Section R590-167-3 - DefinitionsTerms used in this rule are defined in Sections 31A-1-301 and 31A-30-103. Additional terms are defined as follows:
(1) "Act" means Title 31A, Chapter 30, Individual, Small Employer, and Group Health Insurance Act.(2) "Change in a rating factor" means the cumulative change of a rating factor over a 12-month period.(3) "Change in rating method" means: (a) a change in the number of case characteristics used to determine health benefit plan premium rates in a class of business;(b) a change in the manner or procedure by which an insured is assigned into a category for applying a case characteristic to determine health benefit plan premium rates in a class of business;(c) a change in the method of allocating expenses among health benefit plans in a class of business; or(d) a change in one or more rating factors for any case characteristic if the change produces a change in premium for an individual or small employer that exceeds 10%.(4) "New entrant" means an eligible employee, or a dependent of an eligible employee, who becomes part of a small employer group after the initial period for enrollment in a health benefit plan.(5) "Risk characteristic" means a rating factor related to the demographics, health status, or experience of an individual, a small employer, or a member of a small employer group, other than a case characteristic under Section 31A-30-106 or 31A-30-106.1, as applicable, including:(f) duration of coverage; or(g) any similar characteristic.(6) "Risk load" means the percentage above the base premium rate charged by a covered carrier to a covered insured reflecting the risk characteristics of the covered individual.Utah Admin. Code R590-167-3
Adopted by Utah State Bulletin Number 2024-05, effective 2/21/2024