R590-235-4. Licensure and Regulatory Requirements

(1) A stand-alone Medicare PDP sponsor shall be licensed as a risk-bearing entity in the jurisdiction where the sponsor proposes to serve Medicare Part D beneficiaries. (2) A stand-alone Medicare PDP may be licensed and regulated as either a Utah domiciled health maintenance organization (HMO), a limited health plan, or a Utah domiciled or foreign indemnity insurer. (a) Regulatory requirements for a Utah domiciled stand-alone Medicare PDP organized as an HMO or limited health plan are established by Title 31A, Chapter 8, Health Maintenance Organizations and Limited Health Plans. (b) Regulatory requirements for a Utah domiciled stand-alone Medicare PDP organized as an indemnity insurer are established by Title 31A, Chapter 5, Domestic Stock and Mutual Insurance Corporations. (c) Regulatory requirements for a foreign indemnity insurer are established by Title 31A, Chapter 14, Foreign Insurers. (3) A stand-alone Medicare PDP shall file Quarterly and Annual Statement Blanks pursuant to the instructions provided by the NAIC and in accordance with statutory accounting principles. (4) A stand-alone Medicare PDP applicant shall apply for licensure using the appropriate NAIC Uniform Certificate of Authority Application form: (a) Primary Application Form, for a Utah domiciled insurer stand-alone Medicare PDP; or (b) Expansion Application Form, for a foreign indemnity insurer stand-alone Medicare PDP.