Section R590-146-18 - Requirements for Application Forms and Replacement Coverage(1)(a) An application form shall include questions designed to elicit information as to whether, as of the date of the application, the applicant: (i) has Medicare supplement insurance, Medicare Advantage coverage, Medicaid coverage, or other accident and health insurance currently in force; or(ii) intends to replace any other accident and health insurance policy or certificate currently in force.(b) A supplementary application or other form to be signed by the applicant and producer containing the questions and statements in the Application Supplementary Statements and Questions may be used.(2) A producer shall list all other health insurance policies they have sold to the applicant, including a list of each policy sold:(a) that is still in force; and(b) in the past five years, that is no longer in force.(3) In the case of a direct response issuer, a copy of the application or supplemental form, signed by the applicant and acknowledged by the issuer, shall be returned to the applicant by the issuer at policy delivery.(4)(a) Upon determining a sale will involve Medicare supplement insurance coverage replacement, an issuer, other than a direct response issuer or its producer, shall provide to the applicant, prior to issuance or delivery of the policy or certificate, the Notice to Applicant Regarding Replacement of Medicare Supplement Insurance or Medicare Advantage.(b) One copy of the notice signed by the applicant and the producer, except when the coverage is sold without a producer, shall be provided to the applicant and an additional signed copy shall be retained by the issuer.(c) A direct response issuer shall deliver to the applicant when issuing the policy the Notice to Applicant Regarding Replacement of Medicare Supplement Insurance or Medicare Advantage.(d) The notice shall be provided in substantially the same format in no less than 12-point font.(5) Paragraphs one and two of the notice may be deleted by an issuer if the replacement does not involve application of a new preexisting condition limitation.Utah Admin. Code R590-146-18
Amended by Utah State Bulletin Number 2019-13, effective 6/7/2019Adopted by Utah State Bulletin Number 2024-16, effective 8/7/2024