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S.B. 14 Enrolled

                 

INSURANCE CODE EXEMPTION

                 
2004 GENERAL SESSION

                 
STATE OF UTAH

                 
Sponsor: Gregory S. Bell

                 
                  LONG TITLE
                  General Description:
                      This bill exempts specified activities from the insurance code.
                  Highlighted Provisions:
                      This bill:
                      .    provides an exemption from the insurance code for death, accident, health, and
                  disability benefits provided by an Internal Revenue Code Section 501(c)(3)
                  organization to its volunteers under specified circumstances; and
                      .    makes technical corrections.
                  Monies Appropriated in this Bill:
                      None
                  Other Special Clauses:
                      None
                  Utah Code Sections Affected:
                  AMENDS:
                      31A-1-103, as last amended by Chapters 71 and 308, Laws of Utah 2002
                 
                  Be it enacted by the Legislature of the state of Utah:
                      Section 1. Section 31A-1-103 is amended to read:
                       31A-1-103. Scope and applicability of title.
                      (1) This title does not apply to:
                      (a) a retainer contract made by an attorney-at-law:
                      (i) with an individual client; and
                      (ii) under which fees are based on estimates of the nature and amount of services to be


                  provided to the specific client;
                      (b) a contract similar to a contract described in Subsection (1)(a) made with a group of
                  clients involved in the same or closely related legal matters;
                      (c) an arrangement for providing benefits that do not exceed a limited amount of
                  consultations, advice on simple legal matters, either alone or in combination with referral services,
                  or the promise of fee discounts for handling other legal matters;
                      (d) limited legal assistance on an informal basis involving neither an express contractual
                  obligation nor reasonable expectations, in the context of an employment, membership,
                  educational, or similar relationship; [or]
                      (e) legal assistance by employee organizations to their members in matters relating to
                  employment[.]; or
                      (f) death, accident, health, or disability benefits provided to a person by an organization
                  or its affiliate if:
                      (i) the organization is tax exempt under Section 501(c)(3) of the Internal Revenue Code
                  and has had its principal place of business in Utah for at least five years;
                      (ii) the person is not an employee of the organization; and
                      (iii) (A) substantially all the person's time in the organization is spent providing voluntary
                  services:
                      (I) in furtherance of the organization's purposes;
                      (II) for a designated period of time; and
                      (III) for which no compensation, other than expenses, is paid; or
                      (B) the time since the service under Subsection (1)(f)(iii)(A) was completed is no more
                  than 18 months.
                      (2) (a) This title restricts otherwise legitimate business activity.
                      (b) What this title does not prohibit is permitted unless contrary to other provisions of
                  Utah law.
                      (3) Except as otherwise expressly provided, this title does not apply to:
                      (a) those activities of an insurer where state jurisdiction is preempted by Section 514 of

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                  the federal Employee Retirement Income Security Act of 1974, as amended;
                      (b) ocean marine insurance;
                      (c) death [and], accident [and], health, or disability benefits provided by an organization if
                  the organization:
                      (i) has as its principal purpose to achieve charitable, educational, social, or religious
                  objectives rather than to provide death [and], accident [and], health, or disability benefits;
                      (ii) does not incur a legal obligation to pay a specified amount; and
                      (iii) does not create reasonable expectations of receiving a specified amount on the part of
                  an insured person;
                      (d) other business specified in rules adopted by the commissioner on a finding that:
                      (i) the transaction of the business in this state does not require regulation for the
                  protection of the interests of the residents of this state; or
                      (ii) it would be impracticable to require compliance with this title;
                      (e) except as provided in Subsection (4), a transaction independently procured through
                  negotiations under Section 31A-15-104 ;
                      (f) self-insurance;
                      (g) reinsurance;
                      (h) subject to Subsection (5), employee and labor union group or blanket insurance
                  covering risks in this state if:
                      (i) the policyholder exists primarily for purposes other than to procure insurance;
                      (ii) the policyholder:
                      (A) is not a resident of this state;
                      (B) is not a domestic corporation; or
                      (C) does not have its principal office in this state;
                      (iii) no more than 25% of the certificate holders or insureds are residents of this state;
                      (iv) on request of the commissioner, the insurer files with the department a copy of the
                  policy and a copy of each form or certificate; and
                      (v) (A) the insurer agrees to pay premium taxes on the Utah portion of its business, as if it

