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H.B. 269
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5 AN ACT RELATING TO INSURANCE; RECODIFYING RATE REGULATION PROVISIONS;
6 CLARIFYING PURPOSES OF CHAPTER; DEFINING TERMS; PROVIDING RULEMAKING
7 AUTHORITY; AMENDING PROVISIONS RELATED TO RATE STANDARDS; AMENDING
8 PROVISIONS RELATED TO RATE METHODS; AMENDING RATE FILING
9 REQUIREMENTS; AMENDING PROVISIONS FOR DISAPPROVAL OF RATES;
10 AMENDING PROVISION RELATED TO SPECIAL RESTRICTIONS ON INDIVIDUAL
11 INSURERS; ADDRESSING SPECIAL PROVISIONS FOR TITLE INSURERS; ADDRESSING
12 DIVIDEND AND PARTICIPATING PLANS; AMENDING FAULT PROVISION OF CERTAIN
13 PREMIUM INCREASES; ADDRESSING JOINT UNDERWRITING; PROVIDING FOR TIER
14 RATING; ADDRESSING THE RECORDING, REPORTING, AND SHARING OF
15 STATISTICAL AND RATE ADMINISTRATION INFORMATION; PROHIBITING CERTAIN
16 CONDUCT; ADDRESSING GRIEVANCE AND APPEAL PROCEDURES; AMENDING
17 PROVISIONS RELATED TO RATE SERVICE ORGANIZATIONS; SPECIFYING
18 PERMITTED AND PROHIBITED ACTIVITIES FOR RATE SERVICE ORGANIZATIONS;
19 PROVIDING FOR A DESIGNATED RATE SERVICE ORGANIZATION FOR WORKERS
20 COMPENSATION; PROVIDING FOR CERTAIN UNIFORM PLANS; ADDRESSING
21 COOPERATION; AND MAKING TECHNICAL CORRECTIONS.
22 This act affects sections of Utah Code Annotated 1953 as follows:
23 AMENDS:
24 31A-1-301, as last amended by Chapters 13 and 329, Laws of Utah 1998
25 31A-2-308, as last amended by Chapter 293, Laws of Utah 1998
26 31A-6a-103, as enacted by Chapter 203, Laws of Utah 1992
27 31A-11-103, as last amended by Chapter 204, Laws of Utah 1986
28 31A-12-103, as last amended by Chapter 212, Laws of Utah 1993
29 31A-33-107, as last amended by Chapter 107, Laws of Utah 1998
30 31A-33-111, as renumbered and amended by Chapter 240, Laws of Utah 1996
31 34A-2-202, as last amended by Chapters 112, 330 and renumbered and amended by
32 Chapter 375, Laws of Utah 1997
33 53-1-106, as last amended by Chapters 36 and 242, Laws of Utah 1996
34 ENACTS:
35 31A-19a-210, Utah Code Annotated 1953
36 31A-19a-213, Utah Code Annotated 1953
37 31A-19a-214, Utah Code Annotated 1953
38 31A-19a-215, Utah Code Annotated 1953
39 31A-19a-216, Utah Code Annotated 1953
40 31A-19a-306, Utah Code Annotated 1953
41 31A-19a-307, Utah Code Annotated 1953
42 31A-19a-308, Utah Code Annotated 1953
43 31A-19a-407, Utah Code Annotated 1953
44 RENUMBERS AND AMENDS:
45 31A-19a-101, (Renumbered from 31A-19-101, as last amended by Chapter 204, Laws of
46 Utah 1986)
47 31A-19a-102, (Renumbered from 31A-19-102, as last amended by Chapter 204, Laws of
48 Utah 1986)
49 31A-19a-103, (Renumbered from 31A-19-103, as enacted by Chapter 242, Laws of Utah
50 1985)
51 31A-19a-201, (Renumbered from 31A-19-201, as enacted by Chapter 242, Laws of Utah
52 1985)
53 31A-19a-202, (Renumbered from 31A-19-202, as enacted by Chapter 242, Laws of Utah
54 1985)
55 31A-19a-203, (Renumbered from 31A-19-203, as last amended by Chapter 261, Laws of
56 Utah 1989)
57 31A-19a-204, (Renumbered from 31A-19-204, as enacted by Chapter 242, Laws of Utah
58 1985)
59 31A-19a-205, (Renumbered from 31A-19-205, as enacted by Chapter 242, Laws of Utah
60 1985)
61 31A-19a-206, (Renumbered from 31A-19-207, as last amended by Chapter 74, Laws of
62 Utah 1991)
63 31A-19a-207, (Renumbered from 31A-19-206, as last amended by Chapter 204, Laws of
64 Utah 1986)
65 31A-19a-208, (Renumbered from 31A-19-208, as enacted by Chapter 242, Laws of Utah
66 1985)
67 31A-19a-209, (Renumbered from 31A-19-209, as enacted by Chapter 242, Laws of Utah
68 1985)
69 31A-19a-211, (Renumbered from 31A-19-210, as last amended by Chapter 234, Laws of
70 Utah 1993)
71 31A-19a-212, (Renumbered from 31A-19-211, as enacted by Chapter 359, Laws of Utah
72 1998)
73 31A-19a-217, (Renumbered from 31A-19-418, as enacted by Chapter 205, Laws of Utah
74 1992)
75 31A-19a-218, (Renumbered from 31A-19-419, as enacted by Chapter 205, Laws of Utah
76 1992)
77 31A-19a-301, (Renumbered from 31A-19-301, as enacted by Chapter 242, Laws of Utah
78 1985)
79 31A-19a-302, (Renumbered from 31A-19-302, as last amended by Chapter 10, Laws of
80 Utah 1988, Second Special Session)
81 31A-19a-303, (Renumbered from 31A-19-303, as enacted by Chapter 242, Laws of Utah
82 1985)
83 31A-19a-304, (Renumbered from 31A-19-304, as last amended by Chapter 344, Laws of
84 Utah 1995)
85 31A-19a-305, (Renumbered from 31A-19-305, as last amended by Chapter 204, Laws of
86 Utah 1986)
87 31A-19a-309, (Renumbered from 31A-19-306, as enacted by Chapter 242, Laws of Utah
88 1985)
89 31A-19a-401, (Renumbered from 31A-19-401, as last amended by Chapter 91, Laws of
90 Utah 1987)
91 31A-19a-402, (Renumbered from 31A-19-402, as last amended by Chapter 205, Laws of
92 Utah 1992)
93 31A-19a-403, (Renumbered from 31A-19-403, as repealed and reenacted by Chapter 205,
94 Laws of Utah 1992)
95 31A-19a-404, (Renumbered from 31A-19-407, as repealed and reenacted by Chapter 205,
96 Laws of Utah 1992)
97 31A-19a-405, (Renumbered from 31A-19-408, as repealed and reenacted by Chapter 205,
98 Laws of Utah 1992)
99 31A-19a-406, (Renumbered from 31A-19-414, as repealed and reenacted by Chapter 205,
100 Laws of Utah 1992)
101 REPEALS:
102 31A-19-404, as last amended by Chapter 205, Laws of Utah 1992
103 31A-19-405, as last amended by Chapter 185, Laws of Utah 1997
104 31A-19-406, as repealed and reenacted by Chapter 205, Laws of Utah 1992
105 31A-19-409, as enacted by Chapter 242, Laws of Utah 1985
106 31A-19-410, as repealed and reenacted by Chapter 205, Laws of Utah 1992
107 31A-19-411, as repealed and reenacted by Chapter 205, Laws of Utah 1992
108 31A-19-412, as repealed and reenacted by Chapter 205, Laws of Utah 1992
109 31A-19-413, as repealed and reenacted by Chapter 205, Laws of Utah 1992
110 31A-19-415, as repealed and reenacted by Chapter 205, Laws of Utah 1992
111 31A-19-416, as enacted by Chapter 205, Laws of Utah 1992
112 31A-19-417, as enacted by Chapter 205, Laws of Utah 1992
113 31A-19-420, as enacted by Chapter 205, Laws of Utah 1992
114 Be it enacted by the Legislature of the state of Utah:
115 Section 1. Section 31A-1-301 is amended to read:
116 31A-1-301. Definitions.
117 As used in this title, unless otherwise specified:
118 (0.5) "Administrator" is defined in Subsection (77).
119 (1) "Adult" means a natural person who has attained the age of at least 18 years.
120 (2) "Affiliate" means any person who controls, is controlled by, or is under common
121 control with, another person. A corporation is an affiliate of another corporation, regardless of
122 ownership, if substantially the same group of natural persons manages the corporations.
123 (3) "Alien insurer" means an insurer domiciled outside the United States.
124 (4) "Annuities" means all agreements to make periodical payments for a period certain or
125 over the lifetime of one or more natural persons if the making or continuance of all or some of the
126 series of the payments, or the amount of the payment, is dependent upon the continuance of human
127 life.
128 (5) "Articles" or "articles of incorporation" means the original articles, special laws,
129 charters, amendments, restated articles, articles of merger or consolidation, trust instruments, and
130 other constitutive documents for trusts and other entities that are not corporations, and
131 amendments to any of these. Refer also to "bylaws" in this section and Section 31A-5-203 .
132 (6) "Bail bond insurance" means a guarantee that a person will attend court when required,
133 or will obey the orders or judgment of the court, as a condition to the release of that person from
134 confinement.
135 (7) "Binder" is defined in Section 31A-21-102 .
136 (8) "Board," "board of trustees," or "board of directors" means the group of persons with
137 responsibility over, or management of, a corporation, however designated. Refer also to "trustee"
138 in this section.
139 (9) "Business of insurance" is defined in Subsection (44).
140 (10) "Business plan" means the information required to be supplied to the commissioner
141 under Subsections 31A-5-204 (2)(i) and (j), including the information required when these
142 subsections are applicable by reference under Section 31A-7-201 , Section 31A-8-205 , or
143 Subsection 31A-9-205 (2).
144 (11) "Bylaws" means the rules adopted for the regulation or management of a corporation's
145 affairs, however designated. It includes comparable rules for trusts and other entities that are not
146 corporations. Refer also to "articles" and Section 31A-5-203 .
147 (12) "Casualty insurance" means liability insurance as defined in Subsection (50).
148 (13) "Certificate" means the evidence of insurance given to an insured under a group
149 policy.
150 (14) "Certificate of authority" is included within the term "license."
151 (14.5) "Claim," unless the context otherwise requires, means a request or demand on an
152 insurer for payment of benefits according to the terms of an insurance policy.
153 (14.6) "Claims-made coverage" means any insurance contract or provision limiting
154 coverage under a policy insuring against legal liability to claims that are first made against the
155 insured while the policy is in force.
156 (15) "Commissioner" or "commissioner of insurance" means Utah's insurance
157 commissioner. Where appropriate, these terms apply to the equivalent supervisory official of
158 another jurisdiction.
159 (16) "Control," "controlling," "controlled," or "under common control" means the direct
160 or indirect possession of the power to direct or cause the direction of the management and policies
161 of a person. This control may be by contract, by common management, through the ownership of
162 voting securities, or otherwise. There is no presumption that an individual holding an official
163 position with another person controls that person solely by reason of the position. A person having
164 a contract or arrangement giving control is considered to have control despite the illegality or
165 invalidity of the contract or arrangement. There is a rebuttable presumption of control in a person
166 who directly or indirectly owns, controls, holds with the power to vote, or holds proxies to vote
167 10% or more of the voting securities of another person. Refer also to "affiliate" in this section.
168 (17) (a) "Corporation" means insurance corporation, except where referring under Chapter
169 23, Insurance Marketing - Licensing Agents, Brokers [
170 Intermediaries, and Chapter 26, Insurance Adjusters, to corporations doing business as insurance
171 agents, brokers, consultants, or adjusters, or where referring under Chapter 16, Insurance Holding
172 Companies, to a noninsurer which is part of a holding company system.
173 (b) "Stock corporation" means stock insurance corporation.
174 (c) "Mutual" or "mutual corporation" means mutual insurance corporation.
175 (18) "Credit disability insurance" means insurance on a debtor to provide indemnity for
176 payments coming due on a specific loan or other credit transaction while the debtor is disabled.
177 Refer also to Subsection 31A-22-802 (1).
178 (19) "Credit insurance" means surety insurance under which mortgagees and other
179 creditors are indemnified against losses caused by the default of debtors.
180 (20) "Credit life insurance" means insurance on the life of a debtor in connection with a
181 loan or other credit transaction. Refer also to Subsection 31A-22-802 (2).
182 (21) "Creditor" means a person, including an insured, having any claim, whether matured,
183 unmatured, liquidated, unliquidated, secured, unsecured, absolute, fixed, or contingent.
184 (22) "Deemer clause" means a provision under this title under which upon the occurrence
185 of a condition precedent, the commissioner is deemed to have taken a specific action. If the statute
186 so provides, the condition precedent may be the commissioner's failure to take a specific action.
187 Refer also to Section 31A-2-302 .
188 (23) "Degree of relationship" means the number of steps between two persons determined
189 by counting the generations separating one person from a common ancestor and then counting the
190 generations to the other person.
191 (24) "Department" means the Insurance Department.
192 (25) "Director" means a member of the board of directors of a corporation.
193 (26) "Disability insurance" means insurance written to indemnify for losses and expenses
194 resulting from accident or sickness, to provide payments to replace income lost from accident or
195 sickness, and to pay for services resulting directly from accident or sickness, including medical,
196 surgical, hospital, and other ancillary expenses.
197 (27) "Domestic insurer" means an insurer organized under the laws of this state.
198 (28) "Domiciliary state" means the state in which an insurer is incorporated or organized
199 or, in the case of an alien insurer, the state of entry into the United States.
