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S.B. 115
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5 AN ACT RELATING TO INSURANCE; AMENDING DEFINITION OF EXCESS SURPLUS;
6 CLARIFYING AND AMENDING PENALTY PROVISIONS; CLARIFYING METHOD FOR
7 OFFSETTING EXAMINATION EXPENSES AGAINST PREMIUM TAX LIABILITY;
8 AMENDING METHOD FOR ISSUING CERTIFICATE OF AUTHORITY TO A HEALTH
9 MAINTENANCE ORGANIZATION; CLARIFYING CLASS OF INSURERS THAT MUST
10 MAINTAIN RISK-BASED CAPITAL; CLARIFYING INSTANCES IN WHICH A PLAN TO
11 DISTRIBUTE DIVIDENDS MUST BE FILED UNDER SECTION 31A-19-405; AMENDING
12 MEDICARE LANGUAGE AT DIRECTION OF FEDERAL GOVERNMENT; CLARIFYING
13 JURISDICTION OF THE COMMISSIONER OVER OFFICERS OF LICENSED AGENCIES;
14 CLARIFYING INSTANCES IN WHICH A COMMISSION MAY BE SHARED, PAID, OR
15 RECEIVED; AMENDING CLAIM ESTIMATION PROCEDURES FOR CONTINGENT OR
16 UNLIQUIDATED CLAIMS; AMENDING FINANCIAL ASSESSMENTS OF INSURERS;
17 CLARIFYING THE ELEMENTS OF WORKERS' COMPENSATION FRAUD; MAKING
18 TECHNICAL AMENDMENTS; AND PROVIDING AN EFFECTIVE DATE.
19 This act affects sections of Utah Code Annotated 1953 as follows:
20 AMENDS:
21 31A-1-301, as last amended by Chapter 9, Laws of Utah 1996, Second Special Session
22 31A-2-202, as enacted by Chapter 242, Laws of Utah 1985
23 31A-2-205, as last amended by Chapter 2, Laws of Utah 1987
24 31A-8-104, as enacted by Chapter 204, Laws of Utah 1986
25 31A-15-111, as last amended by Chapter 5, Laws of Utah 1991
26 31A-17-602, as enacted by Chapter 9, Laws of Utah 1996, Second Special Session
27 31A-17-609, as enacted by Chapter 9, Laws of Utah 1996, Second Special Session
1 31A-18-108, as last amended by Chapter 9, Laws of Utah 1996, Second Special Session
2 31A-19-405, as repealed and reenacted by Chapter 205, Laws of Utah 1992
3 31A-22-620, as last amended by Chapter 9, Laws of Utah 1996, Second Special Session
4 31A-23-215, as last amended by Chapter 9, Laws of Utah 1996, Second Special Session
5 31A-23-217, as last amended by Chapter 9, Laws of Utah 1996, Second Special Session
6 31A-23-307, as last amended by Chapter 164, Laws of Utah 1990
7 31A-23-404, as last amended by Chapter 95, Laws of Utah 1987
8 31A-26-210, as last amended by Chapter 204, Laws of Utah 1986
9 31A-26-214, as last amended by Chapter 9, Laws of Utah 1996, Second Special Session
10 31A-27-102, as last amended by Chapter 9, Laws of Utah 1996, Second Special Session
11 31A-27-330.5, as enacted by Chapter 9, Laws of Utah 1996, Second Special Session
12 31A-31-108 (Effective 07/01/97), as last amended by Chapter 240, Laws of Utah 1996
13 35A-3-114 (Effective 07/01/97), as renumbered and amended by Chapter 240, Laws of Utah
14 1996
15 59-9-102, as renumbered and amended by Chapter 2, Laws of Utah 1987
16 Be it enacted by the Legislature of the state of Utah:
17 Section 1. Section 31A-1-301 is amended to read:
18 31A-1-301. Definitions.
19 As used in this title, unless otherwise specified:
20 (0.5) "Administrator" is defined in Subsection (77).
21 (1) "Adult" means a natural person who has attained the age of at least 18 years.
22 (2) "Affiliate" means any person who controls, is controlled by, or is under common
23 control with, another person. A corporation is an affiliate of another corporation, regardless of
24 ownership, if substantially the same group of natural persons manages the corporations.
25 (3) "Alien insurer" means an insurer domiciled outside the United States.
26 (4) "Annuities" means all agreements to make periodical payments for a period certain or
27 over the lifetime of one or more natural persons if the making or continuance of all or some of the
28 series of the payments, or the amount of the payment, is dependent upon the continuance of human
29 life.
30 (5) "Articles" or "articles of incorporation" means the original articles, special laws,
31 charters, amendments, restated articles, articles of merger or consolidation, trust instruments, and
1 other constitutive documents for trusts and other entities that are not corporations, and
2 amendments to any of these. Refer also to "bylaws" in this section and Section 31A-5-203.
3 (6) "Bail bond insurance" means a guarantee that a person will attend court when required,
4 or will obey the orders or judgment of the court, as a condition to the release of that person from
5 confinement.
6 (7) "Binder" is defined in Section 31A-21-102.
7 (8) "Board," "board of trustees," or "board of directors" means the group of persons with
8 responsibility over, or management of, a corporation, however designated. Refer also to "trustee"
9 in this section.
10 (9) "Business of insurance" is defined in Subsection (44).
11 (10) "Business plan" means the information required to be supplied to the commissioner
12 under Subsections 31A-5-204(2)(i) and (j), including the information required when these
13 subsections are applicable by reference under Section 31A-7-201, Section 31A-8-205, or
14 Subsection 31A-9-205(2).
15 (11) "Bylaws" means the rules adopted for the regulation or management of a corporation's
16 affairs, however designated. It includes comparable rules for trusts and other entities that are not
17 corporations. Refer also to "articles" and Section 31A-5-203.
18 (12) "Casualty insurance" means liability insurance as defined in Subsection (50).
19 (13) "Certificate" means the evidence of insurance given to an insured under a group
20 policy.
21 (14) "Certificate of authority" is included within the term "license."
22 (14.5) "Claim," unless the context otherwise requires, means a request or demand on an
23 insurer for payment of benefits according to the terms of an insurance policy.
24 (14.6) "Claims-made coverage" means any insurance contract or provision limiting
25 coverage under a policy insuring against legal liability to claims that are first made against the
26 insured while the policy is in force.
27 (15) "Commissioner" or "commissioner of insurance" means Utah's insurance
28 commissioner. Where appropriate, these terms apply to the equivalent supervisory official of
29 another jurisdiction.
30 (16) "Control," "controlling," "controlled," or "under common control" means the direct
31 or indirect possession of the power to direct or cause the direction of the management and policies
1 of a person. This control may be by contract, by common management, through the ownership
2 of voting securities, or otherwise. There is no presumption that an individual holding an official
3 position with another person controls that person solely by reason of the position. A person having
4 a contract or arrangement giving control is considered to have control despite the illegality or
5 invalidity of the contract or arrangement. There is a rebuttable presumption of control in a person
6 who directly or indirectly owns, controls, holds with the power to vote, or holds proxies to vote
7 10% or more of the voting securities of another person. Refer also to "affiliate" in this section.
8 (17) (a) "Corporation" means insurance corporation, except where referring under Chapter
9 23, Insurance Marketing - Licensing Agents, Brokers and Consultants, and Reinsurance
10 Intermediaries, and Chapter 26, Insurance Adjusters, to corporations doing business as insurance
11 agents, brokers, consultants, or adjusters, or where referring under Chapter 16, Insurance Holding
12 Companies, to a noninsurer which is part of a holding company system.
13 (b) "Stock corporation" means stock insurance corporation.
14 (c) "Mutual" or "mutual corporation" means mutual insurance corporation.
15 (18) "Credit disability insurance" means insurance on a debtor to provide indemnity for
16 payments coming due on a specific loan or other credit transaction while the debtor is disabled.
17 Refer also to Subsection 31A-22-802(1).
18 (19) "Credit insurance" means surety insurance under which mortgagees and other
19 creditors are indemnified against losses caused by the default of debtors.
20 (20) "Credit life insurance" means insurance on the life of a debtor in connection with a
21 loan or other credit transaction. Refer also to Subsection 31A-22-802(2).
22 (21) "Creditor" means a person, including an insured, having any claim, whether matured,
23 unmatured, liquidated, unliquidated, secured, unsecured, absolute, fixed, or contingent.
24 (22) "Deemer clause" means a provision under this title under which upon the occurrence
25 of a condition precedent, the commissioner is deemed to have taken a specific action. If the statute
26 so provides, the condition precedent may be the commissioner's failure to take a specific action.
27 Refer also to Section 31A-2-302.
28 (23) "Degree of relationship" means the number of steps between two persons determined
29 by counting the generations separating one person from a common ancestor and then counting the
30 generations to the other person.
31 (24) "Department" means the Insurance Department.
1 (25) "Director" means a member of the board of directors of a corporation.
2 (26) "Disability insurance" means insurance written to indemnify for losses and expenses
3 resulting from accident or sickness, to provide payments to replace income lost from accident or
4 sickness, and to pay for services resulting directly from accident or sickness, including medical,
5 surgical, hospital, and other ancillary expenses.
6 (27) "Domestic insurer" means an insurer organized under the laws of this state.
7 (28) "Domiciliary state" means the state in which an insurer is incorporated or organized
8 or, in the case of an alien insurer, the state of entry into the United States.
9 (29) "Employee benefits" means one or more benefits or services provided employees or
10 their dependents.
