Section R590-283-5 - Unified Rate Review Template, Rate Data Template, and Plans and Benefits Template Modifications(1) A carrier that expects to be eligible to receive a defrayal payment shall modify a federal rate filing template as follows:(a) exclude the expected defrayal payment from the rates submitted on both the Unified Rate Review Template and the Rate Data Template;(b) indicate in the rate filing's actuarial memorandum: (i) whether the carrier anticipates a defrayal payment from the state for the cost of an eligible state-required benefit;(ii) that the cost of the state-required benefit is not included in the premiums; and(iii) the defrayal payment amount the carrier expects to receive; and(c) indicate in the "Benefits Information" field on the Plans and Benefits Template that the carrier covers the state-required benefits, selecting the state-required benefit of "Not EHB" for the "EHB Variance Reason" field.(2)(a) A carrier may not factor a state-required benefit into the calculation for the "EHB Percent of Total Premium" field on the Plans and Benefits Template.(b) A state-required benefit may not be included in the total premium from which the "EHB Percent of Total Premium" field is calculated.Utah Admin. Code R590-283-5
Adopted by Utah State Bulletin Number 2020-02, effective 12/23/2019Amended by Utah State Bulletin Number 2022-04, effective 2/8/2022Amended by Utah State Bulletin Number 2022-21, effective 10/24/2022