200 (29) "Employee benefits" means one or more benefits or services provided employees or
201 their dependents.
202 (30) "Employee welfare fund" means a fund established or maintained by one or more
203 employers, one or more labor organizations, or a combination of employers and labor
204 organizations, whether directly or through trustees. This fund is to provide employee benefits paid
205 or contracted to be paid, other than income from investments of the fund, by or on behalf of an
206 employer doing business in this state or for the benefit of any person employed in this state. It
207 includes plans funded or subsidized by user fees or tax revenues.
208 (31) "Excludes" is not exhaustive and does not mean that other things are not also
209 excluded. The items listed are representative examples for use in interpretation of this title.
210 (31.5) "Fidelity insurance" means insurance guaranteeing the fidelity of persons holding
211 positions of public or private trust.
212 (31.7) "First party insurance" means an insurance policy or contract in which the insurer
213 agrees to pay claims submitted to it by the insured for the insured's losses.
214 (32) "Foreign insurer" means an insurer domiciled outside of this state, including an alien
215 insurer.
216 (33) "Form" means a policy, certificate, or application prepared for general use. It does
217 not include one specially prepared for use in an individual case. Refer also to "policy" in this
218 section.
219 (34) "Franchise insurance" means individual insurance policies provided through a mass
220 marketing arrangement involving a defined class of persons related in some way other than through
221 the purchase of insurance.
222 (35) "Health care insurance" or "health insurance" means disability insurance providing
223 benefits solely of medical, surgical, hospital, or other ancillary services or payment of medical,
224 surgical, hospital, or other ancillary expenses incurred. "Health care insurance" or "health
225 insurance" does not include disability insurance providing benefits for:
226 (a) replacement of income;
227 (b) short-term accident;
228 (c) fixed indemnity;
229 (d) credit disability;
230 (e) supplements to liability;
231 (f) workers' compensation;
232 (g) automobile medical payment;
233 (h) no-fault automobile;
234 (i) equivalent self-insurance; or
235 (j) any type of disability insurance coverage that is a part of or attached to another type of
236 policy.
237 (35.5) "Indemnity" means the payment of an amount to offset all or part of an insured loss.
238 (36) "Independent adjuster" means an insurance adjuster required to be licensed under
239 Section 31A-26-201 who engages in insurance adjusting as a representative of insurers. Refer also
240 to Section 31A-26-102 .
241 (37) "Independently procured insurance" means insurance procured under Section
242 31A-15-104 .
243 (37.5) "Individual" means a natural person.
244 (38) "Inland marine insurance" includes insurance covering:
245 (a) property in transit on or over land;
246 (b) property in transit over water by means other than boat or ship;
247 (c) bailee liability;
248 (d) fixed transportation property such as bridges, electric transmission systems, radio and
249 television transmission towers and tunnels; and
250 (e) personal and commercial property floaters.
251 (39) "Insolvency" means that:
252 (a) an insurer is unable to pay its debts or meet its obligations as they mature;
253 (b) an insurer's total adjusted capital is less than the insurer's mandatory control level RBC
254 under Subsection 31A-17-601 (7)(c); or
255 (c) an insurer is determined to be hazardous under this title.
256 (40) "Insurance" means any arrangement, contract, or plan for the transfer of a risk or risks
257 from one or more persons to one or more other persons, or any arrangement, contract, or plan for
258 the distribution of a risk or risks among a group of persons that includes the person seeking to
259 distribute his risk. "Insurance" includes:
260 (a) risk distributing arrangements providing for compensation or replacement for damages
261 or loss through the provision of services or benefits in kind;
262 (b) contracts of guaranty or suretyship entered into by the guarantor or surety as a business
263 and not as merely incidental to a business transaction; and
264 (c) plans in which the risk does not rest upon the person who makes the arrangements, but
265 with a class of persons who have agreed to share it.
266 (41) "Insurance adjuster" means a person who directs the investigation, negotiation, or
267 settlement of a claim under an insurance policy other than life insurance or an annuity, on behalf
268 of an insurer, policyholder, or a claimant under an insurance policy. Refer also to Section
269 31A-26-102 .
270 (41.5) "Interinsurance exchange" is defined in Subsection (69).
271 (42) "Insurance agent" or "agent" means a person who represents insurers in soliciting,
272 negotiating, or placing insurance. Refer to Subsection 31A-23-102 (2) for exceptions to this
273 definition.
274 (43) "Insurance broker" or "broker" means a person who acts in procuring insurance on
275 behalf of an applicant for insurance or an insured, and does not act on behalf of the insurer except
276 by collecting premiums or performing other ministerial acts. Refer to Subsection 31A-23-102 (2)
277 for exceptions to this definition.
278 (44) "Insurance business" or "business of insurance" includes:
279 (a) providing health care insurance, as defined in Subsection (35), by organizations that
280 are or should be licensed under this title;
281 (b) providing benefits to employees in the event of contingencies not within the control
282 of the employees, in which the employees are entitled to the benefits as a right, which benefits may
283 be provided either by single employers or by multiple employer groups through trusts, associations,
284 or other entities;
285 (c) providing annuities, including those issued in return for gifts, except those provided
286 by persons specified in Subsections 31A-22-1305 (2) and (3);
287 (d) providing the characteristic services of motor clubs as outlined in Subsection (56);
288 (e) providing other persons with insurance as defined in Subsection (40);
289 (f) making as insurer, guarantor, or surety, or proposing to make as insurer, guarantor, or
290 surety, any contract or policy of title insurance;
291 (g) transacting or proposing to transact any phase of title insurance, including solicitation,
292 negotiation preliminary to execution, execution of a contract of title insurance, insuring, and
293 transacting matters subsequent to the execution of the contract and arising out of it, including
294 reinsurance; and
295 (h) doing, or proposing to do, any business in substance equivalent to Subsections (44)(a)
296 through (g) in a manner designed to evade the provisions of this title.
297 (45) "Insurance consultant" or "consultant" means a person who advises other persons
298 about insurance needs and coverages, is compensated by the person advised on a basis not directly
299 related to the insurance placed, and is not compensated directly or indirectly by an insurer, agent,
300 or broker for advice given. Refer to Subsection 31A-23-102 (2) for exceptions to this definition.
301 (46) "Insurance holding company system" means a group of two or more affiliated persons,
302 at least one of whom is an insurer.
303 (47) "Insured" means a person to whom or for whose benefit an insurer makes a promise
304 in an insurance policy. The term includes policyholders, subscribers, members, and beneficiaries.
305 This definition applies only to the provisions of this title and does not define the meaning of this
306 word as used in insurance policies or certificates.
307 (48) (a) "Insurer" means any person doing an insurance business as a principal, including
308 fraternal benefit societies, issuers of gift annuities other than those specified in Subsections
309 31A-22-1305 (2) and (3), motor clubs, employee welfare plans, and any person purporting or
310 intending to do an insurance business as a principal on his own account. It does not include a
311 governmental entity, as defined in Section 63-30-2 , to the extent it is engaged in the activities
312 described in Section 31A-12-107 .
313 (b) "Admitted insurer" is defined in Subsection (80)(b).
314 (c) "Alien insurer" is defined in Subsection (3).
315 (d) "Authorized insurer" is defined in Subsection (80)(b).
316 (e) "Domestic insurer" is defined in Subsection (27).
317 (f) "Foreign insurer" is defined in Subsection (32).
318 (g) "Nonadmitted insurer" is defined in Subsection (80)(a).
319 (h) "Unauthorized insurer" is defined in Subsection (80)(a).
320 (49) "Legal expense insurance" means insurance written to indemnify or pay for specified
321 legal expenses. It includes arrangements that create reasonable expectations of enforceable rights,
322 but it does not include the provision of, or reimbursement for, legal services incidental to other
323 insurance coverages. Refer to Section 31A-1-103 for a list of exemptions.
324 (50) (a) "Liability insurance" means insurance against liability:
325 (i) for death, injury, or disability of any human being, or for damage to property, exclusive
326 of the coverages under Subsection (53) for medical malpractice insurance, Subsection (66) for
327 professional liability insurance, and Subsection (83) for workers' compensation insurance;
328 (ii) for medical, hospital, surgical, and funeral benefits to persons other than the insured
329 who are injured, irrespective of legal liability of the insured, when issued with or supplemental to
330 insurance against legal liability for the death, injury, or disability of human beings, exclusive of
331 the coverages under Subsection (53) for medical malpractice insurance, Subsection (66) for
332 professional liability insurance, and Subsection (83) for workers' compensation insurance;
333 (iii) for loss or damage to property resulting from accidents to or explosions of boilers,
334 pipes, pressure containers, machinery, or apparatus;
335 (iv) for loss or damage to any property caused by the breakage or leakage of sprinklers,
336 water pipes and containers, or by water entering through leaks or openings in buildings; or
337 (v) for other loss or damage properly the subject of insurance not within any other kind
338 or kinds of insurance as defined in this chapter, if such insurance is not contrary to law or public
339 policy.
340 (b) "Liability insurance" includes vehicle liability insurance as defined in Subsection (81),
341 residential dwelling liability insurance as defined in Subsection (70.3), and also includes making
342 inspection of, and issuing certificates of inspection upon, elevators, boilers, machinery, and
343 apparatus of any kind when done in connection with insurance on them.
344 (51) "License" means the authorization issued by the insurance commissioner under this
345 title to engage in some activity that is part of or related to the insurance business. It includes
346 certificates of authority issued to insurers.
347 (52) "Life insurance" means insurance on human lives and insurances pertaining to or
348 connected with human life. The business of life insurance includes granting annuity benefits,
349 granting endowment benefits, granting additional benefits in the event of death by accident or
350 accidental means, granting additional benefits in the event of the total and permanent disability of
351 the insured, and providing optional methods of settlement of proceeds.
352 (53) "Medical malpractice insurance" means insurance against legal liability incident to
353 the practice and provision of medical services other than the practice and provision of dental
354 services.
355 (54) "Member" means a person having membership rights in an insurance corporation.
356 Refer also to "insured" in Subsection (47).
357 (55) "Minimum capital" or "minimum required capital" means the capital that must be
358 constantly maintained by a stock insurance corporation as required by statute. Refer also to
359 "permanent surplus" under Subsection (76)(a) and Sections 31A-5-211 , 31A-8-209 , and
360 31A-9-209 .
361 (56) "Motor club" means a person licensed under Chapter 5, Domestic Stock and Mutual
362 Insurance Corporations, Chapter 11, Motor Clubs, or Chapter 14, Foreign Insurers, that promises
363 for an advance consideration to provide legal services under Subsection 31A-11-102 (1)(b), bail
364 services under Subsection 31A-11-102 (1)(c), trip reimbursement, towing services, emergency road
365 services, stolen automobile services, a combination of these services, or any other services given
366 in Subsections 31A-11-102 (1)(b) through (f) for a stated period of time.
367 (57) "Mutual" means mutual insurance corporation.
368 (57.5) "Nonparticipating" means a plan of insurance under which the insured is not entitled
369 to receive dividends representing shares of the surplus of the insurer.
370 (58) "Ocean marine insurance" means insurance against loss of or damage to:
371 (a) ships or hulls of ships;
372 (b) goods, freight, cargoes, merchandise, effects, disbursements, profits, moneys,
373 securities, choses in action, evidences of debt, valuable papers, bottomry, respondentia interests,
374 or other cargoes in or awaiting transit over the oceans or inland waterways;
375 (c) earnings such as freight, passage money, commissions, or profits derived from
376 transporting goods or people upon or across the oceans or inland waterways; or
377 (d) a vessel owner or operator as a result of liability to employees, passengers, bailors,
378 owners of other vessels, owners of fixed objects, customs or other authorities, or other persons in
379 connection with maritime activity.
380 (59) "Order" means an order of the commissioner.
381 (59.5) "Participating" means a plan of insurance under which the insured is entitled to
382 receive dividends representing shares of the surplus of the insurer.
383 (60) "Person" includes an individual, partnership, corporation, incorporated or
384 unincorporated association, joint stock company, trust, reciprocal, syndicate, or any similar entity
385 or combination of entities acting in concert.
386 (61) (a) "Policy" means any document, including attached endorsements and riders,
387 purporting to be an enforceable contract, which memorializes in writing some or all of the terms
388 of an insurance contract. Service contracts issued by motor clubs under Chapter 11, Motor Clubs,
389 and by corporations licensed under Chapter 7, Nonprofit Health Service Insurance Corporations,
390 or Chapter 8, Health Maintenance Organizations and Limited Health Plans, are policies. A
391 certificate under a group insurance contract is not a policy. A document which does not purport
392 to have legal effect is not a policy.
393 (b) "Group insurance policy" means a policy covering a group of persons that is issued to
394 a policyholder on behalf of the group, for the benefit of group members who are selected under
395 procedures defined in the policy or in agreements which are collateral to the policy. This type of
396 policy may, but is not required to, include members of the policyholder's family or dependents.
397 (c) "Blanket insurance policy" means a group policy covering classes of persons without
398 individual underwriting, where the persons insured are determined by definition of the class with
399 or without designating the persons covered.
400 (62) "Policyholder" means the person who controls a policy, binder, or oral contract by
401 ownership, premium payment, or otherwise. Refer also to "insured" in Subsection (47).
402 (63) "Premium" means the monetary consideration for an insurance policy, and includes
403 assessments, membership fees, required contributions, or monetary consideration, however
404 designated. Consideration paid to third party administrators for their services is not "premium,"
405 though amounts paid by third party administrators to insurers for insurance on the risks
406 administered by the third party administrators are "premium."