11 (30) "Employee welfare fund" means a fund established or maintained by one or more
12 employers, one or more labor organizations, or a combination of employers and labor
13 organizations, whether directly or through trustees. This fund is to provide employee benefits paid
14 or contracted to be paid, other than income from investments of the fund, by or on behalf of an
15 employer doing business in this state or for the benefit of any person employed in this state. It
16 includes plans funded or subsidized by user fees or tax revenues.
17 (31) "Excludes" is not exhaustive and does not mean that other things are not also
18 excluded. The items listed are representative examples for use in interpretation of this title.
19 (31.5) "Fidelity insurance" means insurance guaranteeing the fidelity of persons holding
20 positions of public or private trust.
21 (31.7) "First party insurance" means an insurance policy or contract in which the insurer
22 agrees to pay claims submitted to it by the insured for the insured's losses.
23 (32) "Foreign insurer" means an insurer domiciled outside of this state, including an alien
24 insurer.
25 (33) "Form" means a policy, certificate, or application prepared for general use. It does
26 not include one specially prepared for use in an individual case. Refer also to "policy" in this
27 section.
28 (34) "Franchise insurance" means individual insurance policies provided through a mass
29 marketing arrangement involving a defined class of persons related in some way other than
30 through the purchase of insurance.
31 (35) "Health care insurance" or "health insurance" means disability insurance providing
1 benefits solely of medical, surgical, hospital, or other ancillary services or payment of medical,
2 surgical, hospital, or other ancillary expenses incurred. "Health care insurance" or "health
3 insurance" does not include disability insurance providing benefits for:
4 (a) replacement of income;
5 (b) short-term accident;
6 (c) fixed indemnity;
7 (d) credit disability;
8 (e) supplements to liability;
9 (f) workers' compensation;
10 (g) automobile medical payment;
11 (h) no-fault automobile;
12 (i) equivalent self-insurance; or
13 (j) any type of disability insurance coverage that is a part of or attached to another type of
14 policy.
15 (35.5) "Indemnity" means the payment of an amount to offset all or part of an insured loss.
16 (36) "Independent adjuster" means an insurance adjuster required to be licensed under
17 Section 31A-26-201 who engages in insurance adjusting as a representative of insurers. Refer also
18 to Section 31A-26-102.
19 (37) "Independently procured insurance" means insurance procured under Section
20 31A-15-104.
21 (37.5) "Individual" means a natural person.
22 (38) "Inland marine insurance" includes insurance covering:
23 (a) property in transit on or over land;
24 (b) property in transit over water by means other than boat or ship;
25 (c) bailee liability;
26 (d) fixed transportation property such as bridges, electric transmission systems, radio and
27 television transmission towers and tunnels; and
28 (e) personal and commercial property floaters.
29 (39) "Insolvency" means that:
30 (a) an insurer is unable to pay its debts or meet its obligations as they mature;
31 (b) an insurer's total adjusted capital is less than the insurer's mandatory control level RBC
1 under Subsection 31A-17-601(7)(c); or
2 (c) an insurer is determined to be hazardous under this title.
3 (40) "Insurance" means any arrangement, contract, or plan for the transfer of a risk or risks
4 from one or more persons to one or more other persons, or any arrangement, contract, or plan for
5 the distribution of a risk or risks among a group of persons that includes the person seeking to
6 distribute his risk. "Insurance" includes:
7 (a) risk distributing arrangements providing for compensation or replacement for damages
8 or loss through the provision of services or benefits in kind;
9 (b) contracts of guaranty or suretyship entered into by the guarantor or surety as a business
10 and not as merely incidental to a business transaction; and
11 (c) plans in which the risk does not rest upon the person who makes the arrangements, but
12 with a class of persons who have agreed to share it.
13 (41) "Insurance adjuster" means a person who directs the investigation, negotiation, or
14 settlement of a claim under an insurance policy other than life insurance or an annuity, on behalf
15 of an insurer, policyholder, or a claimant under an insurance policy. Refer also to Section
16 31A-26-102.
17 (41.5) "Interinsurance exchange" is defined in Subsection (69).
18 (42) "Insurance agent" or "agent" means a person who represents insurers in soliciting,
19 negotiating, or placing insurance. Refer to Subsection 31A-23-102(3) for exceptions to this
20 definition.
21 (43) "Insurance broker" or "broker" means a person who acts in procuring insurance on
22 behalf of an applicant for insurance or an insured, and does not act on behalf of the insurer except
23 by collecting premiums or performing other ministerial acts. Refer also to Subsection
24 31A-23-102(3) for exceptions to this definition.
25 (44) "Insurance business" or "business of insurance" includes:
26 (a) providing health care insurance, as defined in Subsection (35), by organizations that
27 are or should be licensed under this title;
28 (b) providing benefits to employees in the event of contingencies not within the control
29 of the employees, in which the employees are entitled to the benefits as a right, which benefits may
30 be provided either by single employers or by multiple employer groups through trusts,
31 associations, or other entities;
1 (c) providing annuities, including those issued in return for gifts, except those provided
2 by persons specified in Subsections 31A-22-1305(2) and (3);
3 (d) providing the characteristic services of motor clubs as outlined in Subsection (56);
4 (e) providing other persons with insurance as defined in Subsection (40);
5 (f) making as insurer, guarantor, or surety, or proposing to make as insurer, guarantor, or
6 surety, any contract or policy of title insurance;
7 (g) transacting or proposing to transact any phase of title insurance, including solicitation,
8 negotiation preliminary to execution, execution of a contract of title insurance, insuring, and
9 transacting matters subsequent to the execution of the contract and arising out of it, including
10 reinsurance; and
11 (h) doing, or proposing to do, any business in substance equivalent to Subsections (44)(a)
12 through (g) in a manner designed to evade the provisions of this title.
13 (45) "Insurance consultant" or "consultant" means a person who advises other persons
14 about insurance needs and coverages, is compensated by the person advised on a basis not directly
15 related to the insurance placed, and is not compensated directly or indirectly by an insurer, agent,
16 or broker for advice given. Refer also to Subsection 31A-23-102(3) for exceptions to this
17 definition.
18 (46) "Insurance holding company system" means a group of two or more affiliated
19 persons, at least one of whom is an insurer.
20 (47) "Insured" means a person to whom or for whose benefit an insurer makes a promise
21 in an insurance policy. The term includes policyholders, subscribers, members, and beneficiaries.
22 This definition applies only to the provisions of this title and does not define the meaning of this
23 word as used in insurance policies or certificates.
24 (48) (a) "Insurer" means any person doing an insurance business as a principal, including
25 fraternal benefit societies, issuers of gift annuities other than those specified in Subsections
26 31A-22-1305(2) and (3), motor clubs, employee welfare plans, and any person purporting or
27 intending to do an insurance business as a principal on his own account. It does not include a
28 governmental entity, as defined in Subsection 63-30-2(3), to the extent it is engaged in the
29 activities described in Section 31A-12-107.
30 (b) "Admitted insurer" is defined in Subsection (80)(b).
31 (c) "Alien insurer" is defined in Subsection (3).
1 (d) "Authorized insurer" is defined in Subsection (80)(b).
2 (e) "Domestic insurer" is defined in Subsection (27).
3 (f) "Foreign insurer" is defined in Subsection (32).
4 (g) "Nonadmitted insurer" is defined in Subsection (80)(a).
5 (h) "Unauthorized insurer" is defined in Subsection (80)(a).
6 (49) "Legal expense insurance" means insurance written to indemnify or pay for specified
7 legal expenses. It includes arrangements that create reasonable expectations of enforceable rights,
8 but it does not include the provision of, or reimbursement for, legal services incidental to other
9 insurance coverages. Refer to Section 31A-1-103 for a list of exemptions.
10 (50) (a) "Liability insurance" means insurance against liability:
11 (i) for death, injury, or disability of any human being, or for damage to property, exclusive
12 of the coverages under Subsection (53) for medical malpractice insurance, Subsection (66) for
13 professional liability insurance, and Subsection (83) for workers' compensation insurance;
14 (ii) for medical, hospital, surgical, and funeral benefits to persons other than the insured
15 who are injured, irrespective of legal liability of the insured, when issued with or supplemental to
16 insurance against legal liability for the death, injury, or disability of human beings, exclusive of
17 the coverages under Subsection (53) for medical malpractice insurance, Subsection (66) for
18 professional liability insurance, and Subsection (83) for workers' compensation insurance;
19 (iii) for loss or damage to property resulting from accidents to or explosions of boilers,
20 pipes, pressure containers, machinery, or apparatus;
21 (iv) for loss or damage to any property caused by the breakage or leakage of sprinklers,
22 water pipes and containers, or by water entering through leaks or openings in buildings; or
23 (v) for other loss or damage properly the subject of insurance not within any other kind
24 or kinds of insurance as defined in this chapter, if such insurance is not contrary to law or public
25 policy.
26 (b) "Liability insurance" includes vehicle liability insurance as defined in Subsection (81),
27 residential dwelling liability insurance as defined in Subsection (70.3), and also includes making
28 inspection of, and issuing certificates of inspection upon, elevators, boilers, machinery, and
29 apparatus of any kind when done in connection with insurance on them.
30 (51) "License" means the authorization issued by the insurance commissioner under this
31 title to engage in some activity that is part of or related to the insurance business. It includes
1 certificates of authority issued to insurers.
2 (52) "Life insurance" means insurance on human lives and insurances pertaining to or
3 connected with human life. The business of life insurance includes granting annuity benefits,
4 granting endowment benefits, granting additional benefits in the event of death by accident or
5 accidental means, granting additional benefits in the event of the total and permanent disability of
6 the insured, and providing optional methods of settlement of proceeds.
7 (53) "Medical malpractice insurance" means insurance against legal liability incident to
8 the practice and provision of medical services other than the practice and provision of dental
9 services.
