UT| The Utah Insurance Department Bulletin 2026-2 sets PY2027 filing timelines and technical requirements for Utah individual and small employer health benefit plans and stand‑alone dental plans, emphasizes complete and compliant SERFF binder/form/rate submissions (with required attestations, MHPAEA analyses, and use of CCIIO tools), and reiterates ongoing federal and state standards for market reforms, network adequacy, EHBs, MHPAEA, No Surprises Act compliance, rating, and SADP certification responsibilities for insurers.
Key Points:
- Substantive standards: plans must follow detailed federal and Utah requirements on market reforms, licensure/solvency, network adequacy and provider directories, accreditation, service areas, quality improvement, EHBs and formularies, non‑discrimination, quality reporting, No Surprises Act (including ground ambulance), MHPAEA parity (with autism now treated as mental health and no state defrayal), actuarial value/CSR variations, rating rules and rating areas, and pediatric dental EHB for SADPs.
- Key deadlines: medical forms/binders (small group May 6, 2026; individual May 18–27, 2026), network/service area changes (June 24, 2026), rates/URRT (small group June 10; individual June 24; transparency changes July 16; final rates August 13), and SADP complete filings for both markets by June 1, 2026, all by 10 a.m. MDT.
- Filing mechanics: separate, timely binders per risk pool with full product/plan inventories and required attestations; distinct form vs. rate filings (no rates in forms and no forms in rates); CSR loading to on‑exchange silver, expanded bronze documentation, MHPAEA quantitative/comparative analyses, Plan Crosswalk and AV Calculator support, and special handling for discontinuances, UPDs, and transitional business.