407 (64) "Principal officers" of a corporation means the officers designated under Subsection
408 31A-5-203 (3).
409 (65) "Proceedings" includes actions and special statutory proceedings.
410 (66) "Professional liability insurance" means insurance against legal liability incident to
411 the practice of a profession and provision of any professional services.
412 (67) "Property insurance" means insurance against loss or damage to real or personal
413 property of every kind and any interest in that property, from all hazards or causes, and against loss
414 consequential upon the loss or damage including vehicle comprehensive and vehicle physical
415 damage coverages, but excluding inland marine insurance and ocean marine insurance as defined
416 under Subsections (38) and (58).
417 (67.5) "Public agency insurance mutual" means any entity formed by joint venture or
418 interlocal cooperation agreement by two or more political subdivisions or public agencies of the
419 state for the purpose of providing insurance coverage for the political subdivisions or public
420 agencies. Any public agency insurance mutual created under this title and Title 11, Chapter 13,
421 Interlocal Cooperation Act, is considered to be a governmental entity and political subdivision of
422 the state with all of the rights, privileges, and immunities of a governmental entity or political
423 subdivision of the state.
424 (68) (a) Except as provided in Subsection (68)(b), "rate service organization" means any
425 person who assists insurers in rate making or filing by:
426 (i) collecting, compiling, and furnishing loss or expense statistics;
427 (ii) recommending, making, or filing rates or supplementary rate information; or
428 (iii) advising about rate questions, except as an attorney giving legal advice. [
429
430 (b) "Rate service organization" does not mean an employee of an insurer, a single insurer
431 or group of insurers under common control, a joint underwriting group, or a natural person serving
432 as an actuarial or legal consultant.
433 (69) "Reciprocal" or "interinsurance exchange" means any unincorporated association of
434 persons operating through an attorney-in-fact common to all of them and exchanging insurance
435 contracts with one another that provide insurance coverage on each other.
436 (70) "Reinsurance" means an insurance transaction where an insurer, for consideration,
437 transfers any portion of the risk it has assumed to another insurer. In referring to reinsurance
438 transactions, this title sometimes refers to the insurer transferring the risk as the "ceding insurer,"
439 and to the insurer assuming the risk as the "assuming insurer" or the "assuming reinsurer."
440 (70.3) "Residential dwelling liability insurance" means insurance against liability resulting
441 from or incident to the ownership, maintenance, or use of a residential dwelling that is a detached
442 single family residence or multifamily residence up to four units.
443 (71) "Retrocession" means reinsurance with another insurer of a liability assumed under
444 a reinsurance contract. A reinsurer "retrocedes" when it reinsures with another insurer part of a
445 liability assumed under a reinsurance contract.
446 (72) (a) "Security" means any:
447 (i) note;
448 (ii) stock;
449 (iii) bond;
450 (iv) debenture;
451 (v) evidence of indebtedness;
452 (vi) certificate of interest or participation in any profit-sharing agreement;
453 (vii) collateral-trust certificate;
454 (viii) preorganization certificate or subscription;
455 (ix) transferable share;
456 (x) investment contract;
457 (xi) voting trust certificate;
458 (xii) certificate of deposit for a security;
459 (xiii) certificate of interest of participation in an oil, gas, or mining title or lease or in
460 payments out of production under such a title or lease;
461 (xiv) commodity contract or commodity option;
462 (xv) any certificate of interest or participation in, temporary or interim certificate for,
463 receipt for, guarantee of, or warrant or right to subscribe to or purchase any of the items listed in
464 Subsections (72)(a)(i) through (xiv); or
465 (xvi) any other interest or instrument commonly known as a security.
466 (b) "Security" does not include:
467 (i) any insurance or endowment policy or annuity contract under which an insurance
468 company promises to pay money in a specific lump sum or periodically for life or some other
469 specified period; or
470 (ii) a burial certificate or burial contract.
471 (73) "Self-insurance" means any arrangement under which a person provides for spreading
472 its own risks by a systematic plan.
473 (a) Except as provided in this subsection, self-insurance does not include an arrangement
474 under which a number of persons spread their risks among themselves.
475 (b) Self-insurance does include an arrangement by which a governmental entity, as defined
476 in Section 63-30-2 , undertakes to indemnify its employees for liability arising out of the
477 employees' employment.
478 (c) Self-insurance does include an arrangement by which a person with a managed
479 program of self-insurance and risk management undertakes to indemnify its affiliates, subsidiaries,
480 directors, officers, or employees for liability or risk which is related to the relationship or
481 employment. Self-insurance does not include any arrangement with independent contractors.
482 (74) (a) "Subsidiary" of a person means an affiliate controlled by that person either directly
483 or indirectly through one or more affiliates or intermediaries.
484 (b) "Wholly owned subsidiary" of a person is a subsidiary of which all of the voting shares
485 are owned by that person either alone or with its affiliates, except for the minimum number of
486 shares the law of the subsidiary's domicile requires to be owned by directors or others.
487 (75) Subject to Subsection (40)(b), "surety insurance" includes:
488 (a) a guarantee against loss or damage resulting from failure of principals to pay or
489 perform their obligations to a creditor or other obligee;
490 (b) bail bond insurance; and
491 (c) fidelity insurance.
492 (76) (a) "Surplus" means the excess of assets over the sum of paid-in capital and liabilities.
493 (b) "Permanent surplus" means the surplus of a mutual insurer that has been designated
494 by the insurer as permanent. Sections 31A-5-211 , 31A-7-201 , 31A-8-209 , 31A-9-209 , and
495 31A-14-209 require that mutuals doing business in this state maintain specified minimum levels
496 of permanent surplus. Except for assessable mutuals, the minimum permanent surplus requirement
497 is essentially the same as the minimum required capital requirement that applies to stock insurers.
498 Refer also to Subsection (55) on "minimum capital."
499 (c) "Excess surplus" means:
500 (i) for life or disability insurers, as defined in Subsection 31A-17-601 (3), and property and
501 casualty insurers, as defined in Subsection 31A-17-601 (4), the lesser of:
502 (A) that amount of an insurer's total adjusted capital, as defined in Subsection (78.5), that
503 exceeds the product of 2.5 and the sum of the insurer's minimum capital or permanent surplus
504 required under Section 31A-5-211 , 31A-9-209 , or 31A-14-205 ; or
505 (B) that amount of an insurer's total adjusted capital, as defined in Subsection (78.5), that
506 exceeds the product of 3.0 and the authorized control level RBC as defined in Subsection
507 31A-17-601 (7)(a); and
508 (ii) for monoline mortgage guaranty insurers, financial guaranty insurers, and title insurers,
509 that amount of an insurer's paid-in-capital and surplus that exceeds the product of 1.5 and the
510 insurer's total adjusted capital required by Subsection 31A-17-609 (1).
511 (77) "Third party administrator" or "administrator" means any person who collects charges
512 or premiums from, or who, for consideration, adjusts or settles claims of residents of the state in
513 connection with life or disability insurance coverage, annuities, or service insurance coverage,
514 except:
515 (a) a union on behalf of its members;
516 (b) a person exempt as a trust under Section 514 of the federal Employee Retirement
517 Income Security Act of 1974;
518 (c) an employer on behalf of his employees or the employees of one or more of the
519 subsidiary or affiliated corporations of the employer;
520 (d) an insurer licensed under Chapter 5, 7, 8, 9, or 14, but only with respect to insurance
521 issued by the insurer; or
522 (e) a person licensed or exempt from licensing under Chapter 23 or 26 whose activities are
523 limited to those authorized under the license the person holds or for which the person is exempt.
524 Refer also to Section 31A-25-101 .
525 (78) "Title insurance" means the insuring, guaranteeing, or indemnifying of owners of real
526 or personal property or the holders of liens or encumbrances on that property, or others interested
527 in the property against loss or damage suffered by reason of liens or encumbrances upon, defects
528 in, or the unmarketability of the title to the property, or invalidity or unenforceability of any liens
529 or encumbrances on the property.
530 (78.5) "Total adjusted capital" means the sum of an insurer's statutory capital and surplus
531 as determined in accordance with:
532 (a) the statutory accounting applicable to the annual financial statements required to be
533 filed under Section 31A-4-113 ; and
534 (b) any other items provided by the RBC instructions, as RBC instructions is defined in
535 Subsection 31A-17-601 (6).
536 (79) (a) "Trustee" means "director" when referring to the board of directors of a
537 corporation.
538 (b) "Trustee," when used in reference to an employee welfare fund, means an individual,
539 firm, association, organization, joint stock company, or corporation, whether acting individually
540 or jointly and whether designated by that name or any other, that is charged with or has the overall
541 management of an employee welfare fund.
542 (80) (a) "Unauthorized insurer," "unadmitted insurer," or "nonadmitted insurer" means an
543 insurer not holding a valid certificate of authority to do an insurance business in this state, or an
544 insurer transacting business not authorized by a valid certificate.
545 (b) "Admitted insurer" or "authorized insurer" means an insurer holding a valid certificate
546 of authority to do an insurance business in this state and transacting business as authorized by a
547 valid certificate.
548 (81) "Vehicle liability insurance" means insurance against liability resulting from or
549 incident to ownership, maintenance, or use of any land vehicle or aircraft, exclusive of vehicle
550 comprehensive and vehicle physical damage coverages under Subsection (67).
551 (82) "Voting security" means a security with voting rights, and includes any security
552 convertible into a security with a voting right associated with it.
553 (83) [
554 (a) insurance for indemnification of employers against liability for compensation:
555 (i) based upon compensable accidental injuries; and
556 (ii) based on occupational disease disability;
557 (b) employer's liability insurance incidental to workers' compensation insurance and
558 written in connection with it; and
559 (c) insurance assuring to the persons entitled to workers' compensation benefits the
560 compensation provided by law.
561 Section 2. Section 31A-2-308 is amended to read:
562 31A-2-308. Enforcement penalties and procedures.
563 (1) (a) A person who violates any insurance statute or rule or any order issued under
564 Subsection 31A-2-201 (4) shall forfeit to the state twice the amount of any profit gained from the
565 violation, in addition to any other forfeiture or penalty imposed.
566 (b) (i) The commissioner may order an individual agent, broker, adjuster, or insurance
567 consultant who violates an insurance statute or rule to forfeit to the state not more than $2,500 for
568 each violation.
569 (ii) The commissioner may order any other person who violates an insurance statute or rule
570 to forfeit to the state not more than $5,000 for each violation.
571 (c) (i) The commissioner may order an individual agent, broker, adjuster, or insurance
572 consultant who violates an order issued under Subsection 31A-2-201 (4) to forfeit to the state not
573 more than $2,500 for each violation. Each day the violation continues is a separate violation.
574 (ii) The commissioner may order any other person who violates an order issued under
575 Subsection 31A-2-201 (4) to forfeit to the state not more than $5,000 for each violation. Each day
576 the violation continues is a separate violation.
577 (d) The commissioner may accept or compromise any forfeiture under this subsection until
578 after a complaint is filed under Subsection (2). After the filing of the complaint, only the attorney
579 general may compromise the forfeiture.
580 (2) Whenever a person fails to comply with an order issued under Subsection
581 31A-2-201 (4), including a forfeiture order, the commissioner may file an action in any court of
582 competent jurisdiction or obtain a court order or judgment:
583 (a) enforcing the commissioner's order;
584 (b) directing compliance with the commissioner's order and restraining further violation
585 of the order, subjecting the person ordered to the procedures and sanctions available to the court
586 for punishing contempt if the failure to comply continues; or
587 (c) imposing a forfeiture in an amount the court considers just, up to $10,000 for each day
588 the failure to comply continues after the filing of the complaint until judgment is rendered.
589 (3) The Utah Rules of Civil Procedure govern actions brought under Subsection (2), except
590 that the commissioner may file a complaint seeking a court-ordered forfeiture under Subsection
591 (2)(c) no sooner than two weeks after giving written notice of his intention to proceed under
592 Subsection (2)(c). The commissioner's order issued under Subsection 31A-2-201 (4) may contain
593 a notice of intention to seek a court-ordered forfeiture if the commissioner's order is disobeyed.
594 (4) If, after a court order is issued under Subsection (2), the person fails to comply with
595 the commissioner's order or judgment, the commissioner may certify the fact of the failure to the
596 court by affidavit, and the court may, after a hearing following at least five days written notice to
597 the parties subject to the order or judgment, amend the order or judgment to add the forfeiture or
598 forfeitures, as prescribed in Subsection (2)(c), until the person complies.
599 (5) The proceeds of all forfeitures under this section, including collection expenses, shall
600 be paid into the General Fund. The expenses of collection shall be credited to the Insurance
601 Department's budget. The attorney general's budget shall be credited to the extent the Insurance
602 Department reimburses the attorney general's office for its collection expenses under this section.
603 (6) Forfeitures and judgments under this section bear interest at the rate then charged by
604 the United States Internal Revenue Service for past due taxes. Interest accrues from the later of the
605 date of entry of the commissioner's order under Subsection (1) or the date of judgment under
606 Subsection (2) until the forfeiture and accrued interest are fully paid.
607 (7) No forfeiture may be imposed under Subsection (2)(c) if, at the time the forfeiture
608 action is commenced, the person was in compliance with the commissioner's order, or if the
609 violation of the order occurred during the order's suspension.
610 (8) The commissioner may seek an injunction as an alternative to issuing an order under
611 Subsection 31A-2-201 (4).
612 (9) A person who intentionally violates, intentionally permits any person over whom he
613 has authority to violate, or intentionally aids any person in violating any insurance statute or rule
614 of this state or any effective order issued under Subsection 31A-2-201 (4) is guilty of a class B
615 misdemeanor. Unless a specific criminal penalty is provided elsewhere in this title, the person may
616 be fined not more than $10,000 if a corporation or not more than $5,000 if a person other than a
617 corporation. If the person is an individual, the person may, in addition, be imprisoned for up to
618 one year. As used in this Subsection (9), "intentionally" has the same meaning as under Subsection
619 76-2-103 (1).