10 (54) "Member" means a person having membership rights in an insurance corporation.
11 Refer also to "insured" in Subsection (47).
12 (55) "Minimum capital" or "minimum required capital" means the capital that must be
13 constantly maintained by a stock insurance corporation as required by statute. Refer also to
14 "permanent surplus" under Subsection (76)(a) and Sections 31A-5-211, 31A-8-209, and
15 31A-9-209.
16 (56) "Motor club" means a person licensed under Chapter 5, Domestic Stock and Mutual
17 Insurance Corporations, Chapter 11, Motor Clubs, or Chapter 14, Foreign Insurers, that promises
18 for an advance consideration to provide legal services under Subsection 31A-11-102(1)(b), bail
19 services under Subsection 31A-11-102(1)(c), trip reimbursement, towing services, emergency road
20 services, stolen automobile services, a combination of these services, or any other services given
21 in Subsections 31A-11-102(1)(b) through (f) for a stated period of time.
22 (57) "Mutual" means mutual insurance corporation.
23 (57.5) "Nonparticipating" means a plan of insurance under which the insured is not entitled
24 to receive dividends representing shares of the surplus of the insurer.
25 (58) "Ocean marine insurance" means insurance against loss of or damage to:
26 (a) ships or hulls of ships;
27 (b) goods, freight, cargoes, merchandise, effects, disbursements, profits, moneys,
28 securities, choses in action, evidences of debt, valuable papers, bottomry, respondentia interests,
29 or other cargoes in or awaiting transit over the oceans or inland waterways;
30 (c) earnings such as freight, passage money, commissions, or profits derived from
31 transporting goods or people upon or across the oceans or inland waterways; or
1 (d) a vessel owner or operator as a result of liability to employees, passengers, bailors,
2 owners of other vessels, owners of fixed objects, customs or other authorities, or other persons in
3 connection with maritime activity.
4 (59) "Order" means an order of the commissioner.
5 (59.5) "Participating" means a plan of insurance under which the insured is entitled to
6 receive dividends representing shares of the surplus of the insurer.
7 (60) "Person" includes an individual, partnership, corporation, incorporated or
8 unincorporated association, joint stock company, trust, reciprocal, syndicate, or any similar entity
9 or combination of entities acting in concert.
10 (61) (a) "Policy" means any document, including attached endorsements and riders,
11 purporting to be an enforceable contract, which memorializes in writing some or all of the terms
12 of an insurance contract. Service contracts issued by motor clubs under Chapter 11, Motor Clubs,
13 and by corporations licensed under Chapter 7, Nonprofit Health Service Insurance Corporations,
14 or Chapter 8, Health Maintenance Organizations and Limited Health Plans, are policies. A
15 certificate under a group insurance contract is not a policy. A document which does not purport
16 to have legal effect is not a policy.
17 (b) "Group insurance policy" means a policy covering a group of persons that is issued to
18 a policyholder on behalf of the group, for the benefit of group members who are selected under
19 procedures defined in the policy or in agreements which are collateral to the policy. This type of
20 policy may, but is not required to, include members of the policyholder's family or dependents.
21 (c) "Blanket insurance policy" means a group policy covering classes of persons without
22 individual underwriting, where the persons insured are determined by definition of the class with
23 or without designating the persons covered.
24 (62) "Policyholder" means the person who controls a policy, binder, or oral contract by
25 ownership, premium payment, or otherwise. Refer also to "insured" in Subsection (47).
26 (63) "Premium" means the monetary consideration for an insurance policy, and includes
27 assessments, membership fees, required contributions, or monetary consideration, however
28 designated. Consideration paid to third party administrators for their services is not "premium,"
29 though amounts paid by third party administrators to insurers for insurance on the risks
30 administered by the third party administrators are "premium."
31 (64) "Principal officers" of a corporation means the officers designated under Subsection
1 31A-5-203(3).
2 (65) "Proceedings" includes actions and special statutory proceedings.
3 (66) "Professional liability insurance" means insurance against legal liability incident to
4 the practice of a profession and provision of any professional services.
5 (67) "Property insurance" means insurance against loss or damage to real or personal
6 property of every kind and any interest in that property, from all hazards or causes, and against loss
7 consequential upon the loss or damage including vehicle comprehensive and vehicle physical
8 damage coverages, but excluding inland marine insurance and ocean marine insurance as defined
9 under Subsections (38) and (58).
10 (67.5) "Public agency insurance mutual" means any entity formed by joint venture or
11 interlocal cooperation agreement by two or more political subdivisions or public agencies of the
12 state for the purpose of providing insurance coverage for the political subdivisions or public
13 agencies. Any public agency insurance mutual created under this title and Title 11, Chapter 13,
14 Interlocal Cooperation Act, is considered to be a governmental entity and political subdivision of
15 the state with all of the rights, privileges, and immunities of a governmental entity or political
16 subdivision of the state.
17 (68) (a) Except as provided in Subsection (68)(b), "rate service organization" means any
18 person who assists insurers in rate making or filing by:
19 (i) collecting, compiling, and furnishing loss or expense statistics;
20 (ii) recommending, making, or filing rates or supplementary rate information; or
21 (iii) advising about rate questions, except as an attorney giving legal advice. Refer also
22 to Subsection 31A-19-102(2).
23 (b) "Rate service organization" does not mean an employee of an insurer, a single insurer
24 or group of insurers under common control, a joint underwriting group, or a natural person serving
25 as an actuarial or legal consultant.
26 (69) "Reciprocal" or "interinsurance exchange" means any unincorporated association of
27 persons operating through an attorney-in-fact common to all of them and exchanging insurance
28 contracts with one another that provide insurance coverage on each other.
29 (70) "Reinsurance" means an insurance transaction where an insurer, for consideration,
30 transfers any portion of the risk it has assumed to another insurer. In referring to reinsurance
31 transactions, this title sometimes refers to the insurer transferring the risk as the "ceding insurer,"
1 and to the insurer assuming the risk as the "assuming insurer" or the "assuming reinsurer."
2 (70.3) "Residential dwelling liability insurance" means insurance against liability resulting
3 from or incident to the ownership, maintenance, or use of a residential dwelling that is a detached
4 single family residence or multifamily residence up to four units.
5 (71) "Retrocession" means reinsurance with another insurer of a liability assumed under
6 a reinsurance contract. A reinsurer "retrocedes" when it reinsures with another insurer part of a
7 liability assumed under a reinsurance contract.
8 (72) (a) "Security" means any:
9 (i) note;
10 (ii) stock;
11 (iii) bond;
12 (iv) debenture;
13 (v) evidence of indebtedness;
14 (vi) certificate of interest or participation in any profit-sharing agreement;
15 (vii) collateral-trust certificate;
16 (viii) preorganization certificate or subscription;
17 (ix) transferable share;
18 (x) investment contract;
19 (xi) voting trust certificate;
20 (xii) certificate of deposit for a security;
21 (xiii) certificate of interest of participation in an oil, gas, or mining title or lease or in
22 payments out of production under such a title or lease;
23 (xiv) commodity contract or commodity option;
24 (xv) any certificate of interest or participation in, temporary or interim certificate for,
25 receipt for, guarantee of, or warrant or right to subscribe to or purchase any of the items listed in
26 Subsections (72)(a)(i) through (xiv); or
27 (xvi) any other interest or instrument commonly known as a security.
28 (b) "Security" does not include:
29 (i) any insurance or endowment policy or annuity contract under which an insurance
30 company promises to pay money in a specific lump sum or periodically for life or some other
31 specified period; or
1 (ii) a burial certificate or burial contract.
2 (73) "Self-insurance" means any arrangement under which a person provides for spreading
3 its own risks by a systematic plan.
4 (a) Except as provided in this subsection, self-insurance does not include an arrangement
5 under which a number of persons spread their risks among themselves.
6 (b) Self-insurance does include an arrangement by which a governmental entity, as defined
7 in Section 63-30-2, undertakes to indemnify its employees for liability arising out of the
8 employees' employment.
9 (c) Self-insurance does include an arrangement by which a person with a managed
10 program of self-insurance and risk management undertakes to indemnify its affiliates, subsidiaries,
11 directors, officers, or employees for liability or risk which is related to the relationship or
12 employment. Self-insurance does not include any arrangement with independent contractors.
13 (74) (a) "Subsidiary" of a person means an affiliate controlled by that person either directly
14 or indirectly through one or more affiliates or intermediaries.
15 (b) "Wholly owned subsidiary" of a person is a subsidiary of which all of the voting shares
16 are owned by that person either alone or with its affiliates, except for the minimum number of
17 shares the law of the subsidiary's domicile requires to be owned by directors or others.
18 (75) Subject to Subsection (40)(b), "surety insurance" includes:
19 (a) a guarantee against loss or damage resulting from failure of principals to pay or
20 perform their obligations to a creditor or other obligee;
21 (b) bail bond insurance; and
22 (c) fidelity insurance.
23 (76) (a) "Surplus" means the excess of assets over the sum of paid-in capital and liabilities.
24 (b) "Permanent surplus" means the surplus of a mutual insurer that has been designated
25 by the insurer as permanent. Sections 31A-5-211, 31A-7-201, 31A-8-209, 31A-9-209, and
26 31A-14-209 require that mutuals doing business in this state maintain specified minimum levels
27 of permanent surplus. Except for assessable mutuals, the minimum permanent surplus requirement
28 is essentially the same as the minimum required capital requirement that applies to stock insurers.
