31A-22-636.  Standardized health insurance information cards.

(1)  As used in this section, “insurer” means:

Terms Used In Utah Code 31A-22-636

  • Administrator: means the same as that term is defined in Subsection (182). See Utah Code 31A-1-301
  • Department: means the Insurance Department. See Utah Code 31A-1-301
  • Health benefit plan: means a policy, contract, certificate, or agreement offered or issued by an insurer to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care, including major medical expense coverage. See Utah Code 31A-1-301
  • Health care: means any of the following intended for use in the diagnosis, treatment, mitigation, or prevention of a human ailment or impairment:
(a) a professional service;
(b) a personal service;
(c) a facility;
(d) equipment;
(e) a device;
(f) supplies; or
(g) medicine. See Utah Code 31A-1-301
  • health insurance: means insurance providing:
    (i) a health care benefit; or
    (ii) payment of an incurred health care expense. See Utah Code 31A-1-301
  • Insurance: includes :
    (i) a risk distributing arrangement providing for compensation or replacement for damages or loss through the provision of a service or a benefit in kind;
    (ii) a contract of guaranty or suretyship entered into by the guarantor or surety as a business and not as merely incidental to a business transaction; and
    (iii) a plan in which the risk does not rest upon the person who makes an arrangement, but with a class of persons who have agreed to share the risk. See Utah Code 31A-1-301
  • Person: includes :
    (a) an individual;
    (b) a partnership;
    (c) a corporation;
    (d) an incorporated or unincorporated association;
    (e) a joint stock company;
    (f) a trust;
    (g) a limited liability company;
    (h) a reciprocal;
    (i) a syndicate; or
    (j) another similar entity or combination of entities acting in concert. See Utah Code 31A-1-301
  • Policy: includes a service contract issued by:
    (i) a motor club under Chapter 11, Motor Clubs;
    (ii) a service contract provided under Chapter 6a, Service Contracts; and
    (iii) a corporation licensed under:
    (A) Chapter 7, Nonprofit Health Service Insurance Corporations; or
    (B) Chapter 8, Health Maintenance Organizations and Limited Health Plans. See Utah Code 31A-1-301
  • State: when applied to the different parts of the United States, includes a state, district, or territory of the United States. See Utah Code 68-3-12.5
  • (a)  an insurer governed by this part as described in Section 31A-22-600;

    (b)  a health maintenance organization governed by Chapter 8, Health Maintenance Organizations and Limited Health Plans;

    (c)  a third party administrator; and

    (d)  notwithstanding Subsection 31A-1-103(3)(f) and Section 31A-22-600, a health, medical, or conversion policy offered under Title 49, Chapter 20, Public Employees’ Benefit and Insurance Program Act.

    (2)  In accordance with Subsection (3), an insurer shall use and issue a health benefit plan information card for the insurer’s enrollees upon the purchase or renewal of, or enrollment in, a health benefit plan.

    (3)  The health benefit plan information card shall include:

    (a)  the covered person‘s name;

    (b)  the name of the carrier and the carrier network name;

    (c)  the contact information for the carrier or health benefit plan administrator;

    (d)  general information regarding copayments and deductibles; and

    (e)  an indication of whether the health benefit plan is regulated by the state.

    (4) 

    (a)  The commissioner shall work with the Department of Health and Human Services, the Health Data Authority, health care providers groups, and with state and national organizations that develop uniform standards for the electronic exchange of health insurance claims or uniform standards for the electronic exchange of clinical health records.

    (b)  The commissioner may make rules in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, to adopt standardized electronic interchange technology.

    (c)  After rules are adopted under Subsection (4)(a), health care providers and their licensing boards under Title 58, Occupations and Professions, and health facilities licensed under 2, shall work together to implement the adoption of card swipe technology.

    Amended by Chapter 328, 2023 General Session