620 (10) When a licensee of the Insurance Department, other than a domestic insurer,
621 persistently or substantially violates the insurance law or violates an order of the commissioner
622 under Subsection 31A-2-201 (4), if there are grounds for delinquency proceedings against the
623 licensee under Section 31A-27-301 or Section 31A-27-307 , or if the licensee's methods and
624 practices in the conduct of his business endanger, or his financial resources are inadequate to
625 safeguard, the legitimate interests of his customers and the public, the commissioner may, after a
626 hearing, in whole or in part, revoke, suspend, place on probation, limit, or refuse to renew the
627 licensee's license or certificate of authority. Additional license termination or probation provisions
628 for licensees other than insurers are set forth in Sections [
629 31A-19a-304 , 31A-23-216 , 31A-23-217 , 31A-25-208 , 31A-25-209 , 31A-26-213 , 31A-26-214 ,
630 31A-35-501 , and 31A-35-503 .
631 (11) The enforcement penalties and procedures set forth in this section are not exclusive,
632 but are cumulative of other rights and remedies the commissioner has pursuant to applicable law.
633 Section 3. Section 31A-6a-103 is amended to read:
634 31A-6a-103. Requirements for doing business.
635 (1) Service contracts may not be issued, sold, or offered for sale in this state unless the
636 service contract is insured under a service contract reimbursement insurance policy issued by an
637 insurer authorized to do business in this state, or a recognized surplus lines carrier.
638 (2) (a) Service contracts may not be issued, sold, or offered for sale unless a true and
639 correct copy of the service contract and the provider's reimbursement insurance policy have been
640 filed with the commissioner. Copies of contracts and policies must be filed no less than 30 days
641 prior to the issuance, sale offering for sale, or use of the service contract or reimbursement
642 insurance policy in this state.
643 (b) Each modification of the terms of any service contract or reimbursement insurance
644 policy must also be filed 30 days prior to its use in this state. Each filing must be accompanied by
645 a filing fee as required under Subsection 31A-3-103 , or the filing shall be rejected.
646 (c) Persons complying with this chapter are not required to comply with:
647 (i) Subsections 31A-21-201 (1) and 31A-23-302 (3)[
648 (ii) Chapter [
649 (3) (a) Premiums collected on service contracts are not subject to premium taxes.
650 (b) Premiums collected by issuers of reimbursement insurance policies are subject to
651 premium taxes.
652 (4) Persons marketing, selling, or offering to sell service contracts for service contract
653 providers that comply with this chapter are exempt from the licensing requirements of this title.
654 (5) Service contract providers complying with this chapter are not required to comply with:
655 (a) Chapter 5, Domestic Stock and Mutual Insurance Corporations[
656 (b) Chapter 7, Nonprofit Health Service Insurance Corporations[
657 (c) Chapter 8, Health Maintenance Organizations and Limited Health Plans[
658 (d) Chapter 9, Insurance Fraternals[
659 (e) Chapter 10, Annuities[
660 (f) Chapter 11, Motor Clubs[
661 (g) Chapter 12, State Risk Management Fund[
662 (h) Chapter 13, Employee Welfare Funds and Plans[
663 (i) Chapter 14, Foreign Insurers[
664 (j) Chapter [
665 (k) Chapter 25, Third Party Administrators[
666 (l) Chapter 28, Guaranty Associations.
667 Section 4. Section 31A-11-103 is amended to read:
668 31A-11-103. Rates.
669 (1) Rates charged to holders of motor club service contracts may not be inadequate,
670 excessive, or unfairly discriminatory.
671 (2) If, after a hearing, the commissioner finds a motor club's rates in violation of this
672 section, [
673 [
674 proceed under Chapter [
675 to the requirements of this section. Chapter [
676 issuance of another order under this section.
677 Section 5. Section 31A-12-103 is amended to read:
678 31A-12-103. Rates charged to school districts.
679 The rates charged to school districts for policies issued under Section 63A-4-204 are not
680 subject to Chapter [
681 31A-19a-203 (1) and the public availability requirement of Section [
682 Rate filing fees under Section 31A-3-103 shall be paid to the department by the Risk Management
683 Fund.
684 Section 6. Section 31A-19a-101 , which is renumbered from Section 31A-19-101 is
685 renumbered and amended to read:
686
687
688 [
689 (1) This chapter is known as the "Utah Rate Regulation Act."
690 [
691 all kinds and lines of direct insurance written on risks or operations in this state by an insurer
692 authorized to do business in this state[
693 (ii) This chapter does not apply to:
694 [
695 [
696 [
697 [
698 [
699
700 (b) This chapter applies to all insurers authorized to do any line of business, except those
701 specified in [
702 [
703 (a) protect policyholders and the public against the adverse effects of excessive,
704 inadequate, or unfairly discriminatory rates;
705 (b) encourage independent action by and reasonable price competition among insurers so
706 that rates are responsive to competitive market conditions;
707 (c) provide formal regulatory controls for use if independent action and price competition
708 fail;
709 (d) provide regulatory procedures for the maintenance of appropriate data reporting
710 systems;
711 [
712 regulate that cooperation to prevent practices that bring about a monopoly or lessen or destroy
713 competition;
714 [
715 [
716 Act, 15 U.S.C. Secs. 1011 through 1015, will preclude application of federal antitrust laws.
717 [
718 continued. Rate filings made after July 1, 1986, are subject to the requirements of this chapter.
719 Section 7. Section 31A-19a-102 , which is renumbered from Section 31A-19-102 is
720 renumbered and amended to read:
721 [
722 As used in this chapter:
723 [
724
725
726
727
728 [
729
730 [
731 [
732 [
733 (1) "Classification system" or "classification" means the process of grouping risks with
734 similar risk characteristics so that differences in anticipated costs may be recognized.
735 (2) (a) "Developed losses" means losses adjusted using standard actuarial techniques to
736 eliminate the effect of differences between:
737 (i) current payment or reserve estimates; and
738 (ii) payments or reserve estimates that are anticipated to provide actual ultimate loss
739 payments.
740 (b) For purposes of Subsection (2)(a), losses includes loss adjustment expense.
741 (3) "Dividend" means money paid to a policyholder from the remaining portion of the
742 premium paid for a policy:
743 (a) based on the participating class of business; and
744 (b) after the insurer has made deductions for:
745 (i) losses;
746 (ii) expenses;
747 (iii) additions to reserves; and
748 (iv) profit and contingencies.
749 (4) "Expenses" means that portion of a rate attributable to:
750 (a) acquisition;
751 (b) field supervision;
752 (c) collection expenses;
753 (d) general expenses;
754 (e) taxes;
755 (f) licenses; and
756 (g) fees.
757 (5) "Experience rating" means a rating procedure that:
758 (a) uses the past insurance experience of an individual policyholder to forecast the future
759 losses of the policyholder by measuring the policyholder's loss experience against the loss
760 experience of policyholders in the same classification; and
761 (b) produces a prospective premium credit, debit, or unity modification.
762 (6) "Joint underwriting" means a voluntary arrangement established to provide insurance
763 coverage for a risk pursuant to which two or more insurers jointly contract with the insured at a
764 price and under policy terms agreed upon between the insurers.
765 (7) "Loss adjustment expense" means the expenses incurred by the insurer in the course
766 of settling claims.
767 (8) (a) "Market" means the interaction between buyers and sellers consisting of a:
768 (i) product component; and
769 (ii) geographic component.
770 (b) A product component consists of identical or readily substitutable products if the
771 products are compared as to factors including:
772 (i) coverage;
773 (ii) policy terms;
774 (iii) rate classifications; and
775 (iv) underwriting.
776 (c) A geographic component is a geographical area in which buyers seek access to the
777 insurance product through sales outlets and other distribution mechanisms or patterns.
778 (9) "Mass marketed plan" means a method of selling insurance when:
779 (a) the insurance is offered to:
780 (i) employees of a particular employer;
781 (ii) members of a particular association or organization; or
782 (iii) persons grouped in a manner other than described in Subsection (8)(a)(i) or (ii), except
783 groupings formed principally for the purpose of obtaining insurance; and
784 (b) the employer, association, or other organization, if any, has agreed to, or otherwise
785 affiliated itself with, the sale of insurance to its employees or members.
786 (10) "Prospective loss costs" means the same as pure premium rate.
787 (11) "Pure premium rate" means that portion of a rate that:
788 (a) does not include provisions for profit or expenses, other than loss adjustment expenses;
789 and
790 (b) is based on historical aggregate losses and loss adjustment expenses that are:
791 (i) adjusted through development to their ultimate value; and
792 (ii) projected through trending to a future point in time.
793 (12) (a) "Rate" means that cost of insurance per exposure unit either expressed as:
794 (i) a single number; or
795 (ii) as a pure premium rate adjusted before any application of individual risk variations
796 based on loss or expense considerations to account for the treatment of:
797 (A) expenses;
798 (B) profit; and
799 (C) individual insurer variation in loss experience.
800 (b) "Rate" does not include a minimum premium.
801 [
802
803
804 (13) "Rating tiers" means an underwriting and rating plan designed to categorize insurance
805 risks that have common characteristics related to potential insurance loss into broad groups for the
806 purpose of establishing a set of rating levels that reflect definable levels of potential hazard or risk.
807 [
808 [
809 needed to determine the applicable rate in effect or to be in effect:
810 (a) a manual or plan of rates[
811 (b) a statistical plan[
812 (c) a classification[
813 (d) a rating schedule[
814 (e) a minimum premium[
815 (f) a policy fee[
816 (g) a rating rule[
817 (h) a rate-related underwriting rule[
818 (i) a rate modification plan; or
819 (j) any other similar information prescribed by rule of the commissioner as supplementary
820 rate information.
821 (16) "Supporting information" includes one or more of the following:
822 (a) data demonstrating actuarial justification for the basic rate factors, classifications,
823 expenses, and profit factors used by the filer;
824 (b) the experience and judgment of the filer;
825 (c) the experience or data of other insurers or rate service organizations relied upon by the
826 filer;
827 (d) the interpretation of any other data relied upon by the filer;
828 (e) descriptions of methods used in making the rates; or
829 (f) any other information defined by rule as supporting information that is required to be
830 filed.
831 (17) "Trending" means any procedure for projecting, for the period during which the
832 policies are to be effective:
833 (a) losses to the average date of loss; or
834 (b) premiums or exposures to the average date of writing.
835 Section 8. Section 31A-19a-103 , which is renumbered from Section 31A-19-103 is
836 renumbered and amended to read:
837 [
838 (1) The commissioner may by rule exempt from any or all of the provisions of this chapter:
839 (a) any person[
840 (b) a class of persons[
841 (c) a market segment [
842 (2) The exemption described in Subsection (1) shall be given only if and to the extent that
843 the commissioner finds the application of the provisions of this chapter to that person or group is
844 unnecessary to achieve the purposes of this chapter.
845 Section 9. Section 31A-19a-201 , which is renumbered from Section 31A-19-201 is
846 renumbered and amended to read:
847
848 [
849 (1) Rates may not be excessive, inadequate, or unfairly discriminatory[
850
851
852 (2) (a) Rates are not excessive if a reasonable degree of price competition exists at the
853 consumer level with respect to the class of business to which they apply. In determining whether
854 a reasonable degree of price competition exists, the commissioner shall consider [
855 (i) relevant tests [
856 (A) market structure;
857 (B) market performance; and
858 (C) market conduct; and
859 (ii) the practical opportunities available to consumers in the market to:
860 (A) acquire pricing and other consumer information; and
861 (B) compare and obtain insurance from competing insurers.
862 (b) The tests described in Subsection (2)(a) include:
863 (i) the size and number of insurers actively engaged in the market and class of business;
864 (ii) [
865 market shares;
866 (iii) the existence of rate differentials in that class of business;
867 (iv) ease of entry and latent competition of insurers capable of easy entry[
868 (v) whether the profitability of companies generally in the market segment is unreasonably
869 high;
870 (vi) availability of consumer information concerning the product and sales outlets or other
871 sales mechanisms; and
872 (vii) efforts of insurers to provide consumer information.
873 [
874 (i) rates are likely to produce a long-term profit that is unreasonably high in relation to the
875 riskiness of the class of business[
876 (ii) expenses are unreasonably high in relation to the services rendered.
877 (3) Rates are inadequate if:
878 (a) they are clearly insufficient, when combined with the investment income attributable
879 to them, to sustain the projected losses and expenses in the class of business to which they apply[
880 and
881 (b) the use of such rates has or, if continued, will have:
882 (i) the effect of substantially lessening competition; or
883 (ii) the tendency to create a monopoly in any market.
884 (4) (a) A rate is unfairly discriminatory [
885
886 expenses[
887 (b) A rate is not unfairly discriminatory [
888
889
890
891 under a:
892 (i) group, franchise, or blanket policy; or
893 (ii) mass marketed plan.
894 Section 10. Section 31A-19a-202 , which is renumbered from Section 31A-19-202 is
895 renumbered and amended to read:
896 [
897 (1) To determine whether rates comply with the standards under Section [
898 31A-19a-201 , the [
899 (a) criteria [
900 (b) classifications, if any, permitted under Subsection (3);
901 (c) expenses described in Subsection (4); and
902 (d) profits described in Subsection (5).