29 Refer also to Subsection (55) on "minimum capital."
30 (c) "Excess surplus" means [
31
1
2 (i) for life or disability insurers as, defined in Subsection 31A-17-601(3), and property and
3 casualty insurers, as defined in Subsection 31A-17-601(4), the lesser of:
4 (A) that amount of an insurer's total adjusted capital, as defined in Subsection
5 31A-1-301(78.5), that exceeds the product of 2.5 and the sum of the insurer's minimum capital or
6 permanent surplus required under Section 31A-5-211, 31A-9-209, or 31A-14-205; or
7 (B) that amount of an insurer's total adjusted capital, as defined in Subsection
8 31A-1-301(78.5), that exceeds the product of 3.0 and the authorized control level RBC as defined
9 in Subsection 31A-17-601(7)(a); and
10 (ii) for monoline mortgage guaranty insurers, financial guaranty insurers, and title insurers,
11 that amount of an insurer's paid-in-capital and surplus that exceeds the product of 1.5 and the
12 insurer's total adjusted capital required by Subsection 31A-17-609(1).
13 (77) "Third party administrator" or "administrator" means any person who collects charges
14 or premiums from, or who, for consideration, adjusts or settles claims of residents of the state in
15 connection with life or disability insurance coverage, annuities, or service insurance coverage,
16 except:
17 (a) a union on behalf of its members;
18 (b) a person exempt as a trust under Section 514 of the federal Employee Retirement
19 Income Security Act of 1974;
20 (c) an employer on behalf of his employees or the employees of one or more of the
21 subsidiary or affiliated corporations of the employer;
22 (d) an insurer licensed under Chapter 5, 7, 8, 9, or 14, but only with respect to insurance
23 issued by the insurer; or
24 (e) a person licensed or exempt from licensing under Chapter 23 or 26 whose activities are
25 limited to those authorized under the license the person holds or for which the person is exempt.
26 Refer also to Section 31A-25-101.
27 (78) "Title insurance" means the insuring, guaranteeing, or indemnifying of owners of real
28 or personal property or the holders of liens or encumbrances on that property, or others interested
29 in the property against loss or damage suffered by reason of liens or encumbrances upon, defects
30 in, or the unmarketability of the title to the property, or invalidity or unenforceability of any liens
31 or encumbrances on the property.
1 (78.5) "Total adjusted capital" means the sum of an insurer's statutory capital and surplus
2 as determined in accordance with:
3 (a) the statutory accounting applicable to the annual financial statements required to be
4 filed under Section 31A-4-113; and
5 (b) any other items provided by the RBC instructions, as RBC instructions is defined in
6 Subsection 31A-17-601(6).
7 (79) (a) "Trustee" means "director" when referring to the board of directors of a
8 corporation.
9 (b) "Trustee," when used in reference to an employee welfare fund, means an individual,
10 firm, association, organization, joint stock company, or corporation, whether acting individually
11 or jointly and whether designated by that name or any other, that is charged with or has the overall
12 management of an employee welfare fund.
13 (80) (a) "Unauthorized insurer," "unadmitted insurer," or "nonadmitted insurer" means an
14 insurer not holding a valid certificate of authority to do an insurance business in this state, or an
15 insurer transacting business not authorized by a valid certificate.
16 (b) "Admitted insurer" or "authorized insurer" means an insurer holding a valid certificate
17 of authority to do an insurance business in this state, and transacting business as authorized by a
18 valid certificate.
19 (81) "Vehicle liability insurance" means insurance against liability resulting from or
20 incident to ownership, maintenance, or use of any land vehicle or aircraft, exclusive of vehicle
21 comprehensive and vehicle physical damage coverages under Subsection (67).
22 (82) "Voting security" means a security with voting rights, and includes any security
23 convertible into a security with a voting right associated with it.
24 (83) "Workers' compensation insurance" means:
25 (a) insurance for indemnification of employers against liability for compensation:
26 (i) based upon compensable accidental injuries; and
27 (ii) based on occupational disease disability;
28 (b) employer's liability insurance incidental to workers' compensation insurance and
29 written in connection with it; and
30 (c) insurance assuring to the persons entitled to workers' compensation benefits the
31 compensation provided by law.
1 Section 2. Section 31A-2-202 is amended to read:
2 31A-2-202. Reports and replies.
3 (1) When relevant, either directly or indirectly to the performance of the commissioner's
4 duties under the Insurance Code, the commissioner may require from any person subject to
5 regulation under this title:
6 (a) [
7 information, and evidence of the information, in whatever reasonable form and reasonable
8 intervals the commissioner designates;
9 (b) full explanation of the programming of any data storage or communication system in
10 use;
11 (c) information from books, records, electronic data processing systems, computers, or any
12 other information storage system be made available to the department, at any reasonable time and
13 in any reasonable manner; and
14 (d) timely delivery to the National Association of Insurance Commissioners or other entity
15 which gathers insurance industry information, a copy of the statistical data prepared for and
16 submitted to the Insurance Department, as specified by the commissioner.
17 (2) The commissioner may prescribe forms for the reports under Subsection (1) and
18 specify who shall execute or certify the reports. The forms shall be consistent, to the extent
19 practicable, with those prescribed by other jurisdictions. For basic financial data, the
20 commissioner shall use the annual statement forms developed by the National Association of
21 Insurance Commissioners.
22 (3) The commissioner may prescribe reasonable minimum standards and techniques of
23 accounting and data handling to ensure that timely and reliable information exists and can be made
24 available. The standards and techniques prescribed shall be consistent, to the extent practicable,
25 with those prescribed by other states.
26 (4) Any person with executive authority over or in charge of any segment of the affairs of
27 an insurer authorized to do or doing an insurance business in this state, the affiliate of this type of
28 insurer, and any other person licensed under the Insurance Code, shall reply promptly in writing
29 or in other designated form, to a reasonable written inquiry from the commissioner.
30 (5) The commissioner may require that any communication made under this section be
31 verified, and may specify by whom it shall be verified.
1 (6) All information submitted to the commissioner shall be accurate and complete.
2 [
3 by law or by the commissioner subjects the person making it to an action for damages for
4 defamation.
5 Section 3. Section 31A-2-205 is amended to read:
6 31A-2-205. Examination costs.
7 (1) (a) Except as provided in Subsection (3), examinees that are insurers, rate service
8 organizations, or the subsidiaries of either shall reimburse the Insurance Department for the
9 reasonable costs of examinations made under Sections 31A-2-203 and 31A-2-204. The following
10 costs shall be reimbursed:
11 (i) actual travel expenses[
12 (ii) reasonable living expense allowance[
13 (iii) compensation at reasonable rates for all professionals reasonably employed for the
14 examination under Subsection (4)[
15 (iv) the administration and supervisory expense of the Insurance Department and the
16 attorney general's office[
17 (v) an amount necessary to cover fringe benefits authorized by the commissioner or
18 provided by law.
19 (b) In determining rates, the commissioner shall consider the rates recommended by the
20 National Association of Insurance Commissioners and outlined in the examination manual
21 sponsored by the association.
22 [
23 examinations are of their surplus lines business.
24 (2) An insurer requesting the examination of one of its agents shall pay the cost of the
25 examination. Otherwise, the department shall pay the cost of examining licensees other than those
26 specified under Subsection (1).
27 (3) On the examinee's request or at the commissioner's discretion, the Insurance
28 Department may pay all or part of the costs of an examination whenever the commissioner finds
29 that because of the frequency of examinations or the financial condition of the examinee,
30 imposition of the costs would place an unreasonable burden on the examinee. The commissioner
31 shall include in his annual report information about any instance in which the commissioner has
1 applied this Subsection (3).
2 (4) Technical experts employed under Subsection 31A-2-203(3) shall present to the
3 commissioner a statement of all expenses incurred by them in conjunction with an examination.
4 The examined insurer shall, at the commissioner's direction, pay to the technical experts or
5 specialists the actual travel expenses, reasonable living expenses, and compensation at customary
6 rates for expenses necessarily incurred as approved by the commissioner. The examined insurer
7 shall reimburse department examiners for their actual travel expenses and reasonable living
8 expenses and shall reimburse the department for the compensation of department examiners
9 involved in the examination. The examined insurer shall certify the consolidated account of all
10 charges and expenses for the examination. One copy shall be retained by the insurer and the other
11 shall be filed with the department as a public record. An annual report of examination charges
12 paid by examined insurers directly to persons employed under Subsection 31A-2-203(3) or to
13 department examiners shall be included with the department's budget request, but amounts paid
14 directly by examined insurers to persons employed under Subsection 31A-2-203(3) or to
15 department examiners may not be deducted from the department's appropriation.
16 (5) The amount payable under Subsection (1) is due ten days after the examinee has been
17 served with a detailed account of the costs. Payments received by the department under this
18 Subsection (5) shall be handled as provided by Subsection 31A-3-101.
19 (6) The commissioner may require an examinee under Subsection (1), or an insurer
20 requesting an examination under Subsection (2), either before or during an examination, to make
21 deposits with the state treasurer to pay the costs of examination. Any deposit made under this
22 Subsection (6) shall be held in trust by the state treasurer until applied to pay the Insurance
23 Department the costs payable under this section. If a deposit exceeds examination costs, the state
24 treasurer shall refund the surplus.
25 (7) (a) Domestic insurers may offset the examination expenses paid under this section
26 against premium taxes under Subsection 59-9-102 (2).
27 (b) To the extent examination expenses exceed premium tax liability in the year the
28 expenses are incurred, the examination expenses may be carried forward and used to offset
29 premium tax liability for a period of five years from the year the expenses were incurred.
30 Section 4. Section 31A-8-104 is amended to read:
31 31A-8-104. Determination of ability to provide services.