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                  were authorized to do business in this state; and
                      (B) the insurer provides the commissioner with the security the commissioner considers
                  necessary for the payment of premium taxes under Title 59, Chapter 9, Taxation of Admitted
                  Insurers;
                      (i) to the extent provided in Subsection (6):
                      (i) a manufacturer's or seller's warranty; and
                      (ii) a manufacturer's or seller's service contract; or
                      (j) except to the extent provided in Subsection (7), a public agency insurance mutual.
                      (4) A transaction described in Subsection (3)(e) is subject to taxation under Section
                  31A-3-301 .
                      (5) (a) After a hearing, the commissioner may order an insurer of certain group or blanket
                  contracts to transfer the Utah portion of the business otherwise exempted under Subsection (3)(h)
                  to an authorized insurer if the contracts have been written by an unauthorized insurer.
                      (b) If the commissioner finds that the conditions required for the exemption of a group or
                  blanket insurer are not satisfied or that adequate protection to residents of this state is not
                  provided, the commissioner may require:
                      (i) the insurer to be authorized to do business in this state; or
                      (ii) that any of the insurer's transactions be subject to this title.
                      (6) (a) As used in Subsection (3)(i) and this Subsection (6):
                      (i) "manufacturer's or seller's service contract" means a service contract:
                      (A) made available by:
                      (I) a manufacturer of a product;
                      (II) a seller of a product; or
                      (III) an affiliate of a manufacturer or seller of a product;
                      (B) made available:
                      (I) on one or more specific products; or
                      (II) on products that are components of a system; and
                      (C) under which the person described in Subsection (6)(a)(i)(A) is liable for services to be

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                  provided under the service contract including, if the manufacturer's or seller's service contract
                  designates, providing parts and labor;
                      (ii) "manufacturer's or seller's warranty" means the guaranty of:
                      (A) (I) the manufacturer of a product;
                      (II) a seller of a product; or
                      (III) an affiliate of a manufacturer or seller of a product;
                      (B) (I) on one or more specific products; or
                      (II) on products that are components of a system; and
                      (C) under which the person described in Subsection (6)(a)(ii)(A) is liable for services to
                  be provided under the warranty, including, if the manufacturer's or seller's warranty designates,
                  providing parts and labor; and
                      (iii) "service contract" is as defined in Section 31A-6a-101 .
                      (b) A manufacturer's or seller's warranty may be designated as:
                      (i) a warranty;
                      (ii) a guaranty; or
                      (iii) a term similar to a term described in Subsection (6)(b)(i) or (ii).
                      (c) This title does not apply to:
                      (i) a manufacturer's or seller's warranty;
                      (ii) a manufacturer's or seller's service contract paid for with consideration that is in
                  addition to the consideration paid for the product itself; and
                      (iii) a service contract that is not a manufacturer's or seller's warranty or manufacturer's or
                  seller's service contract if:
                      (A) the service contract is paid for with consideration that is in addition to the
                  consideration paid for the product itself;
                      (B) the service contract is for the repair or maintenance of goods;
                      (C) the cost of the product is equal to an amount determined in accordance with
                  Subsection (6)(e); and
                      (D) the product is not a motor vehicle.

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                      (d) This title does not apply to a manufacturer's or seller's warranty or service contract
                  paid for with consideration that is in addition to the consideration paid for the product itself
                  regardless of whether the manufacturer's or seller's warranty or service contract is sold:
                      (i) at the time of the purchase of the product; or
                      (ii) at a time other than the time of the purchase of the product.
                      (e) (i) For fiscal year 2001-02, the amount described in Subsection (6)(c)(iii)(C) shall be
                  equal to $3,700 or less.
                      (ii) For each fiscal year after fiscal year 2001-02, the commissioner shall annually
                  determine whether the amount described in Subsection (6)(c)(iii)(C) should be adjusted in
                  accordance with changes in the Consumer Price Index published by the United States Bureau of
                  Labor Statistics selected by the commissioner by rule, between:
                      (A) the Consumer Price Index for the February immediately preceding the adjustment;
                  and
                      (B) the Consumer Price Index for February 2001.
                      (iii) If under Subsection (6)(e)(ii) the commissioner determines that an adjustment should
                  be made, the commissioner shall make the adjustment by rule.
                      (7) (a) For purposes of this Subsection (7), "public agency insurance mutual" means an
                  entity formed by two or more political subdivisions or public agencies of the state:
                      (i) under Title 11, Chapter 13, Interlocal Cooperation Act; and
                      (ii) for the purpose of providing for the political subdivisions or public agencies:
                      (A) subject to Subsection (7)(b), insurance coverage; or
                      (B) risk management.
                      (b) Notwithstanding Subsection (7)(a)(ii)(A), a public agency insurance mutual may not
                  provide health insurance unless the public agency insurance mutual provides the health insurance
                  using:
                      (i) a third party administrator licensed under Chapter 25, Third Party Administrators;
                      (ii) an admitted insurer; or
                      (iii) a program authorized by Title 49, Chapter 20, Public Employees' Benefit and

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                  Insurance Program Act.
                      (c) Except for this Subsection (7), a public agency insurance mutual is exempt from this
                  title.
                      (d) A public agency insurance mutual is considered to be a governmental entity and
                  political subdivision of the state with all of the rights, privileges, and immunities of a
                  governmental entity or political subdivision of the state including all the rights and benefits of
                  Title 63, Chapter 30, Governmental Immunity Act.

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