31A-30-110 - Individual enrollment cap. - Utah Statutes

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31A-30-110. Individual enrollment cap.
(1) The commissioner shall set the individual enrollment cap at .5% on July 1, 1997.
(2) The commissioner shall raise the individual enrollment cap by .5% at the later of thefollowing dates:
(a) six months from the last increase in the individual enrollment cap; or
(b) the date when CCI/TI is greater than .90, where:
(i) "CCI" is the total individual coverage count for all carriers certifying that theiruninsurable percentage has reached the individual enrollment cap; and
(ii) "TI" is the total individual coverage count for all carriers.
(3) The commissioner may establish a minimum number of uninsurable individuals that acarrier entering the market who is subject to this chapter must accept under the individualenrollment provisions of this chapter.
(4) Beginning July 1, 1997, an individual carrier may decline to accept individualsapplying for individual enrollment under Subsection 31A-30-108(3), other than individualsapplying for coverage as set forth in P.L. 104-191, 110 Stat. 1979, Sec. 2741 (a)-(b), if:
(a) the uninsurable percentage for that carrier equals or exceeds the cap established inSubsection (1); and
(b) the covered carrier has certified on forms provided by the commissioner that itsuninsurable percentage equals or exceeds the individual enrollment cap.
(5) The department may audit a carrier's records to verify whether the carrier'suninsurable classification meets industry standards for underwriting criteria as established by thecommissioner in accordance with Subsection 31A-30-106(1)(i).
(6) (a) If the commissioner determines that individual enrollment is causing a substantialadverse effect on premiums, enrollment, or experience, the commissioner may suspend, limit, ordelay further individual enrollment for up to 12 months.
(b) The commissioner shall adopt rules to establish a uniform methodology forcalculating and reporting loss ratios for individual policies for determining whether the individualenrollment provisions of Section 31A-30-108 should be waived for an individual carrierexperiencing significant and adverse financial impact as a result of complying with thoseprovisions.

Amended by Chapter 308, 2002 General Session

State Codes and Statutes

Statutes > Utah > Title-31a > Chapter-30 > 31a-30-110

31A-30-110. Individual enrollment cap.
(1) The commissioner shall set the individual enrollment cap at .5% on July 1, 1997.
(2) The commissioner shall raise the individual enrollment cap by .5% at the later of thefollowing dates:
(a) six months from the last increase in the individual enrollment cap; or
(b) the date when CCI/TI is greater than .90, where:
(i) "CCI" is the total individual coverage count for all carriers certifying that theiruninsurable percentage has reached the individual enrollment cap; and
(ii) "TI" is the total individual coverage count for all carriers.
(3) The commissioner may establish a minimum number of uninsurable individuals that acarrier entering the market who is subject to this chapter must accept under the individualenrollment provisions of this chapter.
(4) Beginning July 1, 1997, an individual carrier may decline to accept individualsapplying for individual enrollment under Subsection 31A-30-108(3), other than individualsapplying for coverage as set forth in P.L. 104-191, 110 Stat. 1979, Sec. 2741 (a)-(b), if:
(a) the uninsurable percentage for that carrier equals or exceeds the cap established inSubsection (1); and
(b) the covered carrier has certified on forms provided by the commissioner that itsuninsurable percentage equals or exceeds the individual enrollment cap.
(5) The department may audit a carrier's records to verify whether the carrier'suninsurable classification meets industry standards for underwriting criteria as established by thecommissioner in accordance with Subsection 31A-30-106(1)(i).
(6) (a) If the commissioner determines that individual enrollment is causing a substantialadverse effect on premiums, enrollment, or experience, the commissioner may suspend, limit, ordelay further individual enrollment for up to 12 months.
(b) The commissioner shall adopt rules to establish a uniform methodology forcalculating and reporting loss ratios for individual policies for determining whether the individualenrollment provisions of Section 31A-30-108 should be waived for an individual carrierexperiencing significant and adverse financial impact as a result of complying with thoseprovisions.

Amended by Chapter 308, 2002 General Session

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State Codes and Statutes

Statutes > Utah > Title-31a > Chapter-30 > 31a-30-110

31A-30-110. Individual enrollment cap.
(1) The commissioner shall set the individual enrollment cap at .5% on July 1, 1997.
(2) The commissioner shall raise the individual enrollment cap by .5% at the later of thefollowing dates:
(a) six months from the last increase in the individual enrollment cap; or
(b) the date when CCI/TI is greater than .90, where:
(i) "CCI" is the total individual coverage count for all carriers certifying that theiruninsurable percentage has reached the individual enrollment cap; and
(ii) "TI" is the total individual coverage count for all carriers.
(3) The commissioner may establish a minimum number of uninsurable individuals that acarrier entering the market who is subject to this chapter must accept under the individualenrollment provisions of this chapter.
(4) Beginning July 1, 1997, an individual carrier may decline to accept individualsapplying for individual enrollment under Subsection 31A-30-108(3), other than individualsapplying for coverage as set forth in P.L. 104-191, 110 Stat. 1979, Sec. 2741 (a)-(b), if:
(a) the uninsurable percentage for that carrier equals or exceeds the cap established inSubsection (1); and
(b) the covered carrier has certified on forms provided by the commissioner that itsuninsurable percentage equals or exceeds the individual enrollment cap.
(5) The department may audit a carrier's records to verify whether the carrier'suninsurable classification meets industry standards for underwriting criteria as established by thecommissioner in accordance with Subsection 31A-30-106(1)(i).
(6) (a) If the commissioner determines that individual enrollment is causing a substantialadverse effect on premiums, enrollment, or experience, the commissioner may suspend, limit, ordelay further individual enrollment for up to 12 months.
(b) The commissioner shall adopt rules to establish a uniform methodology forcalculating and reporting loss ratios for individual policies for determining whether the individualenrollment provisions of Section 31A-30-108 should be waived for an individual carrierexperiencing significant and adverse financial impact as a result of complying with thoseprovisions.

Amended by Chapter 308, 2002 General Session