1 (1) The commissioner may not issue a certificate of authority to an applicant for a
2 certificate of authority under this chapter unless the commissioner has determined that the
3 applicant has:
4 (a) demonstrated the willingness and potential ability to furnish the proposed health care
5 services in a manner to assure both availability and accessibility of adequate personnel and
6 facilities and continuity of service;
7 (b) arrangements for an ongoing quality of health care assurance program concerning
8 health care processes and outcomes, established in accordance with rules adopted by the director
9 of the Department of Health based upon prevailing standards for quality assurance for other forms
10 of health care delivery in this state; and
11 (c) a procedure, established in accordance with rules of the director of the Department of
12 Health, to develop, compile, evaluate, and report statistics relating to the cost of its operations, the
13 pattern of utilization of its services, the availability and accessibility of its services, and such other
14 matters as may be reasonably required by the director of the Department of Health.
15 (2) Upon receipt of an application for a certificate of authority under this chapter, the
16 commissioner shall transmit a copy of the application and accompanying documents to the director
17 of the Department of Health. Upon receipt of the application, the director of the Department of
18 Health shall review the application, investigate the surrounding facts and circumstances, and make
19 a finding concerning whether the applicant satisfies the requirements of Subsection (1). The
20 director of the Department of Health is considered to have found the applicant to comply with
21 Subsection (1) unless he delivers to the commissioner a finding of noncompliance within [
22 days after receiving the application from the commissioner.
23 (3) In determining whether the requirements of Subsection (1) are satisfied, the
24 commissioner [
25 delivered to the commissioner in accordance with Subsection (2). [
26
27
28
29
30
31 (4) A finding of noncompliance with Subsection (1) shall specify in what respects the
1 applicant is deficient[
2
3 (5) An organization's certificate of authority issued under this chapter is conclusive
4 evidence of compliance with Subsection (1), as to the services authorized to be performed under
5 the certificate of authority, except in a proceeding by the state against the organization. Licensing
6 under this chapter does not exempt an organization from any licensing requirement applicable
7 under Title 26, Chapter 21.
8 Section 5. Section 31A-15-111 is amended to read:
9 31A-15-111. Surplus lines advisory organizations.
10 (1) Advisory organizations of surplus lines brokers may be formed to:
11 (a) facilitate and encourage compliance by its members with the laws of this state and the
12 rules of the commissioner relative to surplus lines insurance;
13 (b) if authorized by the commissioner, perform and report to the commissioner on the
14 confidential examinations and assess and receive the stamping fees described in Subsection
15 31A-15-103(11);
16 (c) make recommendations to the commissioner concerning classes of insurance for which
17 a rule under Subsection 31A-15-103(6)(a) is appropriate;
18 (d) investigate "abuses of placements," as described in Subsection 31A-15-103(6)(b), and
19 provide recommendations to the commissioner concerning rules under Subsection
20 31A-15-103(6)(b);
21 (e) bring to the commissioner's attention the existence of grounds for issuing an order
22 under Subsection 31A-15-103(6)(c) concerning a particular unauthorized insurer;
23 (f) provide recommendations to the commissioner concerning unauthorized insurers which
24 should be listed on a "doubtful or objectionable" list under Subsection 31A-15-103(6)(d);
25 (g) provide comments to the commissioner concerning whether an unauthorized insurer
26 has a good reputation and financial integrity under Subsection 31A-15-103(6)(d)(ii);
27 (h) provide recommendations to the commissioner concerning rules under Subsection
28 31A-15-103(10) necessary to protect the interests of insureds and the public; and
29 (i) receive and disseminate to its members information relative to surplus lines coverages.
30 (2) Every advisory organization formed under this section shall file with the
31 commissioner:
1 (a) a copy of its constitution, articles of agreement or association or articles of
2 incorporation, and any amendments to these documents;
3 (b) a copy of its bylaws and any other writing governing the organization's activities and
4 any amendments to these documents;
5 [
6 [
7 orders of the commissioner or processes issued at his direction may be served, with changes in this
8 list to be filed within ten days of a change; and
9 [
10 advisory organization, that the commissioner may examine the advisory organization in
11 accordance with the provisions of Sections 31A-2-203, 31A-2-204, and 31A-2-205.
12 (3) The commissioner may by rule or order require each person licensed as a surplus lines
13 broker under Chapter 23 to be a member of one or more specified advisory organizations operating
14 under this section. The commissioner may make compliance with the rule or order a condition to
15 continued licensure as a surplus lines broker.
16 (4) The comments and recommendations given the commissioner under Subsection (1)
17 are merely advisory. The formation of an advisory organization under this section does not alter
18 the commissioner's authority under this chapter.
19 Section 6. Section 31A-17-602 is amended to read:
20 31A-17-602. RBC reports -- RBC of life and disability insurers -- RBC of property
21 and casualty insurers.
22 (1) Every domestic life or disability insurer and every domestic property and casualty
23 insurer shall[
24 (a) on or before March 1, prepare and submit to the commissioner a report of its RBC
25 levels as of the end of the calendar year just ended, in a form and containing the information as is
26 required by the RBC instructions[
27 (b) file its RBC report with the insurance commissioner in any state in which the insurer
28 is authorized to do business, if the insurance commissioner of that state notifies the insurer of its
29 request in writing, in which case the insurer may file its RBC report not later than the later of:
30 [
31 [
1 (2) A life and disability insurer's RBC shall be determined in accordance with the formula
2 set forth in the RBC instructions. The formula shall take into account and may adjust for the
3 covariance between:
4 (a) the risk with respect to the insurer's assets;
5 (b) the risk of adverse insurance experience with respect to the insurer's liabilities and
6 obligations;
7 (c) the interest rate risk with respect to the insurer's business; and
8 (d) all other business risks and other relevant risks as set forth in the RBC instructions.
9 (3) A property and casualty insurer's RBC shall be determined in accordance with the
10 formula set forth in the RBC instructions. The formula shall take the following into account and
11 may adjust for the covariance between:
12 (a) asset risk;
13 (b) credit risk;
14 (c) underwriting risk; and
15 (d) all other business risks and the other relevant risks as set forth in the RBC instructions.
16 (4) (a) If a domestic insurer files an RBC report that the commissioner determines is
17 inaccurate, the commissioner shall adjust the RBC report to correct the inaccuracy and shall notify
18 the insurer of the adjustment.
19 (b) The notice under Subsection (4)(a) shall contain a statement of the reason for the
20 adjustment.
21 Section 7. Section 31A-17-609 is amended to read:
22 31A-17-609. Alternate adjusted capital.
23 (1) Except as provided in Section 31A-17-602, insurers licensed under Chapters 5, 7, 9,
24 and 14 shall maintain total adjusted capital as defined in Subsection 31A-1-301(78.5) in an amount
25 equal to the greater of:
26 (a) [
27 in the case of nonassessable mutuals, required by Section 31A-5-211, 31A-7-201, 31A-9-209, or
28 31A-14-205; or
29 (b) the net total of:
30 (i) 10% of net insurance premiums earned during the year; plus
31 (ii) 5% of the admitted value of common stocks and real estate; plus
1 (iii) 2% of the admitted value of all other invested assets, exclusive of cash deposits,
2 short-term investments, policy loans, and premium notes; less
3 (iv) the amount of any asset valuation reserve being maintained by the insurer, but not to
4 exceed the sum of Subsections (1)(b)(ii) and (iii).
5 (2) As used in Subsection (1)(b), "premiums earned" means premiums and other
6 consideration earned for insurance in the 12-month period ending on the date the calculation is
7 made.
8 (3) The commissioner may consider an insurer to be financially hazardous under
9 Subsection 31A-27-307(3), if the insurer does not have qualified assets in an aggregate value
10 exceeding the sum of the insurer's[
11
12 adjusted capital required by Subsection (1).
13 (4) The commissioner shall consider an insurer to be financially hazardous under
14 Subsection 31A-27-307(3) if the insurer does not have qualified assets in an aggregate value
15 exceeding the sum of the insurer's[
16
17 total adjusted capital required by Subsection (1).
18 Section 8. Section 31A-18-108 is amended to read:
19 31A-18-108. Investment of excess surplus.
20 If an insurer has excess surplus, as defined under Subsection 31A-1-301(76)(c), then to the
21 extent of its excess surplus, the insurer may invest in a manner inconsistent with the limitations
22 of [
23 commissioner. This section does not empower any insurer to make investments that are illegal or
24 that are prohibited under Section 31A-4-107. Each insurer has the burden of establishing the
25 extent of its excess surplus.
26 Section 9. Section 31A-19-405 is amended to read:
27 31A-19-405. Payment of dividends.
28 (1) This part does not prohibit the [
29 unabsorbed premium deposits allowed or returned by insurers to their policyholders, members, or
30 subscribers.
31 (2) In the payment of dividends, savings, or unabsorbed premium deposits, there may not
1 be any unfair discrimination between policyholders.
2 (3) A plan for the [
3 deposits allowed or returned by insurers to their policyholders, members, or subscribers developed
4 after the inception of the insurance contracts to be included in the distribution plan and filed
5 pursuant to Section 31A-21-310 is not considered a rating plan or system. Filing under this part
6 is not required.
7 (4) A dividend or participating plan developed by insurers establishing given criteria for
8 eligibility and the general basis for distribution for a dividend, if declared, which plan existed at
9 the inception of an insurance policy, is considered a rating plan. Such plans must be filed with the
10 commissioner pursuant to this part.
11 [
12 of a dividend conditioned upon renewal of the policy or contract.
13 Section 10. Section 31A-22-620 is amended to read:
14 31A-22-620. Medicare Supplement Insurance Minimum Standards Act.
