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Utah – Health Insurance Premium Rate Review Laws

If you buy health insurance on the individual market, without help from an employer, you may want to know what Utah is doing to protect you from unfair and unnecessary premium rate increases. Here’s a summary of the Utah laws that govern rate increases.

If you buy health insurance on the individual market, without help from an employer, you may want to know what Utah is doing to protect you from unfair and unnecessary premium rate increases.  Here’s a summary of the Utah laws that govern rate increases.

  • Utah does not have prior approval authority to approve or deny rates before they go into effect.
  • By regulation, insurers must include rates when they file policy forms for individual accident and health policies.  U.A.C. R590-85-4.  Forms can be used as soon as they are filed.  Utah Code Ann. § 31A-21-201
  • The benefits for individual accident and health insurance policies must be “reasonable in relation to the premiums charged.”  Utah Code Ann. § 31A-22-602.  This standard will be met if state medical loss ratio standards are met.  U.A.C. R590-85-5.
  • Each year, insurers must file a certification that rates comply with rate bands.  Utah Code Ann. § 31A-30-106.
IssuesHealth