903 (2) In determining rates the commissioner shall consider within and outside of Utah:
904 [
905
906 (b) catastrophe hazards [
907 (c) trends [
908 (d) loadings for leveling premium rates over time[
909 (e) reasonable margin for profit and contingencies;
910 (f) dividends, savings, or unabsorbed premium deposits allowed or returned by insurers
911 to their policyholders[
912 (g) other relevant factors[
913
914
915 [
916 the establishment of rates and minimum premiums[
917
918 (b) (i) A classification rate may be modified to produce rates for individual risks in
919 accordance with rating plans or schedules that establish reasonable standards for measuring
920 probable variations in hazards or expense provisions.
921 (ii) The standards described in Subsection (3)(b)(i) may measure any differences among
922 risks that can be demonstrated to have a probable effect upon losses or expenses.
923 (c) Notwithstanding Subsection (3)(b), risk classification may not be based upon race,
924 color, creed, [
925
926
927
928 [
929 reflect:
930 (a) the operating methods of the insurer; and[
931
932 (b) its anticipated expenses.
933 [
934 a profit that is not unreasonable in relation to the riskiness of the class of business. In determining
935 the reasonableness of the profit, consideration may be given to investment income.
936 Section 11. Section 31A-19a-203 , which is renumbered from Section 31A-19-203 is
937 renumbered and amended to read:
938 [
939 (1) (a) Except as provided in Subsections [
940 and every rate service organization licensed under Section [
941 been designated by any insurer for the filing of pure premium rates under Subsection [
942 31A-19a-205 (2), shall file with the commissioner the following for use in this state:
943 (i) all rates [
944 (ii) all supplementary information; and
945 (iii) all changes and amendments to [
946 and supplementary information.
947 (b) An insurer shall file its rates by filing:
948 (i) its final rates; or
949 (ii) either of the following to be applied to pure premium rates that have been filed by a
950 rate service organization on behalf of the insurer as permitted by Section 31A-19a-205 :
951 (A) a multiplier; or
952 (B) (I) a multiplier; and
953 (II) an expense constant adjustment.
954 (c) Every filing under this Subsection (1) shall state:
955 (i) the effective date of the rates; and
956 (ii) the character and extent of the coverage contemplated.
957 [
958 and 31A-19a-406 , each filing shall be within 30 days after the rates and supplementary
959 information, changes, and amendments are effective.
960 (e) A rate filing is considered filed when it has been received by the commissioner:
961 (i) with the applicable filing fee as prescribed under Section 31A-3-103 ; and
962 (ii) pursuant to procedures established by the commissioner.
963 (f) The commissioner may by rule prescribe procedures for submitting rate filings by
964 electronic means.
965 (2) (a) To show compliance with Section 31A-19a-201 , at the same time as the filing of
966 the rate and supplementary rate information, an insurer shall file all supporting information to be
967 used in support of or in conjunction with a rate.
968 (b) If the rate filing provides for a modification or revision of a previously filed rate, the
969 insurer is required to file only the supporting information that supports the modification or
970 revision.
971 (c) If the commissioner determines that the insurer did not file sufficient supporting
972 information, the commissioner shall inform the insurer in writing of the lack of sufficient
973 supporting information.
974 (d) If the insurer does not provide the necessary supporting information within 45 calendar
975 days of the date on which the commissioner mailed notice under Subsection (2)(c), the rate filing
976 may be:
977 (i) considered incomplete and unfiled; and
978 (ii) returned to the insurer as not filed and not available for use.
979 (e) Notwithstanding Subsection (2)(d), the commissioner may extend the time period for
980 filing supporting information.
981 (f) If a rate filing is returned to an insurer as not filed and not available for use under
982 Subsection (2)(d), the insurer may not use the rate filing for any policy issued or renewed on or
983 after 30 calendar days from the date the rate filing was returned.
984 (3) At the request of the commissioner, an insurer using the services of a rate service
985 organization shall provide a description of the rationale for using the services of the rate service
986 organization, including the insurer's own information and method of use of the rate service
987 organization's information.
988 (4) (a) An insurer may not make or issue a contract or policy except in accordance with
989 the rate filings that are in effect for the insurer as provided in this chapter.
990 (b) Subsection (4)(a) does not apply to contracts or policies for inland marine risks for
991 which filings are not required.
992 [
993 are not written according to standardized manual rules or rating plans.
994 [
995 using a higher rate than that otherwise applicable to a specific risk.
996 (b) If [
997 by the commissioner within ten days after filing, the higher rate may be applied to the specific risk.
998 (c) The rate may be disapproved without a hearing.
999 (d) If disapproved, the rate otherwise applicable applies from the effective date of the
1000 policy, but the insurer may cancel the policy pro rata on ten days' notice to the policyholder.
1001 (e) If the insurer does not cancel the policy, the insurer shall refund any excess premium
1002 from the effective date of the policy.
1003 [
1004 modifications for insurance provided under Section 31A-22-310 .
1005 (b) These rate modifications shall be filed with the commissioner immediately upon
1006 agreement by the insurers.
1007 Section 12. Section 31A-19a-204 , which is renumbered from Section 31A-19-204 is
1008 renumbered and amended to read:
1009 [
1010 [
1011 (1) Rates and supplementary rate information filed under this chapter shall[
1012 be open to public inspection at any reasonable time.
1013 (2) The commissioner shall supply copies to any person on:
1014 (a) request; and [
1015 (b) payment of a reasonable charge.
1016 Section 13. Section 31A-19a-205 , which is renumbered from Section 31A-19-205 is
1017 renumbered and amended to read:
1018 [
1019 obligation.
1020 (1) An insurer may:
1021 (a) itself establish rates and supplementary rate information for any market segment based
1022 on the factors in Section [
1023 (b) use rates, pure premium rates, and supplementary rate information prepared by a rate
1024 service organization that the insurer selects, with:
1025 (i) average expense factors determined by the rate service organization; or [
1026 (ii) any modification for its own expense and loss experience as the credibility of that
1027 experience allows.
1028 (2) An insurer may discharge its obligation under Subsection [
1029 31A-19a-203 (1) by [
1030 (a) notification that [
1031 information prepared by a [
1032 insurer selects; and
1033 (b) any information about modifications [
1034 information as is necessary fully to inform the commissioner. [
1035 (3) If an insurer has discharged its obligation in accordance with Subsection (2), the
1036 insurer's rates and supplementary rate information shall be those, including any amendments, filed
1037 at intervals by the rate service organization, subject to any modifications filed by the insurer.
1038 Section 14. Section 31A-19a-206 , which is renumbered from Section 31A-19-207 is
1039 renumbered and amended to read:
1040 [
1041 [
1042
1043
1044
1045 [
1046
1047
1048 [
1049
1050
1051 (1) (a) Except for a conflict with the requirements of Section 31A-19a-201 or
1052 31A-19a-202 , the commissioner may disapprove a rate at any time that the rate directly conflicts
1053 with:
1054 (i) this title; or
1055 (ii) any rule made under this title.
1056 (b) The disapproval under Subsection (1)(a) shall:
1057 (i) be in writing;
1058 (ii) specify the statute or rule with which the filing conflicts; and
1059 (iii) state when the rule is no longer effective.
1060 (c) (i) If an insurer or rate service organization's rate filing is disapproved under Subsection
1061 (1)(a), the insurer or rate organization may request a hearing on the disapproval within 30 calendar
1062 days of the date on which the order described in Subsection (1)(a) is issued.
1063 (ii) If a hearing is requested under Subsection (1)(c)(i), the commissioner shall schedule
1064 the hearing within 30 calendar days of the date on which the commissioner receives the request
1065 for a hearing.
1066 (iii) After the hearing, the commissioner shall issue an order:
1067 (A) approving the rate filing; or
1068 (B) disapproving the rate filing.
1069 (2) (a) If within 90 calendar days of the date on which a rate filing is filed the
1070 commissioner finds that the rate filing does not meet the requirements of Section 31A-19a-201 or
1071 31A-19a-202 , the commissioner shall send a written order disapproving the rate filing to the
1072 insurer or rate organization that made the filing.
1073 (b) The order described in Subsection (2)(a) shall specify how the rate filing fails to meet
1074 the requirements of Section 31A-19a-201 or 31A-19a-202 .
1075 (c) (i) If an insurer's or rate service organization's rate filing is disapproved under
1076 Subsection (2)(a), the insurer or rate organization may request a hearing on the disapproval within
1077 30 calendar days of the date on which the order described in Subsection (2)(a) is issued.
1078 (ii) If a hearing is requested under Subsection (2)(c)(i), the commissioner shall schedule
1079 the hearing within 30 calendar days of the date on which the commissioner receives the request
1080 for a hearing.
1081 (iii) After the hearing, the commissioner shall issue an order:
1082 (A) approving the rate filing; or
1083 (B) (I) disapproving the rate filing; and
1084 (II) stating when, within a reasonable time from the date on which the order is issued, the
1085 rate is no longer effective.
1086 (d) In a hearing held under this Subsection (2), the insurer or rate organization bears the
1087 burden of proving compliance with the requirements of Section 31A-19a-201 or 31A-19a-202 .
1088 (3) (a) If the order described in Subsection (2)(a) is issued after the implementation of the
1089 rate filing, the commissioner may order that use of the rate filing be discontinued for any policy
1090 issued or renewed on or after a date not less than 30 calendar days from the date the order was
1091 issued.
1092 (b) If an insurer or rate service organization requests a hearing under Subsection (2), the
1093 order to discontinue use of the rate filing is stayed:
1094 (i) beginning on the date the insurer or rate service organization requests a hearing; and
1095 (ii) ending on the date the commissioner issues an order after the hearing that addresses
1096 the stay.
1097 (4) If the order described in Subsection (2)(a) is issued before the implementation of the
1098 rate filing:
1099 (a) an insurer or rate service organization may not implement the rate filing; and
1100 (b) the rates of the insurer or rate service organization at the time of disapproval continue
1101 to be in effect.
1102 (5) (a) If after a hearing the commissioner finds that a rate that has been previously filed
1103 and has been in effect for more than 90 calendar days no longer meets the requirements of Section
1104 31A-19a-201 or 31A-19a-202 , the commissioner may order that use of the rate by any insurer or
1105 rate service organization be discontinued.
1106 (b) The commissioner shall give any insurer that will be affected by an order that may be
1107 issued under Subsection (5)(a) notice of the hearing at least ten business days prior to the hearing.
1108 (c) The order issued under Subsection (5)(a) shall:
1109 (i) be in writing;
1110 (ii) state the grounds for the order; and
1111 (iii) state when, within a reasonable time from the date on which the order is issued, the
1112 rate is no longer effective.
1113 (d) The order issued under Subsection (5)(a) shall not affect any contract or policy made
1114 or issued prior to the expiration of the period set forth in the order.
1115 (e) The order issued under Subsection (5)(a) may include a provision for a premium
1116 adjustment for contracts or policies made or issued after the effective date of the order.
1117 [
1118 commissioner's disapproval of rates or other act, the commissioner shall, on the insurer's request,
1119 specify interim rates for the insurer. [
1120 (b) An interim [
1121 (i) shall be high enough to protect the interests of all parties; and
1122 (ii) may, when necessary to protect the policyholders, order that a specified portion of the
1123 premiums be placed in an escrow account approved by the commissioner. [
1124
1125
1126 (c) When the new rates become effective, the commissioner shall order the escrowed funds
1127 or any overcharge in the interim rates to be distributed appropriately, except that minimal refunds
1128 to policyholders need not be distributed.
1129 Section 15. Section 31A-19a-207 , which is renumbered from Section 31A-19-206 is
1130 renumbered and amended to read:
1131 [
1132 (1) [
1133 with the commissioner any changes in rates or supplementary rate information at least 30 calendar
1134 days before they become effective if the commissioner finds, after a hearing, that in [
1135 market segment[
1136 (i) competition is not an effective regulator of the rates charged[
1137 (ii) that a substantial number of companies are competing irresponsibly through the rates
1138 charged[
1139 (iii) that there are widespread violations of this chapter[
1140
1141
1142
1143 (b) The commissioner may extend the waiting period under Subsection (1)(a) for not to
1144 exceed [
1145 30-day period expires.
1146 (c) In determining whether competition is an effective regulator of the rates charged, the
1147 commissioner shall consider, as to the particular market segment:
1148 [
1149 [
1150 [
1151 [
1152 [
1153 [
1154
1155
1156 [
1157
1158 [
1159 [
1160 [
1161 [
1162
1163
1164 [
1165
1166
1167 [
1168 Subsection (1), all rates previously filed and in use may continue to be used until disapproved.
1169 [
1170 (b) After a finding of a noncompetitive market under Subsection (1), for purposes of
1171 disapproval, the commissioner shall treat the filing of existing rates [
1172 as having been filed as of the date of the rule under Subsection (1). [
1173
1174 [
1175 contrary finding under Subsection (1).
1176 (4) (a) A rule issued under Subsection (1) expires no later than one year [
1177 date on which the rule was adopted, unless the commissioner, after a hearing, renews the rule.
1178 [
1179 (b) A renewal hearing for a rule issued under Subsection (1) may not be held earlier than
1180 nine months after the date on which the rule was issued or last renewed.
1181 Section 16. Section 31A-19a-208 , which is renumbered from Section 31A-19-208 is
1182 renumbered and amended to read:
1183 [
1184 (1) The commissioner may require by order that a particular insurer file any or all of its
1185 rates and supplementary rate information [
1186 the commissioner finds, after a hearing, that [
1187 insureds and the public in Utah, the commissioner must exercise closer supervision of the insurer's
1188 rates, because of the insurer's financial condition or rating practices.