15 (1) As used in this section:
16 (a) "Applicant" means:
17 (i) in the case of an individual Medicare supplement policy, the person who seeks to
18 contract for insurance benefits; and
19 (ii) in the case of a group Medicare supplement policy, the proposed certificate holder.
20 (b) "Certificate" means any certificate delivered or issued for delivery in this state under
21 a group Medicare supplement policy.
22 (c) "Certificate form" means the form on which the certificate is delivered or issued for
23 delivery by the issuer.
24 (d) "Issuer" includes insurance companies, fraternal benefit societies, health care service
25 plans, health maintenance organizations, and any other entity delivering, or issuing for delivery
26 in this state, Medicare supplement policies or certificates.
27 (e) "Medicare" means the "Health Insurance for the Aged Act," Title XVIII of the Social
28 Security Amendments of 1965, as [
29 (f) "Medicare Supplement Policy" means a group or individual policy of disability
30 insurance, other than a policy issued pursuant to a contract under Section 1876 of the federal
31 Social Security Act, 42 U.S.C. Section 1395 et seq., or an issued policy under a demonstration
1 project specified in 41 U.S.C. Section 1395ss(g)(1), that is advertised, marketed, or designed
2 primarily as a supplement to reimbursements under Medicare for the hospital, medical, or surgical
3 expenses of persons eligible for Medicare.
4 (g) "Policy Form" means the form on which the policy is delivered or issued for delivery
5 by the issuer.
6 (2) (a) Except as otherwise specifically provided, this section applies to:
7 (i) all Medicare supplement policies delivered or issued for delivery in this state on or after
8 the effective date of this section;
9 (ii) all certificates issued under group Medicare supplement policies, that have been
10 delivered or issued for delivery in this state on or after the effective date of this section; and
11 (iii) policies or certificates that were in force prior to the effective date of this section, with
12 respect to requirements for benefits, claims payment, and policy reporting practice under
13 Subsection (3)(d), and loss ratios under Subsection (4).
14 (b) This section does not apply to a policy of one or more employers or labor
15 organizations, or of the trustees of a fund established by one or more employers or labor
16 organizations, or a combination of employers and labor unions, for employees or former
17 employees or a combination of employees and former employees, or for members or former
18 members of the labor organizations, or a combination of members and former members of labor
19 organizations.
20 (c) This section does not prohibit, nor does it apply to insurance policies or health care
21 benefit plans, including group conversion policies, provided to Medicare eligible persons that are
22 not marketed or held out to be Medicare supplement policies or benefit plans.
23 (3) (a) A Medicare supplement policy or certificate in force in the state may not contain
24 benefits that duplicate benefits provided by Medicare.
25 (b) Notwithstanding any other provision of law of this state, a Medicare supplement policy
26 or certificate may not exclude or limit benefits for loss incurred more than six months from the
27 effective date of coverage because it involved a preexisting condition. The policy or certificate
28 may not define a preexisting condition more restrictively than: "A condition for which medical
29 advice was given or treatment was recommended by or received from a physician within six
30 months before the effective date of coverage."
31 (c) The commissioner shall adopt rules to establish specific standards for policy provisions
1 of Medicare supplement policies and certificates. The standards adopted shall be in addition to
2 and in accordance with applicable laws of this state. A requirement of this title relating to
3 minimum required policy benefits, other than the minimum standards contained in this section,
4 may not apply to Medicare supplement policies and certificates. The standards may include:
5 (i) terms of renewability;
6 (ii) initial and subsequent conditions of eligibility;
7 (iii) nonduplication of coverage;
8 (iv) probationary periods;
9 (v) benefit limitations, exceptions, and reductions;
10 (vi) elimination periods;
11 (vii) requirements for replacement;
12 (viii) recurrent conditions; and
13 (ix) definitions of terms.
14 (d) The commissioner shall adopt rules establishing minimum standards for benefits,
15 claims payment, marketing practices, compensation arrangements, and reporting practices for
16 Medicare supplement policies and certificates.
17 (e) The commissioner may adopt such rules as are necessary to conform Medicare
18 supplement policies and certificates to the requirements of federal law and regulations promulgated
19 thereunder, including:
20 (i) requiring refunds or credits if the policies do not meet loss ratio requirements;
21 (ii) establishing a uniform methodology for calculating and reporting loss ratios;
22 (iii) assuring public access to policies, premiums and loss ratio information of issuers of
23 Medicare supplement insurance;
24 (iv) establishing a process for approving or disapproving policy forms and certificate
25 forms and proposed premium increases;
26 (v) establishing a policy for holding public hearings prior to approval of premium
27 increases; and
28 (vi) establishing standards for Medicare select policies and certificates.
29 (f) The commissioner may adopt rules that prohibit policy provisions not otherwise
30 specifically authorized by statute that, in the opinion of the commissioner, are unjust, unfair, or
31 unfairly discriminatory to any person insured or proposed to be insured under a Medicare
1 supplement policy or certificate.
2 (4) Medicare supplement policies shall return to policyholders benefits that are reasonable
3 in relation to the premium charged. The commissioner shall make rules to establish minimum
4 standards for loss ratios of Medicare supplement policies on the basis of incurred claims
5 experience, or incurred health care expenses where coverage is provided by a health maintenance
6 organization on a service basis rather than on a reimbursement basis, and earned premiums in
7 accordance with accepted actuarial principles and practices.
8 (5) (a) To provide for full and fair disclosure in the sale of Medicare supplement policies,
9 a Medicare supplement policy or certificate may not be delivered in this state unless an outline of
10 coverage is delivered to the applicant at the time application is made.
11 (b) The commissioner shall prescribe the format and content of the outline of coverage
12 required by Subsection (5)(a).
13 (c) For purposes of this section, "format" means style arrangements and overall
14 appearance, including such items as the size, color, and prominence of type and arrangement of
15 text and captions. The outline of coverage shall include:
16 (i) a description of the principal benefits and coverage provided in the policy;
17 (ii) a statement of the renewal provisions, including any reservation by the issuer of a right
18 to change premiums; and disclosure of the existence of any automatic renewal premium increases
19 based on the policyholder's age; and
20 (iii) a statement that the outline of coverage is a summary of the policy issued or applied
21 for and that the policy should be consulted to determine governing contractual provisions.
22 (d) The commissioner may prescribe by rule a standard form and the contents of an
23 informational brochure for persons eligible for Medicare, that is intended to improve the buyer's
24 ability to select the most appropriate coverage and improve the buyer's understanding of Medicare.
25 Except in the case of direct response insurance policies, the commissioner may require by rule that
26 the informational brochure be provided concurrently with delivery of the outline of coverage to
27 any prospective insureds eligible for Medicare. With respect to direct response insurance policies,
28 the commissioner may require by rule that the prescribed brochure be provided upon request to
29 any prospective insureds eligible for Medicare, but in no event later than the time of policy
30 delivery.
31 (e) The commissioner may adopt reasonable rules to govern the full and fair disclosure of
1 the information in connection with the replacement of [
2
3 Medicare.
4 (6) Notwithstanding Subsection (1), Medicare supplement policies and certificates shall
5 have a notice prominently printed on the first page of the policy or certificate, or attached to the
6 front page, stating in substance that the applicant has the right to return the policy or certificate
7 within 30 days of its delivery and to have the premium refunded if, after examination of the policy
8 or certificate, the applicant is not satisfied for any reason. Any refund made pursuant to this
9 section shall be paid directly to the applicant by the issuer in a timely manner.
10 (7) Every issuer of Medicare supplement insurance policies or certificates in this state shall
11 provide a copy of any Medicare supplement advertisement intended for use in this state, whether
12 through written or broadcast medium, to the commissioner for review.
13 Section 11. Section 31A-23-215 is amended to read:
14 31A-23-215. Agency licensees -- Reports -- Suspension, revocation, or limitation of
15 license.
16 (1) Every two years, on a date specified by rule, each agency licensed as an agent,
17 managing general agent, broker, or consultant shall report to the commissioner, in a form the
18 commissioner establishes by rule, all natural person agents, brokers, or consultants acting in those
19 capacities for the organization.
20 (2) An agency licensed under this chapter shall report to the commissioner promptly, in
21 the detail and form prescribed by rule, every change in the list of natural person agents, managing
22 general agents, brokers, or consultants authorized to act in those capacities for the agency.
23 (3) (a) An agency licensed under this chapter shall report to the commissioner the cause
24 of termination of a designated licensee's appointment. The information provided the commissioner
25 shall remain confidential.
26 (b) An agency is immune from civil action, civil penalty, or damages if the agency
27 complies in good faith with Subsection (3) in reporting to the commissioner the cause of
28 termination of licensees' appointments. Notwithstanding any other provision in this section, an
29 agency is not immune from any action or resulting penalty imposed on the reporting agency as a
30 result of proceedings brought by or on behalf of the department if the action is based on evidence
31 other than the report submitted in compliance with Subsection (3).
1 (4) Agencies licensed under this chapter may act in the capacities for which it is licensed
2 only through natural persons who are licensed under this chapter to act in the same manner.
3 (5) Agencies licensed under this chapter shall designate and report promptly to the
4 commissioner the name of at least one natural person who has authority to act on behalf of the
5 agency in all matters pertaining to compliance with this title and orders of the commissioner.
6 (6) When a license is held by an agency, both the agency itself and any persons named on
7 the license shall, for purposes of this section, be considered to be the holders of the license. If a
8 person named on the agency license commits any act or fails to perform any duty that is a ground
9 for suspending, revoking, or limiting the agency license, the commissioner may suspend, revoke,
10 or limit the license of that person or of the agency, or both.
11 (7) When a license is held by an agency, all partners, directors, principal officers, or
12 persons having comparable powers who are not otherwise licensees are subject to the jurisdiction
13 of the commissioner and the provisions of this title.
