Section R590-146-11 - Open Enrollment(1)(a) An issuer may not deny or condition the issuance or effectiveness of a policy or certificate available for sale in this state, nor discriminate in the pricing of a policy or certificate because of the health status, claims experience, receipt of health care, or medical condition of an applicant in the case of an application for a policy or certificate that is submitted prior to or during the six month period beginning with the first day of the first month in which an individual is both 65 years of age or older and is enrolled for benefits under Medicare Part B.(b) Each policy or certificate currently available from an issuer shall be available to an applicant who qualifies under this section regardless of age.(c) During an applicant's open enrollment period, an issuer shall offer the lowest rate available to an applicant without regard to health or smoker status.(2)(a) An issuer may not exclude benefits based on a preexisting condition if an applicant described in Subsection (1) has had a continuous period of creditable coverage of at least six months.(b) An issuer shall reduce the period of a preexisting condition exclusion by the aggregate of the period of creditable coverage if an applicant, described in Subsection (1), as of the date of application, has had a continuous period of creditable coverage that is less than six months. The Secretary shall specify the manner of the reduction under this subsection.(3) Except as provided in Subsection (2) and Sections R590-146-12 and R590-146-13, Subsection (1) may not be construed as preventing the exclusion of benefits under a policy, during the first six months, for a preexisting condition.Utah Admin. Code R590-146-11
Amended by Utah State Bulletin Number 2019-13, effective 6/7/2019Adopted by Utah State Bulletin Number 2024-16, effective 8/7/2024