This version of the form is not currently in use and is provided for reference only. Download this version of the document for the current year.
Utah Accident & Health Insurance Request for Discretionary Group Authorization is a legal document that was released by the Utah Insurance Department - a government authority operating within Utah.
Q: What is the Utah Accident & Health Insurance Request for Discretionary Group Authorization?
A: The Utah Accident & Health Insurance Request for Discretionary Group Authorization is a form used to request authorization for a discretionary group health insurance plan in Utah.
Q: What is a discretionary group health insurance plan?
A: A discretionary group health insurance plan is a type of health insurance plan that allows the insurer to exercise discretion in determining coverage and benefits.
Q: Who can use the Utah Accident & Health Insurance Request for Discretionary Group Authorization?
A: Insurance companies or organizations offering discretionary group health insurance plans in Utah can use this form.
Q: What information is required in the form?
A: The form requires details such as the insurer's name, contact information, a description of the health insurance plan, and supporting documents.
Form Details:
Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Utah Insurance Department.