14 Section 12. Section 31A-23-217 is amended to read:
15 31A-23-217. Probation.
16 (1) In any circumstances that would justify a suspension under Section 31A-23-216, the
17 commissioner may instead, after a formal adjudicative proceeding, put the licensee on probation
18 for a specified period no longer than [
19 (2) The probation order shall state the conditions for retention of the license, which shall
20 be reasonable.
21 (3) Any violation of the probation is grounds for revocation pursuant to any proceeding
22 authorized under Title 63, Chapter 46b, Administrative Procedures Act.
23 Section 13. Section 31A-23-307 is amended to read:
24 31A-23-307. Title insurance agents' business.
25 A title insurance agent may engage in the escrow, settlement, or closing business, or any
26 combination of such businesses, and operate as escrow, settlement, or closing agent provided that
27 all the following exist:
28 (1) The title insurance agent is properly licensed under this chapter.
29 (2) (a) All funds deposited with the agent in connection with any escrow, settlement, or
30 closing are deposited in a federally insured financial institution in separate trust accounts, with the
31 funds being the property of the persons entitled to them under the provisions of the escrow,
1 settlement, or closing. The funds shall be segregated escrow by escrow, settlement by settlement,
2 or closing by closing in the records of the agent. These funds are not subject to any debts of the
3 agent and may only be used to fulfill the terms of the individual escrow, settlement, or closing
4 under which the funds were accepted. None of the funds may be used until all conditions of the
5 escrow, settlement, or closing have been met.
6 (b) Any interest received on funds deposited with the agent in connection with any escrow,
7 settlement, or closing shall be paid over to the depositing party to the escrow, settlement, or
8 closing and may not be transferred to the account of the agent.
9 (c) No check may be drawn, executed[
10 segregated escrow account [
11 contains a sufficient credit balance consisting of collected or cleared funds[
12 is drawn, executed[
13 (d) As used in this Subsection (2), funds are considered to be "collected or cleared," and
14 may be disbursed as follows:
15 (i) cash may be disbursed on the same day it is deposited;
16 (ii) wire transfers may be disbursed on the same day they are deposited;
17 (iii) cashier's checks, certified checks, teller's checks, U.S. Postal Service money orders,
18 and checks drawn on a Federal Reserve Bank or Federal Home Loan Bank may be disbursed on
19 the day following the date of deposit; and
20 (iv) other checks or deposits may be disbursed within the time limits provided under the
21 Expedited Funds Availability Act, 12 U.S.C. Section 4001 et seq., as amended, and related
22 regulations of the Federal Reserve System or upon written notification from the financial
23 institution to which the funds have been deposited, that final settlement has occurred on the
24 deposited item.
25 (3) The title insurance agent shall maintain records of all receipts and disbursements of
26 escrow, settlement, and closing funds.
27 (4) The title insurance agent shall comply with any rules adopted by the commissioner
28 governing escrows, settlements, or closings.
29 Section 14. Section 31A-23-404 is amended to read:
30 31A-23-404. Sharing commissions.
31 (1) (a) Except as provided in Subsection 31A-15-103(3), [
1 [
2 a person [
3 knows [
4
5 (b) A person may only accept commission compensation or other compensation as an
6 agent, broker, or consultant that is directly or indirectly the result of any insurance transaction
7 [
8 as to the particular type of insurance.
9 (2) (a) Except as provided in Section 31A-23-301, a consultant may not pay or receive any
10 commission or other compensation that is directly or indirectly the result of any insurance
11 transaction.
12 (b) A consultant may share a consultant fee or other compensation received for consulting
13 services performed within Utah only with another consultant licensed under this chapter, and only
14 to the extent that the other consultant contributed to the services performed.
15 [
16 licensees under this chapter, former Title 31, Chapter 17, or their successors in interest under a
17 deferred compensation or agency sales agreement.
18 [
19 Subsection [
20 connection with controlled business, or in payment of a forwarding fee or finder's fee. A person
21 may share compensation for the issuance of a title insurance policy only to the extent that he
22 contributed to the search and examination of the title or other services connected with it.
23 Section 15. Section 31A-26-210 is amended to read:
24 31A-26-210. Reports from organizations licensed as adjusters.
25 (1) Organizations licensed as adjusters under Section 31A-26-203 shall report to the
26 commissioner, at the times and in the detail and form as prescribed by rule, every change in the
27 list of natural person adjusters authorized to act in that position for the organization.
28 (2) Each organization licensed as an adjuster shall, at the time of paying its license
29 continuation fee under Subsection 31A-3-103, report to the commissioner, in the form established
30 by the commissioner by rule, all natural person adjusters acting in that position for the
31 organization.
1 (3) Organizations licensed under this chapter shall designate and report promptly to the
2 commissioner the name of at least one natural person who has authority to act on behalf of the
3 organization in all matters pertaining to compliance with this title and orders of the commissioner.
4 (4) Where a license is held by an organization, both the organization itself and any persons
5 named on the license shall, for purposes of this section, be considered to be the holders of the
6 license. If a person named on the organization license commits any act or fails to perform any
7 duty which is a ground for suspending, revoking, or limiting the organization license, the
8 commissioner may suspend, revoke, or limit the license of that person or the organization, or both.
9 (5) When a license is held by an organization, all partners, directors, principal officers, or
10 persons having comparable powers who are not otherwise licensees are subject to the jurisdiction
11 of the commissioner and the provisions of this title.
12 Section 16. Section 31A-26-214 is amended to read:
13 31A-26-214. Probation.
14 (1) In any circumstances that would justify a suspension under Section 31A-26-213, the
15 commissioner may instead, after a formal adjudicative proceeding, put the licensee on probation
16 for a specified period no longer than [
17 (2) The probation order shall state the conditions for retention of the license, which shall
18 be reasonable.
19 (3) Violation of the probation is grounds for revocation pursuant to any proceeding
20 authorized under Title 63, Chapter 46b, Administrative Procedures Act.
21 Section 17. Section 31A-27-102 is amended to read:
22 31A-27-102. Definitions.
23 (1) As used in this chapter:
24 (a) "Alien insurer domiciled in Utah" means an insurer domiciled outside the United States
25 whose entry into the United States is through Utah.
26 (b) "Ancillary state" means any state other than an insurer's state of domicile.
27 (c) "Contingent claims" means a claim or demand upon which a right of action has accrued
28 at the date of the order of liquidation and upon which liability has not been determined.
29 (d) "Date of liquidation" means the date of the filing of a petition for liquidation that
30 results in an order for liquidation.
31 (e) "Delinquency proceeding" means any proceeding commenced against an insurer for
1 the purpose of liquidating, rehabilitating, reorganizing, or conserving the insurer, and any
2 summary proceeding under Sections 31A-27-201 through 31A-27-203.
3 (f) "Domestic insurer" includes, for purposes of this chapter, foreign insurers commercially
4 domiciled in this state under Section 31A-14-206.
5 (g) (i) "Estate" or "property of the estate" means:
6 (A) all legal or equitable interests of an insurer that are the subject of a rehabilitation,
7 liquidation, conservation, or other proceeding under this chapter in property as of the date of filing
8 of the petition for rehabilitation, liquidation, or conservation;
9 (B) any interest in property recoverable by the receiver under the provisions of this title;
10 (C) any interest in property acquired after the date of filing of the petition; and
11 (D) all proceeds, products, rents, and profits from this property.
12 (ii) It includes property in which the insurer holds only legal title, but no equitable interest,
13 only to the extent of the insolvent insurer's interest.
14 (h) "Fair consideration" is given for property or an obligation:
15 (i) when in exchange for the property or obligation, as a fair equivalent for it, and in good
16 faith, property is conveyed, services are rendered, an obligation is incurred, or an antecedent debt
17 is satisfied; or
18 (ii) when the property or obligation is received in good faith to secure a present advance
19 or an antecedent debt in amount not disproportionately small compared to the value of the property
20 or obligation obtained.
21 (i) "General assets" means all property not encumbered by a security agreement for the
22 security or benefit of specified persons or classes of persons. It does not include separate account
23 assets under Section 31A-5-217. For encumbered property "general assets" includes all that
24 property or its proceeds which is in excess of the amount necessary to discharge the sums secured
25 by the property. Assets held in trust or on deposit for the security or benefit of all policyholders,
26 or all policyholders and creditors, in more than a single state, are general assets.
27 (j) "Guaranty association" means the applicable association under Chapter 28 or the
28 similar association under the laws of another state.
29 (k) "Immature claim" means a claim or demand upon which payment is due, except for
30 the passage of time.
31 (l) "Insolvency" has the same meaning as in Subsection 31A-1-301(39).
1 (m) "Insurer" means any person who is doing, has done, purports to do, or is licensed to
2 do an insurance business on its own account and is or has been subject to the authority of, or to
3 liquidation, rehabilitation, reorganization, or supervision by, a commissioner. A separate account
4 created under Section 31A-5-217 is an "insurer" for purposes of Chapter 27.
5 (n) "Preferred claim" means any claim which the law gives priority of payment from the
6 general assets of the insurer.
7 (o) "Qualified loss reserve specialist" means:
8 (i) a member in good standing of the American Academy of Actuaries; or
9 (ii) a person who otherwise has competency in loss reserve evaluation as demonstrated to
10 the satisfaction of the commissioner.
11 [
12 requires.
13 [
14 Subsection 31A-27-310(1), Subsections 31A-27-403(1) and (3), Sections 31A-27-404 and
15 31A-27-406 through 31A-27-409 are in force, and which has laws requiring the commissioner to
16 be the receiver of a delinquent insurer, and which has laws for the avoidance of fraudulent
17 conveyances and preferential transfers by the receiver of a delinquent insurer.
