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First Substitute H.B. 19
7 LONG TITLE
8 General Description:
9 This bill modifies the Insurance Code and other provisions related to the regulation of
10 insurance and insurance products.
11 Highlighted Provisions:
12 This bill:
13 . amends definitions;
14 . addresses fees for captive insurance companies and the cap on the Captive
15 Insurance Restricted Account;
16 . modifies restrictions on foreign title insurers;
17 . removes outdated language;
18 . addresses grace periods for accident and health insurance policies;
19 . modifies provisions related to individuals, group, or blanket accident and health
20 insurance coverage;
21 . addresses health benefit plan offerings;
22 . addresses producer lines of authority;
23 . addresses a written agreement related to a voluntary surrender of a license;
24 . amends provisions related to continuing education;
25 . provides for training related to long-term care insurance;
26 . modifies title insurance agency and producer licensing requirements;
27 . addresses when a title insurance producer may do an escrow involving a real
28 property transaction;
29 . modifies provisions related to disbursements from escrow accounts;
30 . modifies title insurance related assessments;
31 . addresses when a person may represent that the person acts in behalf of an insurer;
32 . modifies provisions related to providing the commissioner address, telephone, and
33 email address information;
34 . addresses verification under a nonresident jurisdictional agreement;
35 . addresses per diem and travel expenses of public representatives on the board of
36 directors of the Utah Life and Health Insurance Guaranty Association;
37 . addresses the establishment of classes of business;
38 . modifies rating restrictions;
39 . addresses the renewal of a bail bond surety company license;
40 . permits the commissioner to assign a department employee to engage in certain
41 activities related to the regulation of captive insurance companies;
42 . requires a professional employer organization to notify the commissioner of
43 material changes;
44 . removes the title insurance assessment from the sunset act;
45 . converts certain dedicated credits into several restricted accounts and provides that
46 related appropriations are nonlapsing; and
47 . makes technical and conforming amendments.
48 Money Appropriated in this Bill:
50 Other Special Clauses:
51 This bill has an effective date.
52 This bill provides for retrospective operation of certain provisions.
53 Utah Code Sections Affected:
55 31A-1-301, as last amended by Laws of Utah 2010, Chapter 10
56 31A-2-208, as last amended by Laws of Utah 2010, Chapter 391
57 31A-2-212, as last amended by Laws of Utah 2007, Chapter 309
58 31A-3-304, as last amended by Laws of Utah 2010, Chapters 10, 68 and last amended
59 by Coordination Clause, Laws of Utah 2010, Chapter 265
60 31A-14-211, as last amended by Laws of Utah 2003, Chapter 298
61 31A-22-305, as last amended by Laws of Utah 2010, Chapter 354
62 31A-22-607, as last amended by Laws of Utah 2004, Chapter 329
63 31A-22-610.6, as enacted by Laws of Utah 2008, Chapters 345, 383, and 390
64 31A-22-614.5, as last amended by Laws of Utah 2010, Chapter 357
65 31A-22-618.5, as last amended by Laws of Utah 2010, Chapter 68
66 31A-22-625, as last amended by Laws of Utah 2010, Chapters 10 and 68
67 31A-22-701, as last amended by Laws of Utah 2010, Chapter 10
68 31A-22-716, as last amended by Laws of Utah 2005, Chapter 71
69 31A-22-721, as last amended by Laws of Utah 2004, Chapter 329
70 31A-22-723, as last amended by Laws of Utah 2010, Chapter 68
71 31A-23a-102, as last amended by Laws of Utah 2009, Chapter 349
72 31A-23a-106, as last amended by Laws of Utah 2009, Chapter 349
73 31A-23a-111, as last amended by Laws of Utah 2009, Chapters 349 and 355
74 31A-23a-202, as last amended by Laws of Utah 2009, Chapter 127
75 31A-23a-203, as last amended by Laws of Utah 2009, Chapter 349
76 31A-23a-204, as last amended by Laws of Utah 2009, Chapter 349
77 31A-23a-406, as last amended by Laws of Utah 2007, Chapter 325
78 31A-23a-408, as renumbered and amended by Laws of Utah 2003, Chapter 298
79 31A-23a-412, as renumbered and amended by Laws of Utah 2003, Chapter 298
80 31A-23a-415, as last amended by Laws of Utah 2010, Chapter 10 and last amended by
81 Coordination Clause, Laws of Utah 2010, Chapter 265
82 31A-25-208, as last amended by Laws of Utah 2009, Chapter 349
83 31A-26-206, as last amended by Laws of Utah 2008, Chapter 382
84 31A-26-208, as last amended by Laws of Utah 2008, Chapter 3
85 31A-26-213, as last amended by Laws of Utah 2009, Chapter 349
86 31A-26-306, as last amended by Laws of Utah 2004, Chapter 173
87 31A-28-107, as last amended by Laws of Utah 2010, Chapter 292
88 31A-29-103, as last amended by Laws of Utah 2008, Chapters 3 and 385
89 31A-29-106, as last amended by Laws of Utah 2008, Chapter 382
90 31A-30-103, as last amended by Laws of Utah 2010, Chapter 68
