Instructions & Forms
The 2018 Utah Open Enrollment Survey (January) is the first data call specifically for Utah’s individual, small group, and large group comprehensive hospital & medical markets. The purpose of this survey is to measure what the enrollment of Utah’s individual, small group, and large group markets was during open enrollment as of January 1, 2018. This the first of two data calls related to the 2018 Utah Open Enrollment Survey. The second data call is the 2018 Utah Open Enrollment Survey (March), which will be due in May 2018. The second data call will request the same type of data as the first data call but will be after Utah’s special enrollment period ends.
Who is required to file?
All Fraternal, Health, Life and Property & Casualty insurers in Utah who offer Comprehensive Hospital & Medical (Major Medical) Insurance in either the Individual or Small Group or Large Group Markets are required to complete and file this survey. All other insurers are exempt. The completed survey form should be sent to the Utah Insurance Department by February 23, 2018. Failure to file by the deadline may subject your company to the enforcement penalties under Utah Code Annotated § 31A-2-308.
Please review the instructions and new survey form carefully so that you will understand how to report your data. This will reduce the number of corrections after the survey is filed. However, as always we will work with you to understand and file the survey form.
The Utah Insurance Department has made a change in how it handles the security of electronic transmissions. As of January 1, 2017, the Utah Insurance Department will only accept electronic submissions of the Utah Accident & Health Survey as an Excel spreadsheet via the UID secure file upload website at: https://forms.uid.utah.gov/insurance/fileUploads/. The website address is case sensitive.
Any other forms of data submission are not acceptable. Also, do not make any changes to the formatting of the Excel survey form. This file is designed to allow us to import your data directly into a software database, while attempting to remain “user friendly”. Any changes to the line numbers, columns, or other parts of the survey form (other than simple data entry) may cause errors when we import your survey form.
Also, a new transmittal form has been added to assist companies with filing their surveys through the UID secure file upload site. Please remember to add your 5-digit NAIC company code to each file that you submit through the UID secure file upload site.
Please remember each insurer is required to file a complete survey. In cases where your company has nothing to report, answer with a “0” rather than leaving a section blank. To make this easier, we have pre-populated the survey with sample data, so that you can change just the sections that are applicable to your company. This includes providing a contact person, with correct contact information, including a valid telephone number and email address.
Please note that all data in the survey form should be whole numbers. Use of decimals creates rounding errors when the data is processed.
Also, please only submit one company per Excel form. Filings with multiple companies in multiple Excel sheets will not import correctly.
How to get the survey
Please download the instructions, the signature form, and the survey form using the links available below. Right-click on each link and select “Save Target As” to download each file to your computer.
The survey instructions and signature form are available in Adobe PDF format. The survey form is available as a data entry form in Microsoft Excel format.
Insurers are expected to read the instructions before completing the form. Questions regarding the survey should be directed to Daron Funn, Research Assistant at email@example.com.
Survey Instructions in Adobe PDF format:
Signature Form in Adobe PDF format:
(Please note that the Signature Form should be submitted along with the Survey Form.)
Transmittal Form in Adobe PDF format
(Please note that the Transmittal Form should be submitted along with all filings submitted through the UID secure file upload site.)
Survey Form in Microsoft Excel format: