31A-2-201.2 - Evaluation of health insurance market.
31A-2-201.2. Evaluation of health insurance market.
(1) Each year the commissioner shall:
(a) conduct an evaluation of the state's health insurance market;
(b) report the findings of the evaluation to the Health and Human Services InterimCommittee before October 1 of each year; and
(c) publish the findings of the evaluation on the department website.
(2) The evaluation required by this section shall:
(a) analyze the effectiveness of the insurance regulations and statutes in promoting ahealthy, competitive health insurance market that meets the needs of the state, and includes ananalysis of:
(i) the availability and marketing of individual and group products;
(ii) rate changes;
(iii) coverage and demographic changes;
(iv) benefit trends;
(v) market share changes; and
(vi) accessibility;
(b) assess complaint ratios and trends within the health insurance market, whichassessment shall include complaint data from the Office of Consumer Health Assistance withinthe department;
(c) contain recommendations for action to improve the overall effectiveness of the healthinsurance market, administrative rules, and statutes; and
(d) include claims loss ratio data for each health insurance company doing business inthe state.
(3) When preparing the evaluation required by this section, the commissioner shallinclude a report of:
(a) the types of health benefit plans sold in the Health Insurance Exchange created inSection 63M-1-2504;
(b) the number of insurers participating in the defined contribution arrangement healthbenefit plans in the Health Insurance Exchange;
(c) the number of employers and covered lives in the defined contribution arrangementmarket in the Health Insurance Exchange; and
(d) the number of lives covered by health benefit plans that do not include state mandatesas permitted by Subsection 31A-30-109(2).
(4) When preparing the evaluation and report required by this section, the commissionermay seek the input of insurers, employers, insured persons, providers, and others with an interestin the health insurance market.
(5) The commissioner may adopt administrative rules for the purpose of collecting thedata required by this section, taking into account the business confidentiality of the insurers.
(6) Records submitted to the commissioner under this section shall be maintained by thecommissioner as protected records under Title 63G, Chapter 2, Government Records Access andManagement Act.
Enacted by Chapter 68, 2010 General Session