Section R590-277-7 - Restrictions Relating to Premium Rates(1) The premium charged shall not be adjusted more frequently than annually, except that the premium rates may be changed:(a) to reflect changes to the enrollment;(b) to reflect changes to the health benefit plan; or(c) as expressly permitted by federal or state law.(2) Premium rates may vary only with respect to the particular coverage involved on the basis of the following: (a) whether the plan covers an individual or family:(i) the total family premium shall include only the premiums for all covered family members over the age of twenty-one and the three oldest children under the age of twenty one; and(ii) any rating variation on the basis of age or tobacco use must be applied separately to the portion of the premium attributable to each covered family member;(b) geographic rating area, determined by the policyholder's primary address, as follows: (i) Area 1, comprised of Cache and Rich counties;(ii) Area 2, comprised of Box Elder, Morgan, and Weber counties;(iii) Area 3, comprised of Davis, Salt Lake, Summit, Tooele, and Wasatch counties;(iv) Area 4, comprised of Utah county;(v) Area 5, comprised of Iron and Washington counties; and(vi) Area 6, comprised of Beaver, Carbon, Daggett, Duchesne, Emery, Garfield, Grand, Juab, Kane, Millard, Piute, San Juan, Sanpete, Sevier, Uintah, and Wayne counties;(c) age of each enrollee, as of the date of the policy issuance or renewal, in accordance with the Utah Individual and Small Employer Health Benefit Plan Age Curve; and(d) tobacco rate factor, not greater than 1.5.(3) R590-277-7(2) does not apply to:(a) a large employer health benefit plan; or(b) an individual or small employer health benefit plan issued prior to January 1, 2014 in which the policy rating complies with:(i) Title 31A-30, Individual, Small Employer, and Group Health Insurance Act; and(ii) Rule R590-167, Individual, Small Employer, and Group Health Benefit Plan Rule.Utah Admin. Code R590-277-7
Adopted by Utah State Bulletin Number 2019-18, effective 8/20/2019