Exemptions from standards.

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  • (1) the Department of Health offers a choice of coverage as part of a Medicaid waiver under Title 26, Chapter 18, Medical Assistance Act, which includes:
    • (a) less or different coverage than the basic coverage;
    • (b) less or different coverage than is otherwise required in an insurance policy or health maintenance organization contract under applicable state law; or
    • (c) less or different coverage than required by Subsection 31A-22-605(4)(b); and
  • (2) the choice of coverage offered by the carrier:
    • (a) is the same or similar coverage as the coverage offered by the Department of Health under Subsection (1);
    • (b) is offered to the same or similar population as the coverage offered by the Department of Health under Subsection (1); and
    • (c) contains an explanation for each insured of coverage exclusions and limitations.




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