18 [
19 agreement, pledge, deposit as security, escrow or otherwise, but not including special deposit
20 claims. The term also includes claims that have become liens upon specific assets through judicial
21 processes.
22 [
23 Section 31A-5-217.
24 [
25 pursuant to this title for the security or benefit of one or more limited classes of persons.
26 [
27 voluntarily or involuntarily, by or without judicial proceedings, of disposing of or parting with
28 property or with an interest in property. The retention of a security interest in or title to property
29 delivered to a debtor is considered a transfer by the debtor.
30 [
31 (i) a right of action has accrued at the date of the order of liquidation; and
1 (ii) liability has been established but the amount of which has not been determined.
2 (2) If the subject of a rehabilitation or liquidation proceeding under this chapter is an
3 insurer engaged in a surety business, then as used in this chapter:
4 (a) "Policy" includes a bond issued by a surety.
5 (b) "Policyholder" includes a principal on a bond.
6 (c) "Beneficiary" includes an obligee of a bond.
7 (d) "Insured" includes both the principal and obligee of a bond.
8 Section 18. Section 31A-27-330.5 is amended to read:
9 31A-27-330.5. Claim estimation.
10 (1) (a) After the entry of a liquidation order, the liquidator may apply to the court for an
11 order authorizing the estimation of the liabilities owed by or to the insurer. The liquidator's
12 application shall:
13 (i) identify the proposed method for estimating the liabilities; and
14 (ii) provide for reasonable participation in the estimation process of the claimant and other
15 affected parties, including reinsurers.
16 (b) The proof and allowance of liability, value and due date of such a claim may be
17 estimated if:
18 (i) the proof, allowance, or adjudication of any contingent, unliquidated, or immature
19 claim owed by or to the insurer would unduly delay the administration of the liquidation; or
20 (ii) the administrative expense of processing and adjudicating the claim would be unduly
21 excessive when compared with the funds that are estimated to be available for distribution with
22 respect to the claim.
23 (c) An estimation made pursuant to this section:
24 (i) [
25
26
27 claims representing known losses of any claimant that are not made absolute and liquidated by the
28 date of the court's order allowing estimation, be estimated in a commercially reasonable and
29 actuarially sound manner;
30 (ii) shall provide for reasonable participation of affected reinsurers, consistent with this
31 section; and
1 (iii) may authorize the present value estimation of contingent, unliquidated, and immature
2 claims, including incurred but not reported losses utilizing an actuarial methodology of valuing
3 claims with reasonable certainty.
4 (2) Contingent, unliquidated, and immature claims shall not share in any distribution to
5 creditors of an insurer under Section 31A-27-336 until the liability, value, and due date of the
6 claims have been proved, allowed, and adjudicated. The liability of the insurer, the value, and the
7 due date of contingent, unliquidated, or immature claims that have been estimated in accordance
8 with this section shall be proved, allowed, and adjudicated for all purposes in the estate.
9 (3) Nothing in Subsection (1)(c)(i) shall be construed to prevent the liquidator from using
10 a qualified loss reserve specialist to estimate outstanding liabilities of a claimant.
11 Section 19. Section 31A-31-108 (Effective 07/01/97) is amended to read:
12 31A-31-108 (Effective 07/01/97). Assessment of insurers.
13 (1) To implement this chapter, Section 35A-3-114, and Section 76-6-521, the
14 commissioner may assess each admitted insurer and each nonadmitted insurer transacting
15 insurance under Chapter 15, Parts 1 and 2, an annual fee as follows:
16 (a) [
17 (b) [
18 but more than $1,000,000;
19 (c) [
20 but more than $2,500,000;
21 (d) [
22 $10,000,000 but more than $5,000,000;
23 (e) [
24 $50,000,000 but more than $10,000,000; and
25 (f) [
26 more.
27 (2) All money received by the state under this section shall be deposited in the General
28 Fund as a nonlapsing dedicated credit of the Insurance Department for the purpose of providing
29 funds to pay for any costs and expenses incurred by the Insurance Department in the
30 administration, investigation, and enforcement of this chapter, Section 35A-3-114, and Section
31 76-6-521.
1 (3) As used in this section, "Utah risks" means insurance coverage on the lives, health, or
2 against the liability of persons residing in Utah, or on property located in Utah, other than property
3 temporarily in transit through Utah.
4 Section 20. Section 35A-3-114 (Effective 07/01/97) is amended to read:
5 35A-3-114 (Effective 07/01/97). Workers' compensation insurance fraud -- Elements
6 -- Penalties -- Notice.
7 (1) As used in this section:
8 (a) "Corporation" has the same meaning as in Subsection 76-2-201(3).
9 (b) "Intentionally" has the same meaning as in Subsection 76-2-103(1).
10 (c) "Knowingly" has the same meaning as in Subsection 76-2-103(2).
11 (d) "Person" has the same meaning as in Subsection 76-1-601(8).
12 (e) "Recklessly" has the same meaning as in Subsection 76-2-103(3).
13 (2) Any person who has intentionally, knowingly, or recklessly, devised any scheme or
14 artifice to obtain workers' compensation insurance coverage, disability compensation, medical
15 benefits, goods, professional services, fees for professional services, or anything of value under
16 this chapter by means of false or fraudulent pretenses, representations, promises, or material
17 omissions, and who intentionally, knowingly, or recklessly communicates or causes a
18 communication with another in furtherance of the scheme or artifice, is guilty of workers'
19 compensation insurance fraud, which is punishable in the manner prescribed by Section
20 76-10-1801 for communication fraud.
21 (3) A corporation or association is guilty of the offense of workers' compensation
22 insurance fraud under the same conditions as those set forth in Section 76-2-204.
23 (4) The determination of the degree of any offense under Subsection (2) shall be measured
24 by the total value of all property, money, or other things obtained or sought to be obtained by the
25 scheme or artifice described in Subsection (2), except as provided in Subsection 76-10-1801(1)(e).
26 (5) Reliance on the part of any person is not a necessary element of the offense described
27 in Subsection (2).
28 (6) An intent on the part of the perpetrator of any offense described in Subsection (2) to
29 permanently deprive any person of property, money, or anything of value is not a necessary
30 element of this offense.
31 (7) An insurer or self-insured employer giving written notice in accordance with
1 Subsection (10) that workers' compensation insurance fraud is a crime is not a necessary element
2 of the offense described in Subsection (2).
3 [
4 any scheme or artifice to make or cause to be made any false written or oral statement or business
5 reorganization, incorporation, or change in ownership intended to obtain insurance coverage as
6 mandated by this chapter at rates that do not reflect the risk, industry, employer, or class codes
7 actually covered by the policy.
8 [
9 artifice to collect or make a claim for temporary disability compensation as provided in Section
10 35A-3-410 while working for gain.
11 [
12 of this chapter prints, reproduces, or furnishes a form to any person upon which that person applies
13 for insurance coverage, reports payroll, makes a claim by reason of accident, injury, death, disease,
14 or other claimed loss, or otherwise reports or gives notice to the insurer or self-insured employer,
15 shall cause to be printed or displayed in comparative prominence with other content the statement:
16 "Any person who knowingly presents false or fraudulent underwriting information, files or causes
17 to be filed a false or fraudulent claim for disability compensation or medical benefits, or submits
18 a false or fraudulent report or billing for health care fees or other professional services is guilty of
19 a crime and may be subject to fines and confinement in state prison." [
20
21
22 [
23 financial instrument in payment of compensation issued under this chapter shall cause to be printed
24 or displayed in comparative prominence above the area for endorsement the statement: "Workers'
25 compensation insurance fraud is a crime punishable by Utah law."
26 (c) (i) The provisions of Subsections (10)(a) and (b) apply only to the legal obligations of
27 an insurer or a self-insured employer.
28 (ii) A person who violates Subsection (2) is guilty of workers' compensation insurance
29 fraud, and the failure of an insurer or a self-insured employer to fully comply with the provisions
30 of Subsections (10)(a) and (b) may not be:
31 (A) a defense to violating Subsection (2); or
1 (B) grounds for suppressing evidence.
2 (11) In the absence of malice, a person, employer, insurer, or governmental entity that
3 reports a suspected fraudulent act relating to a workers' compensation insurance policy or claim
4 is not subject to any civil liability for libel, slander, or any other relevant cause of action.
5 (12) In any action involving workers' compensation, this section supersedes Title 31A,
6 Chapter 31, Insurance Fraud Act.
7 Section 21. Section 59-9-102 is amended to read:
8 59-9-102. Offsets.
9 (1) If any authorized insurer doing business in this state during the tax year pays a property
10 tax in this state, the insurer may deduct from the tax provided under this chapter that portion of the
11 property tax paid for general state purposes.
12 (2) Any domestic insurance company paying a fee for examination under Section
13 31A-2-205 may deduct from the tax provided under this chapter the amount of the examination
14 fee paid in the manner provided for in Section 31A-2-205, subject to the limitations of Subsection
15 31A-2-203(2)(d).
16 (3) There is offset against the taxes imposed under Section 59-9-101 the amount of any
17 assessments paid by an insurance company under the guaranty associations established under Title
18 31A, Chapter 28, in the manner provided by Sections 31A-28-113 and 31A-28-212.
19 (4) The state has no liability to insurers for any amount by which offsets allowed under
20 this section exceed the insurer's premium tax liability.
21 Section 22. Effective date.
22 This act takes effect on July 1, 1997.
Legislative Review Note
as of 12-31-96 12:08 PM
A limited legal review of this bill raises no obvious constitutional or statutory concerns.
Office of Legislative Research and General Counsel
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