnity insurer are established by Title 31A, Chapter 5, Domestic Stock and Mutual Insurance Corporations.(c) Regulatory requirements for a foreign indemnity insurer are established by Title 31A, Chapter 14, Foreign Insurers.(3) A stand-alone Medicare PDP shall file Quarterly and Annual Statement Blanks pursuant to the instructions provided by the NAIC and in accordance with statutory accounting principles.(4) A stand-alone Medicare PDP applicant shall apply for licensure using the appropriate NAIC Uniform Certificate of Authority Application form:(a) Primary Application Form, for a Utah domiciled insurer stand-alone Medicare PDP; or(b) Expansion Application Form, for a foreign indemnity insurer stand-alone Medicare PDP.Utah Admin. Code R590-235-4
Amended by Utah State Bulletin Number 2022-24, effective 12/8/2022