1189 (2) The commissioner may extend the waiting period described in Subsection (1) for any
1190 filing for not to exceed [
1191 first [
1192 (3) A filing [
1193 period is considered to meet the requirements of this chapter, subject to the possibility of
1194 subsequent disapproval under Section [
1195 Section 17. Section 31A-19a-209 , which is renumbered from Section 31A-19-209 is
1196 renumbered and amended to read:
1197 [
1198 [
1199
1200 [
1201
1202
1203
1204 [
1205 and rating methods as set forth in [
1206 the commissioner shall also consider the [
1207 insurance companies [
1208
1209
1210
1211 (a) the maintenance of title plants; and
1212 (b) the searching and examining of public records to determine insurability of title to real
1213 property.
1214 [
1215
1216
1217
1218 [
1219 the commissioner a schedule of the escrow, settlement, and closing charges [
1220 proposes to use in this state for services performed in connection with the issuance of policies of
1221 title insurance.
1222 (b) The filing required by Subsection (2)(a) shall state the effective date of this schedule,
1223 which may not be less than 30 calendar days after the date of filing.
1224 (3) A title insurance company, agency, or agent may not file or use any rate or other charge
1225 relating to the business of title insurance, including rates or charges filed for escrow, settlement,
1226 and closing charges that would cause the title insurance company, agency, or agent to:
1227 (a) operate at less than the cost of doing:
1228 (i) the insurance business; or
1229 (ii) the escrow, settlement, and closing business; or
1230 (b) fail to adequately underwrite a title insurance policy.
1231 [
1232 schedule of escrow, settlement, and closing charges, may be changed or amended at any time,
1233 subject to the limitations in this [
1234 (b) Each change or amendment shall:
1235 (i) be filed with the commissioner[
1236 (ii) state the effective date of the change or amendment, which may not be less than 30
1237 calendar days after the date of filing.
1238 (c) Any change or amendment remains in force for a period of at least 90 calendar days
1239 from its effective date.
1240 [
1241 shall be:
1242 (a) retained in each of the offices of:
1243 (i) the insurance company in this state; and
1244 (ii) its agents in this state[
1245 (iii) upon request, [
1246 [
1247 commissioner, a title insurance company [
1248 impose any premium or other charge:
1249 (a) in connection with the issuance of a policy of title insurance[
1250 (b) for escrow, settlement, or closing services performed in connection with the issuance
1251 of a policy of title insurance[
1252
1253 Section 18. Section 31A-19a-210 is enacted to read:
1254 31A-19a-210. Dividend and participating plans.
1255 (1) (a) This part does not prohibit the distribution by an insurer to a policyholder of any
1256 of the following allowed or returned by the insurer:
1257 (i) dividends;
1258 (ii) savings; or
1259 (iii) unabsorbed premium deposits.
1260 (b) Notwithstanding Subsection (1)(a), an insurer may not distribute dividends, savings,
1261 or unabsorbed premium deposits to an entity that has no insurable interest in the insurance.
1262 (2) An insurer may not unfairly discriminate between policyholders in the payment of
1263 dividends, savings, or unabsorbed premium deposits.
1264 (3) (a) A declaration of dividends or schedule explaining the basis for the distribution of
1265 dividends, savings, or unabsorbed premium deposits allowed or returned by an insurer to its
1266 policyholders is not a rating plan or system if the insurer:
1267 (i) determines and declares the declaration or schedule after a specified policy accounting
1268 period; and
1269 (ii) files the declaration or schedule pursuant to Section 31A-21-310 .
1270 (b) A declaration or schedule described under Subsection (3)(a) is not required to be filed
1271 with the commissioner under this chapter.
1272 (4) (a) A dividend or participating plan developed by insurers establishing given criteria
1273 for eligibility and the general basis for distribution for a dividend, if declared, is considered a rating
1274 plan if the plan is to be applicable to an insurance policy from its inception.
1275 (b) A plan described in Subsection (4)(a) shall be filed with the commissioner pursuant
1276 to this part.
1277 (5) An insurer may not make the distribution of a dividend or any portion of a dividend
1278 conditioned upon renewal of the policy or contract.
1279 Section 19. Section 31A-19a-211 , which is renumbered from Section 31A-19-210 is
1280 renumbered and amended to read:
1281 [
1282 vehicle accident prevention course -- Curriculum -- Certificate -- Exception.
1283 (1) (a) Each rate, rating schedule, and rating manual for the liability, personal injury
1284 protection, and collision coverages of private passenger motor vehicle insurance policies submitted
1285 to or filed with the commissioner shall provide for an appropriate reduction in premium charges
1286 for those coverages if the principal operator of the covered vehicle:
1287 (i) is a named insured who is 55 years of age or older; and
1288 (ii) has successfully completed a motor vehicle accident prevention course as outlined in
1289 Subsection (2).
1290 (b) Any premium reduction provided by an insurer under this section is presumed to be
1291 appropriate unless credible data demonstrates otherwise.
1292 (2) (a) The curriculum for a motor vehicle accident prevention course under this section
1293 shall include:
1294 (i) how impairment of visual and audio perception affects driving performance and how
1295 to compensate for that impairment;
1296 (ii) the effects of fatigue, medications, and alcohol on driving performance, when
1297 experienced alone or in combination, and precautionary measures to prevent or offset ill effects;
1298 (iii) updates on rules of the road and equipment, including safety belts and safe, efficient
1299 driving techniques under present day road and traffic conditions;
1300 (iv) how to plan travel time and select routes for safety and efficiency; and
1301 (v) how to make crucial decisions in dangerous, hazardous, and unforeseen situations.
1302 (b) (i) In accordance with Title 63, Chapter 46a, Utah Administrative Rulemaking Act, the
1303 Department of Public Safety may make rules to establish and clarify standards pertaining to the
1304 curriculum and teaching methods of a course under this section.
1305 (ii) These rules may include provisions allowing the department to conduct on-site visits
1306 to ensure compliance with agency rules and this chapter.
1307 (iii) These rules shall be specific as to time and manner of visits and provide for methods
1308 to prohibit or remedy forcible visits.
1309 (3) (a) The premium reduction required by this section shall be effective for a named
1310 insured for a three-year period after successful completion of the course outlined in Subsection (2).
1311 (b) The insurer may require, as a condition of maintaining the premium reduction, that the
1312 named insured not be convicted or plead guilty or nolo contendere to a moving traffic violation
1313 for which points may be assessed against the named insured's driver license except for a violation
1314 under Subsection 53-3-221 (11).
1315 (4) Each person who successfully completes the course outlined in Subsection (2) shall
1316 be issued a certificate by the organization offering the course. The certificate qualifies the person
1317 for the premium reduction required by this section.
1318 (5) This section does not apply if the approved course outlined in Subsection (2) is
1319 attended as a penalty imposed by a court or other governmental entity for a moving traffic
1320 violation.
1321 Section 20. Section 31A-19a-212 , which is renumbered from Section 31A-19-211 is
1322 renumbered and amended to read:
1323 [
1324 or inquiries.
1325 (1) Each rate, rating schedule, and rating manual filed with the commissioner for insurance
1326 covering a vehicle or the operation of a vehicle may not permit a premium increase due to:
1327 (a) a telephone [
1328 payment of a claim; or
1329 (b) a claim resulting from any incident, including acts of vandalism, in which the person
1330 named in the policy or any other person using the insured motor vehicle with the express or
1331 implied permission of the named insured is not at fault[
1332 (2) This section is an exception to [
1333 Section 21. Section 31A-19a-213 is enacted to read:
1334 31A-19a-213. Joint underwriting.
1335 Notwithstanding Subsection 31A-19a-306 (2)(a), insurers participating in joint underwriting
1336 associations or joint reinsurance pursuant to Section 31A-20-102 or other arrangements for risk
1337 sharing may in connection with such activity act in cooperation with each other in the making of
1338 one or more of the following:
1339 (1) rates;
1340 (2) rating systems;
1341 (3) policy forms;
1342 (4) underwriting rules;
1343 (5) surveys;
1344 (6) inspections and investigations;
1345 (7) the furnishing of loss and expense statistics or other information; or
1346 (8) research.
1347 Section 22. Section 31A-19a-214 is enacted to read:
1348 31A-19a-214. Rating tiers.
1349 (1) An insurer may file with the commissioner a rate filing that provides for a program
1350 with more than one rate level in the same company or group of companies if:
1351 (a) the program is based, to the extent feasible, upon mutually exclusive underwriting rules
1352 per tier;
1353 (b) the underwriting rules are based on clear, objective criteria that would lead to a logical
1354 distinguishing of potential risk; and
1355 (c) in filing to establish tiers, the insurer provides supporting information that evidences
1356 a clear distinction between the expected losses and expenses for each tier.
1357 (2) A rating tier may not be continued if premium, loss, and expense data fail to show a
1358 continued clear distinction between the tiers.
1359 Section 23. Section 31A-19a-215 is enacted to read:
1360 31A-19a-215. False or misleading information.
1361 A person or organization may not:
1362 (1) willfully withhold from the commissioner, any rate organization, or any insurer
1363 information that will affect the rates or premiums chargeable under this chapter; or
1364 (2) knowingly give false or misleading information to the commissioner, any rate service
1365 organization, or any insurer.
1366 Section 24. Section 31A-19a-216 is enacted to read:
1367 31A-19a-216. Charging of rates.
1368 An authorized insurer, licensed insurance agent, employee, other representative of an
1369 authorized insurer, or licensed insurance broker may not knowingly:
1370 (1) charge or demand a rate or receive a premium that departs from the rates, rating plans,
1371 classifications, schedules, rules, and standards in effect on behalf of the insurer; or
1372 (2) issue or make any policy or contract involving a violation of Subsection (1).
1373 Section 25. Section 31A-19a-217 , which is renumbered from Section 31A-19-418 is
1374 renumbered and amended to read:
1375 [
1376 (1) [
1377 to the rate service organization or insurer that made the rate.
1378 (b) The rate service organization or insurer shall answer [
1379 Subsection (1)(a) within [
1380 by furnishing all pertinent rating information to:
1381 (i) the insured; or [
1382 (ii) the insured's authorized representative.
1383 (2) [
1384 an insurer has applied its rating system in connection with the insurance afforded to [
1385 person may submit a written request for review to the rate service organization or insurer. [
1386 (b) If a request for review is filed under Subsection (2)(a), the rate service organization or
1387 insurer shall provide a reasonable review procedure within Utah.
1388 (c) The [
1389 connection with the insurance afforded the [
1390 (d) The [
1391 authorized representative.
1392 [
1393 within 30 calendar days [
1394 writing to the commissioner. [
1395 (f) If an appeal is filed under Subsection (2)(e), the commissioner may order the rate
1396 service organization or insurer [
1397 Subsection (2).
1398 [
1399 requested review may request the commissioner to confirm that the insurance afforded was rated
1400 according to filed rates and rating plans.
1401 Section 26. Section 31A-19a-218 , which is renumbered from Section 31A-19-419 is
1402 renumbered and amended to read:
1403 [
1404 (1) [
1405 to the commissioner in writing for a hearing.
1406 (b) The application described under Subsection (1)(a) shall:
1407 (i) specify the grounds upon which the applicant intends to rely to establish the grievance;
1408 and [
1409 (ii) state why the filing does not meet the requirements of law.
1410 (2) [
1411 shall grant the requested hearing if [
1412 (a) the application was made in good faith;
1413 (b) the grievance is justified, assuming the applicant's grounds can be established; and
1414 (c) the grounds otherwise justify holding such a hearing.
1415 (3) [
1416 (a) within 30 calendar days [
1417 (b) not less than ten days after written notice to:
1418 (i) the applicant [
1419 (ii) each insurer [
1420 (iii) each rate service organization that made the filing.
1421 (4) (a) If after the hearing the commissioner finds that the filing is defective, [
1422 commissioner shall issue an order:
1423 [
1424 law; and
1425 [
1426 [
1427 [
1428 forth in the order.
1429 Section 27. Section 31A-19a-301 , which is renumbered from Section 31A-19-301 is
1430 renumbered and amended to read:
1431
1432 [
1433 organizations.
1434 (1) (a) [
1435 collection or the rates of any insurance [
1436 organization is licensed under Section 31-19a-302 .
1437 (b) An insurer may [
1438 the purposes described in Subsection (1)(a), unless the organization [
1439 licensed under Section [
1440 (2) [
1441 licensed in this state to any insurer:
1442 (a) authorized to do business in this state; and [
1443 (b) that offers to pay the fair and usual compensation for the services.
1444 Section 28. Section 31A-19a-302 , which is renumbered from Section 31A-19-302 is
1445 renumbered and amended to read:
1446 [
1447 (1) A rate service organization applying for a license shall include with its application:
1448 (a) a copy of its constitution, charter, articles of organization, agreement, association, or
1449 incorporation, and a copy of its bylaws, plan of operation, and any other rules or regulations
1450 governing the conduct of its business;
1451 (b) a list of its members and subscribers;
1452 (c) the name and address of one or more residents of Utah upon whom notices, processes
1453 affecting it, or orders of the commissioner may be served;
1454 (d) a statement explaining in what capacity it plans to function and showing its technical
1455 qualifications for acting in the capacity for which it seeks a license; [
1456 (e) biographical information, as defined by the department, of the officers and directors
1457 of the organization; and
1458 [
1459 (2) [
1460 Subsection (1) shall promptly notify the commissioner of every material change in the facts or in
1461 the documents on which its application was based.
