Section R590-261-2 - Purpose and Scope(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.Utah Admin. Code R590-261-2
Amended by Utah State Bulletin Number 2023-10, effective 5/9/2023