1462 (3) [
1463 applicant, if the commissioner finds that:
1464 (i) the applicant and the natural persons through whom it acts are competent, trustworthy,
1465 and technically qualified to provide the services proposed[
1466 (ii) all the requirements of law are met[
1467
1468 (b) The commissioner may not issue a license if the proposed activity would tend to:
1469 (i) create a monopoly; or [
1470 (ii) lessen or [
1471 (4) (a) Any license issued under this chapter shall be subject to annual renewal.
1472 (b) A fee shall be charged for the initial license and for renewal. The fee shall be set by the
1473 Legislature under Section 31A-3-103 .
1474 (5) Any amendment to a document filed under Subsection (1)(a) shall be filed within at
1475 least 30 calendar days [
1476 with this [
1477 Subsection (3).
1478 (6) The license of each rate service organization licensed under former Title 31, Chapter
1479 18, is continued under this chapter.
1480 Section 29. Section 31A-19a-303 , which is renumbered from Section 31A-19-303 is
1481 renumbered and amended to read:
1482 [
1483 (1) A license issued under this chapter remains in force until:
1484 (a) revoked, suspended, or limited under Subsection (2);
1485 (b) lapsed under Subsection (3); or
1486 (c) surrendered to and accepted by the commissioner.
1487 (2) (a) After a hearing, the commissioner may revoke, suspend, or limit in whole or in part,
1488 the license of any person licensed under this part, if:
1489 (i) the licensee is found to be unqualified [
1490 (ii) the licensee is found to have violated:
1491 (A) an insurance statute[
1492 (B) a valid rule under Subsection 31A-2-201 (3)[
1493 (C) a valid order under Subsection 31A-2-201 (4)[
1494 (iii) the licensee's methods and practices in the conduct of business endanger the legitimate
1495 interests of policyholders, insurers, or the public. [
1496 (b) An order suspending a license issued under this chapter shall specify the period of
1497 suspension, but in no event may the suspension period exceed 12 months.
1498 (3) (a) Any license issued under this chapter shall lapse if the licensee fails to pay a fee
1499 when due.
1500 (b) A license [
1501 if the licensee, within 90 calendar days [
1502 usual license renewal fee.
1503 (4) A licensee whose license is suspended or revoked, but who continues to act as a
1504 licensee is subject to the penalties applicable to violating Subsection [
1505 31A-19a-301 (1).
1506 (5) (a) An order revoking a license under Subsection (2) may specify a time, not to exceed
1507 five years, within which the former licensee may not apply for a new license.
1508 (b) If under Subsection (5)(a) no time is specified, the former licensee may not apply for
1509 five years, without the express approval of the commissioner.
1510 (6) (a) Any person whose license is suspended or revoked shall, when the suspension ends
1511 or a new license is issued, pay all fees that would have been payable if the license had not been
1512 suspended or revoked, unless the commissioner, by order, waives the payment of the interim fees.
1513 (b) If a new license is issued more than three years after the revocation of a similar license,
1514 [
1515 during the three years immediately following the revocation.
1516 Section 30. Section 31A-19a-304 , which is renumbered from Section 31A-19-304 is
1517 renumbered and amended to read:
1518 [
1519 (1) (a) In any circumstances that would justify a suspension under Section [
1520 31A-19a-303 , instead of a suspension, the commissioner may, after a hearing, put the licensee on
1521 probation for a specified period [
1522 probation.
1523 (b) The probation order shall state the conditions for retention of the license, which shall
1524 be reasonable.
1525 (2) Violation of the probation constitutes grounds for revocation pursuant to a proceeding
1526 authorized under Title 63, Chapter 46b, Administrative Procedures Act.
1527 Section 31. Section 31A-19a-305 , which is renumbered from Section 31A-19-305 is
1528 renumbered and amended to read:
1529 [
1530 [
1531 policyholder or other [
1532 rates or rating procedures[
1533 (b) Except for a policyholder or other company under common control, a person may not
1534 impose any penalty or other adverse consequence for failure of an insurer to adhere to certain rates
1535 or rating procedures.
1536 (2) This section does not apply to rates used:
1537 (a) by a joint underwriting group[
1538 (b) by [
1539 (c) under quota share reinsurance treaties[
1540 (d) by a residual market [
1541 Section 32. Section 31A-19a-306 is enacted to read:
1542 31A-19a-306. Insurers and rate service organizations -- Prohibited activity.
1543 (1) An insurer or rate service organization may not:
1544 (a) attempt to monopolize, or combine or conspire with any other person to monopolize
1545 an insurance market; or
1546 (b) engage in a boycott of an insurance market on a concerted basis.
1547 (2) (a) Except as provided in Subsection (2)(c), an insurer may not agree with any other
1548 insurer or with a rate service organization to mandate adherence to or to mandate use of any:
1549 (i) rate;
1550 (ii) prospective loss cost;
1551 (iii) rating plan;
1552 (iv) rating schedule;
1553 (v) rating rule;
1554 (vi) policy or bond form;
1555 (vii) rate classification;
1556 (viii) rate territory;
1557 (ix) underwriting rule;
1558 (x) survey;
1559 (xi) inspection: or
1560 (xii) material similar to those described in Subsections (2)(a)(i) through (xi).
1561 (b) The fact that two or more insurers, whether or not members or subscribers of a rate
1562 service organization, use consistently or intermittently the same materials described in Subsection
1563 (2)(a) is not sufficient in itself to support a finding that an agreement exists.
1564 (c) An insurer may enter into an agreement prohibited by Subsection (2)(a):
1565 (i) to the extent needed to facilitate the reporting of statistics to:
1566 (A) a rate service organization;
1567 (B) a statistical agent; or
1568 (C) the commissioner; or
1569 (ii) as provided in Part 4.
1570 (3) Two or more insurers having a common ownership or operating in this state under
1571 common management or control may act in concert between or among themselves with respect to
1572 any matters pertaining to those activities authorized in this section as if they constituted a single
1573 insurer.
1574 (4) An insurer or rate service organization may not make any arrangement with any other
1575 insurer, rate service organization, or other person that has the purpose or effect of unreasonably
1576 restraining trade or unreasonably lessening competition in the business of insurance.
1577 Section 33. Section 31A-19a-307 is enacted to read:
1578 31A-19a-307. Rate service organizations -- Permitted activity.
1579 A rate service organization may on behalf of its members and subscribers:
1580 (1) develop statistical plans including territorial and class definitions;
1581 (2) collect statistical data from:
1582 (a) members;
1583 (b) subscribers; or
1584 (c) any other source;
1585 (3) prepare, file, and distribute prospective loss costs which may include provisions for
1586 special assessments;
1587 (4) prepare, file, and distribute:
1588 (a) factors;
1589 (b) calculations;
1590 (c) formulas pertaining to classification; or
1591 (d) territory, increased limits, and other variables;
1592 (5) prepare, file, and distribute supplementary rating information;
1593 (6) distribute information that is required or directed to be filed with the commissioner;
1594 (7) conduct research and on-site inspections to prepare classifications of public fire
1595 defenses;
1596 (8) consult with public officials regarding public fire protection as it would affect
1597 members, subscribers, and others;
1598 (9) conduct research and onsight inspections to discover, identify, and classify information
1599 relating to causes or prevention of losses;
1600 (10) conduct research relating to the impact of statutory changes upon prospective loss
1601 costs;
1602 (11) prepare, file, and distribute policy forms and endorsements;
1603 (12) consult with members, subscribers, and others concerning use and application of the
1604 policy forms and endorsements described in Subsection (11);
1605 (13) conduct research and on-site inspections for the purpose of providing risk information
1606 relating to individual structures;
1607 (14) conduct on-site inspections to determine rating classifications for individual insureds;
1608 (15) collect, compile, and publish past and current prices of individual insurers, provided
1609 the information is also made available to the general public at a reasonable cost;
1610 (16) collect and compile exposure and loss experience for the purpose of individual risk
1611 experience ratings;
1612 (17) furnish any other services, as approved or directed by the commissioner, related to
1613 those enumerated in this section; and
1614 (18) engage in any other activity not prohibited by this title.
1615 Section 34. Section 31A-19a-308 is enacted to read:
1616 31A-19a-308. Rate service organizations -- Filing requirements.
1617 (1) A rate service organization shall file with the commissioner any of the following that
1618 is used in this state:
1619 (a) any statistical plan;
1620 (b) all prospective loss costs;
1621 (c) provisions for special assessments;
1622 (d) all supplementary rating information; and
1623 (e) any change, amendment, or modification of an item described in Subsections (1)(a)
1624 through (d).
1625 (2) The filings required under Subsection (1) shall be subject to Sections 31A-19a-203 and
1626 31A-19a-206 and other provisions of this chapter relating to filings made by insurers.
1627 Section 35. Section 31A-19a-309 , which is renumbered from Section 31A-19-306 is
1628 renumbered and amended to read:
1629 [
1630 (1) (a) The commissioner may adopt rules for the development of statistical plans, for use
1631 by all insurers in recording and reporting their loss and expense experience, in order that the
1632 experience of those insurers may be made available to the commissioner.
1633 (b) The rules provided for in Subsection (1) may include:
1634 (i) the data that must be reported by an insurer;
1635 (ii) definitions of data elements;
1636 (iii) the timing and frequency of data reporting by an insurer;
1637 (iv) data quality standards;
1638 (v) data edit and audit requirements;
1639 (vi) data retention requirements;
1640 (vii) reports to be generated; and
1641 (viii) the timing of reports to be generated.
1642 (c) Except for workers compensation insurance under Section 31A-19a-404 , an insurer
1643 may not be required to record or report its experience on a classification basis that is inconsistent
1644 with its own rating system.
1645 (2) (a) The commissioner may designate one or more rate service organizations to assist
1646 the commissioner in gathering that experience and making compilations of [
1647 experience.
1648 (b) The compilations developed under Subsection (2)(a) shall be made available to the
1649 public. [
1650
1651 (3) The commissioner may make rules and plans for the interchange of data necessary for
1652 the application of rating plans.
1653 (4) To further uniform administration of rate regulatory laws, the commissioner and every
1654 insurer and rate service organization may:
1655 (a) exchange information and experience data with insurance supervisory officials,
1656 insurers, and rate service organizations in other states; and
1657 (b) consult with the persons described in Subsection (4)(a) with respect to the application
1658 of rating systems and the reporting of statistical data.
1659 Section 36. Section 31A-19a-401 , which is renumbered from Section 31A-19-401 is
1660 renumbered and amended to read:
1661
1662 [
1663 (1) This part applies to [
1664 insurance written in connection with it.
1665 (2) All insurers writing [
1666 Compensation Fund of Utah, are subject to this part.
1667 Section 37. Section 31A-19a-402 , which is renumbered from Section 31A-19-402 is
1668 renumbered and amended to read:
1669 [
1670 It is the purpose of this part to:
1671 (1) establish [
1672 of [
1673 (2) provide for review by the department of workers' compensation rate-making and the
1674 results of it; and
1675 (3) provide for a designated rate service organization to perform certain functions on
1676 behalf of the commissioner.
1677 [
1678
1679 [
1680
1681 [
1682
1683 [
1684 [
1685
1686
1687 [
1688 Section 38. Section 31A-19a-403 , which is renumbered from Section 31A-19-403 is
1689 renumbered and amended to read:
1690 [
1691 As used in this part:
1692 [
1693
1694
1695 [
1696
1697 [
1698
1699
1700
1701 [
1702
1703 [
1704 [
1705
1706 [
1707
1708 [
1709
1710 [
1711 [
1712 [
1713 [
1714 [
1715 [
1716 [
1717 [
1718 (1) "Uniform classification plan," in addition to the definition of "classification system"
1719 in Section 31A-19a-201 , means a plan:
1720 (a) that is consistent between all insurers of classification codes and descriptions; and
1721 (b) by which like workers compensation exposures are grouped for the purposes of
1722 underwriting, rating, and statistical reporting.
1723 (2) "Uniform experience rating plan" means a plan that is consistent between all insurers
1724 for experience rating entities insured for workers compensation insurance.
1725 (3) "Uniform statistical plan" means a plan that is consistent between all insurers that is
1726 used for the reporting of workers compensation insurance statistical data.
1727 Section 39. Section 31A-19a-404 , which is renumbered from Section 31A-19-407 is
1728 renumbered and amended to read:
1729 [
1730 (1) [
1731 For purposes of workers compensation insurance, the commissioner shall designate one rate
1732 service organization to:
1733 (a) develop and administer the uniform statistical plan, uniform classification plan, and
1734 uniform experience rating plan filed with and approved by the commissioner [
1735
1736 [
1737
1738
1739
1740
1741
1742 (b) assist [
1743 information[
1744
1745
1746 on an aggregate basis;
1747 (c) develop and file manual rules, subject to the approval of the commissioner, that are
1748 reasonably related to the recording and reporting of data pursuant to the uniform statistical plan,
1749 uniform experience rating plan, and the uniform classification [
1750
1751 (d) develop and file the prospective loss costs pursuant to Section 31A-19a-406 .
1752 (2) The uniform experience rating plan [
1753
1754
1755 (a) contain reasonable eligibility standards;
1756 (b) provide adequate incentives for loss prevention; and
1757 (c) provide for sufficient premium differentials so as to encourage safety.
1758 (3) Each workers compensation insurer, directly or through its selected rate service
1759 organization, shall:
1760 (a) record and report its workers compensation experience to the designated rate service
1761 organization as set forth in the uniform statistical plan approved by the commissioner;
1762 (b) adhere to a uniform classification plan and uniform experience rating plan filed with
1763 the commissioner by the rate service organization designated by the commissioner; and
1764 (c) adhere to the prospective loss costs filed by the designated rate service organization.
1765 (4) The commissioner may adopt rules for:
1766 (a) the development and administration by the designated rate service organization of the:
1767 (i) uniform statistical plan;
1768 (ii) uniform experience rating plan; and
1769 (iii) uniform classification plan;
1770 (b) the recording and reporting of statistical data [
1771
1772 workers compensation insurance; and
1773 (c) the selection, retention, and termination of the designated rate service organization.
1774 (5) (a) Notwithstanding Subsection (3), an insurer may develop directly or through its
1775 selected rate service organization subclassifications of the uniform classification system upon
1776 which a rate may be made.
1777 (b) A subclassification shall be filed with the commissioner 30 days before its use.
1778 (c) The commissioner shall disapprove subclassifications if the insurer fails to demonstrate
1779 that the data produced by the subclassifications can be reported consistently with the uniform
1780 statistical plan and uniform classification plan.
1781 (6) Notwithstanding Subsection (3), an insurer may, directly or though its selected rate
1782 service organization, develop its own experience modifications based on the uniform statistical
1783 plan, uniform classification plan, and uniform rating plan filed by the rate service organization
1784 designated by the commissioner under Subsection (1).
1785 Section 40. Section 31A-19a-405 , which is renumbered from Section 31A-19-408 is
1786 renumbered and amended to read:
1787 [
1788 (1) (a) [
1789 [
1790
1791 and supporting information [
1792 the effective date[
1793 (b) Notwithstanding Subsection (1)(a), on application by the filer, the commissioner may
1794 authorize an earlier effective date.
1795 (2) The loss and loss adjustment expense factors included in the rates filed under
1796 Subsection (1) shall be the prospective loss costs filed by the designated rate service organization
1797 under Section [
1798 [
1799
1800
1801
1802 [
1803
1804
1805
1806 Section 41. Section 31A-19a-406 , which is renumbered from Section 31A-19-414 is
1807 renumbered and amended to read:
1808 [
1809 organization.
1810 (1) The rate service organization designated [
1811 Section 31A-19a-404 shall file with the commissioner the following items proposed for use in this
1812 state at least 30 calendar days before the date they are distributed to members, subscribers, or
1813 others:
1814 (a) each prospective loss cost with its supporting information;
1815 (b) [
1816 (c) [
1817 (d) the uniform statistical plan manual; and
1818 [
1819 Subsections (1)(a) through (d).
1820 (2) (a) If the commissioner believes that prospective loss costs filed violate the excessive,
1821 inadequate, or unfair discriminatory standard in Section [
1822 applicable requirement of this part, [
1823 organization file additional supporting information.
1824 (b) If, after reviewing the supporting information, the commissioner determines that the
1825 prospective loss costs violate these requirements, [
1826 (i) require that adjustments to the prospective loss costs be made[
1827 (ii) call a hearing for any purpose regarding the filing.
1828 Section 42. Section 31A-19a-407 is enacted to read:
1829 31A-19a-407. Cooperation among rating organizations and insurers.
1830 (1) Notwithstanding Section 31A-19a-305 , rate service organizations and insurers may
1831 cooperate with each other in rate-making or in other matters within the scope of this part.
1832 (2) (a) The commissioner may review the cooperative activities and practices permitted
1833 under Subsection (1).
1834 (b) If, after a hearing, the commissioner finds any of the cooperative activities or practices
1835 permitted under Subsection (1) to be unfair, unreasonable, or otherwise inconsistent with the law,
1836 the commissioner may issue an order:
1837 (i) specifying in what respects the activity or practice is unfair, unreasonable, or otherwise
1838 inconsistent with the law; and
1839 (ii) requiring the persons or entities involved to discontinue the activity or practice.
1840 Section 43. Section 31A-33-107 is amended to read:
1841 31A-33-107. Duties of board -- Creation of subsidiaries -- Entering into joint
1842 enterprises.
1843 (1) The board shall:
1844 (a) appoint a chief executive officer to administer the Workers' Compensation Fund;
1845 (b) receive and act upon financial, management, and actuarial reports covering the
1846 operations of the Workers' Compensation Fund;
1847 (c) ensure that the Workers' Compensation Fund is administered according to law;
1848 (d) examine and approve an annual operating budget for the Workers' Compensation Fund;
1849 (e) serve as investment trustees and fiduciaries of the Injury Fund;
1850 (f) receive and act upon recommendations of the chief executive officer;
1851 (g) develop broad policy for the long-term operation of the Workers' Compensation Fund,
1852 consistent with its mission and fiduciary responsibility;
1853 (h) subject to Chapter [
1854 [
1855 (i) subject to Chapter [
1856 [
1857 (j) approve the amount of the dividends, if any, to be returned to policyholders;
1858 (k) adopt a procurement policy consistent with the provisions of Title 63, Chapter 56, Utah
1859 Procurement Code;
1860 (l) develop and publish an annual report to policyholders, the governor, the Legislature,
1861 and interested parties that describes the financial condition of the Injury Fund, including a
1862 statement of expenses and income and what measures were taken or will be necessary to keep the
1863 Injury Fund actuarially sound;
1864 (m) establish a fiscal year;
1865 (n) determine and establish an actuarially sound price for insurance offered by the fund;
1866 (o) establish conflict of interest requirements that govern the board, officers, and
1867 employees; and
1868 (p) perform all other acts necessary for the policymaking and oversight of the Workers'
1869 Compensation Fund.
1870 (2) Subject to board review and its responsibilities under Subsection (1)(e), the board may
1871 delegate authority to make daily investment decisions.
1872 (3) The fund may form or acquire a subsidiary or enter into a joint enterprise:
1873 (a) only if that action is approved by the board; and
1874 (b) subject to the limitations in Section 31A-33-103.5 .
1875 Section 44. Section 31A-33-111 is amended to read:
1876 31A-33-111. Adoption of rates.
1877 (1) The Workers' Compensation Fund shall adopt the rates approved by the insurance
1878 commissioner under Chapter [
1879 (2) The chief executive officer, with the approval of the board, may file with the insurance
1880 commissioner a resolution to deviate from the rates approved by the insurance commissioner in
1881 order to provide workers' compensation insurance at the lowest possible cost to policyholders
1882 consistent with maintaining the actuarial soundness of the Injury Fund.
1883 Section 45. Section 34A-2-202 is amended to read:
1884 34A-2-202. Assessment on employers and counties, cities, towns, or school districts
1885 paying compensation direct.
1886 (1) (a) An employer, including a county, city, town, or school district, who by authority
1887 of the division under Section 34A-2-201 is authorized to pay compensation direct shall pay
1888 annually, on or before March 31, an assessment in accordance with this section and rules made by
1889 the commission under this section.
1890 (b) The assessment required by Subsection (1)(a) is to be collected by the State Tax
1891 Commission and paid by the State Tax Commission into the state treasury as provided in
1892 Subsection 59-9-101 (2).
1893 (c) The assessment under Subsection (1)(a) shall be based on a total calculated premium
1894 multiplied by the premium assessment rate established pursuant to Subsection 59-9-101 (2).
1895 (d) The total calculated premium, for purposes of calculating the assessment under
1896 Subsection (1)(a), shall be calculated by:
1897 (i) multiplying the total of the standard premium for each class code calculated in
1898 Subsection (1)(e) by the employer's experience modification factor; and
1899 (ii) multiplying the total under Subsection (1)(d)(i) by a safety factor determined under
1900 Subsection (1)(g).
1901 (e) A standard premium shall be calculated by:
1902 (i) multiplying the prospective loss cost for the year being considered, as filed with the
1903 insurance department pursuant to Section [
1904 code by 1.10 to determine the manual rate for each class code; and
1905 (ii) multiplying the manual rate for each class code under Subsection (1)(e)(i) by each $100
1906 of the employer's covered payroll for each class code.
1907 (f) (i) Each employer paying compensation direct shall annually obtain the experience
1908 modification factor required in Subsection (1)(d)(i) by using the rate service organization
1909 designated by the insurance commissioner in [
1910 (ii) If an employer's experience modification factor under Subsection (1)(f)(i) is less than
1911 0.50, the employer shall use an experience modification factor of 0.50 in determining the total
1912 calculated premium.
1913 (g) To provide incentive for improved safety, the safety factor required in Subsection
1914 (1)(d)(ii) shall be determined based on the employer's experience modification factor as follows:
1915 EXPERIENCE
1916 MODIFICATION FACTOR SAFETY FACTOR
1917 Less than or equal to 0.90 0.56
1918 Greater than 0.90 but less than or equal to 1.00 0.78
1919 Greater than 1.00 but less than or equal to 1.10 1.00
1920 Greater than 1.10 but less than or equal to 1.20 1.22
1921 Greater than 1.20 1.44
1922 (h) (i) A premium or premium assessment modification other than a premium or premium
1923 assessment modification under this section may not be allowed.
1924 (ii) If an employer paying compensation direct fails to obtain an experience modification
1925 factor as required in Subsection (1)(f)(i) within the reasonable time period established by rule by
1926 the State Tax Commission, the State Tax Commission shall use an experience modification factor
1927 of 2.00 and a safety factor of 2.00 to calculate the total calculated premium for purposes of
1928 determining the assessment.
1929 (iii) Prior to calculating the total calculated premium under Subsection (1)(h)(ii), the State
1930 Tax Commission shall provide the employer with written notice that failure to obtain an
1931 experience modification factor within a reasonable time period, as established by rule by the State
1932 Tax Commission:
1933 (A) shall result in the State Tax Commission using an experience modification factor of
1934 2.00 and a safety factor of 2.00 in calculating the total calculated premium for purposes of
1935 determining the assessment; and
1936 (B) may result in the division revoking the employer's right to pay compensation direct.
1937 (i) The division may immediately revoke an employer's certificate issued under Section
1938 34A-2-201 that permits the employer to pay compensation direct if the State Tax Commission
1939 assigns an experience modification factor and a safety factor under Subsection (1)(h) because the
1940 employer failed to obtain an experience modification factor.
1941 (2) Notwithstanding the annual payment requirement in Subsection (1)(a), an employer
1942 whose total assessment obligation under Subsection (1)(a) for the preceding year was $10,000 or
1943 more shall pay the assessment in quarterly installments in the same manner provided in Section
1944 59-9-104 and subject to the same penalty provided in Section 59-9-104 for not paying or
1945 underpaying an installment.
1946 (3) (a) The State Tax Commission shall have access to all the records of the division for
1947 the purpose of auditing and collecting any amounts described in this section.
1948 (b) Time periods for the State Tax Commission to allow a refund or make an assessment
1949 shall be determined in accordance with Section 59-9-106 .
1950 (4) (a) A review of appropriate use of job class assignment and calculation methodology
1951 may be conducted as directed by the division at any reasonable time as a condition of the
1952 employer's certification of paying compensation direct.
1953 (b) The State Tax Commission shall make any records necessary for the review available
1954 to the commission.
1955 (c) The commission shall make the results of any review available to the State Tax
1956 Commission.
1957 Section 46. Section 53-1-106 is amended to read:
1958 53-1-106. Department duties -- Powers.
1959 (1) In addition to the responsibilities contained in this title, the department shall:
1960 (a) make rules and perform the functions specified in Title 41, Chapter 6, Traffic Rules
1961 and Regulations, including:
1962 (i) setting performance standards for towing companies to be used by the department, as
1963 required by Section 41-6-102 ; and
1964 (ii) advising the Department of Transportation regarding the safe design and operation of
1965 school buses, as required by Section 41-6-115 ;
1966 (b) make rules to establish and clarify standards pertaining to the curriculum and teaching
1967 methods of a motor vehicle accident prevention course under Section [
1968 (c) aid in enforcement efforts to combat drug trafficking using funds appropriated under
1969 Section 58-37-20 ;
1970 (d) as part of the annual budget hearings, provide the Executive Offices, Criminal Justice,
1971 and Legislature Appropriations Subcommittee with a complete accounting of expenditures and
1972 revenues from the funds under Section 58-37-20 ;
1973 (e) meet with the Department of Administrative Services to formulate contracts, establish
1974 priorities, and develop funding mechanisms for dispatch and telecommunications operations, as
1975 required by Section 63A-6-107 ;
1976 (f) provide assistance to the Crime Victims' Reparations Board and Reparations Office in
1977 conducting research or monitoring victims' programs, as required by Section 63-25a-405 ;
1978 (g) develop sexual assault exam protocol standards in conjunction with the Utah Hospital
1979 Association, as required by Section 63-25a-409 ; and
1980 (h) engage in emergency planning activities, including preparation of policy and procedure
1981 and rulemaking necessary for implementation of the federal Emergency Planning and Community
1982 Right to Know Act of 1986, as required by Section 63-5-5 .
1983 (2) (a) The department may establish a schedule of fees as required or allowed in this title
1984 for services provided by the department.
1985 (b) The fees shall be established in accordance with Section 63-38-3.2 .
1986 Section 47. Repealer.
1987 This act repeals:
1988 Section 31A-19-404, Rate standard.
1989 Section 31A-19-405, Payment of dividends.
1990 Section 31A-19-406, Rating criteria.
1991 Section 31A-19-409, Excess rates.
1992 Section 31A-19-410, Uniform experience rating plan.
1993 Section 31A-19-411, Timing of rate disapproval.
1994 Section 31A-19-412, Basis for rate disapproval.
1995 Section 31A-19-413, Rate disapproval procedure.
1996 Section 31A-19-415, Cooperation among rating organizations and insurers.
1997 Section 31A-19-416, Rate service organization activities.
1998 Section 31A-19-417, Rating organization committee membership.
1999 Section 31A-19-420, Cooperation among rating organizations and insurers.
Legislative Review Note
as of 1-27-99 5:22 PM
A limited legal review of this legislation raises no obvious constitutional or statutory concerns.