91 31A-30-105, as last amended by Laws of Utah 2010, Chapter 68
92 31A-30-106, as last amended by Laws of Utah 2010, Chapter 68
93 31A-30-106.1, as enacted by Laws of Utah 2010, Chapter 68
94 31A-30-106.5, as last amended by Laws of Utah 2010, Chapter 68
95 31A-30-108, as last amended by Laws of Utah 2008, Chapter 383
96 31A-30-110, as last amended by Laws of Utah 2002, Chapter 308
97 31A-30-112, as last amended by Laws of Utah 2009, Chapter 12
98 31A-31-108, as last amended by Laws of Utah 2010, Chapter 391
99 31A-31-109, as last amended by Laws of Utah 2010, Chapter 391
100 31A-35-202, as last amended by Laws of Utah 2000, Chapter 259
101 31A-35-406, as last amended by Laws of Utah 2010, Chapter 10
102 31A-35-602, as last amended by Laws of Utah 2000, Chapter 259
103 31A-37-103, as last amended by Laws of Utah 2008, Chapter 302
104 31A-37-202, as last amended by Laws of Utah 2009, Chapter 183
105 31A-37-504, as last amended by Laws of Utah 2007, Chapter 309
106 59-9-105, as last amended by Laws of Utah 2002, Chapter 308
107 63I-2-231, as last amended by Laws of Utah 2010, Chapters 68 and 285
108 63J-1-602.2, as enacted by Laws of Utah 2010, Chapter 265 and last amended by
109 Coordination Clause, Laws of Utah 2010, Chapter 265
110 63J-1-602.3, as enacted by Laws of Utah 2010, Chapter 265
112 31A-40-308, Utah Code Annotated 1953
113 Uncodified Material Affected:
114 ENACTS UNCODIFIED MATERIAL
116 Be it enacted by the Legislature of the state of Utah:
117 Section 1. Section 31A-1-301 is amended to read:
118 31A-1-301. Definitions.
119 As used in this title, unless otherwise specified:
120 (1) (a) "Accident and health insurance" means insurance to provide protection against
121 economic losses resulting from:
122 (i) a medical condition including:
123 (A) a medical care expense; or
124 (B) the risk of disability;
125 (ii) accident; or
126 (iii) sickness.
127 (b) "Accident and health insurance":
128 (i) includes a contract with disability contingencies including:
129 (A) an income replacement contract;
130 (B) a health care contract;
131 (C) an expense reimbursement contract;
132 (D) a credit accident and health contract;
133 (E) a continuing care contract; and
134 (F) a long-term care contract; and
135 (ii) may provide:
136 (A) hospital coverage;
137 (B) surgical coverage;
138 (C) medical coverage;
139 (D) loss of income coverage;
140 (E) prescription drug coverage;
141 (F) dental coverage; or
142 (G) vision coverage.
143 (c) "Accident and health insurance" does not include workers' compensation insurance.
144 (2) "Actuary" is as defined by the commissioner by rule, made in accordance with Title
145 63G, Chapter 3, Utah Administrative Rulemaking Act.
146 (3) "Administrator" is defined in Subsection [
147 (4) "Adult" means an individual who has attained the age of at least 18 years.
148 (5) "Affiliate" means a person who controls, is controlled by, or is under common
149 control with, another person. A corporation is an affiliate of another corporation, regardless of
150 ownership, if substantially the same group of individuals manage the corporations.
151 (6) "Agency" means:
152 (a) a person other than an individual, including a sole proprietorship by which an
153 individual does business under an assumed name; and
154 (b) an insurance organization licensed or required to be licensed under Section
155 31A-23a-301 , 31A-25-207 , or 31A-26-209 .
156 (7) "Alien insurer" means an insurer domiciled outside the United States.
157 (8) "Amendment" means an endorsement to an insurance policy or certificate.
158 (9) "Annuity" means an agreement to make periodical payments for a period certain or
159 over the lifetime of one or more individuals if the making or continuance of all or some of the
160 series of the payments, or the amount of the payment, is dependent upon the continuance of
161 human life.
162 (10) "Application" means a document:
163 (a) (i) completed by an applicant to provide information about the risk to be insured;
165 (ii) that contains information that is used by the insurer to evaluate risk and decide
166 whether to:
167 (A) insure the risk under:
168 (I) the coverage as originally offered; or
169 (II) a modification of the coverage as originally offered; or
170 (B) decline to insure the risk; or
171 (b) used by the insurer to gather information from the applicant before issuance of an
172 annuity contract.
173 (11) "Articles" or "articles of incorporation" means:
174 (a) the original articles;
175 (b) a special law;
176 (c) a charter;
177 (d) an amendment;
178 (e) restated articles;
179 (f) articles of merger or consolidation;
180 (g) a trust instrument;
181 (h) another constitutive document for a trust or other entity that is not a corporation;
183 (i) an amendment to an item listed in Subsections (11)(a) through (h).
184 (12) "Bail bond insurance" means a guarantee that a person will attend court when
185 required, up to and including surrender of the person in execution of a sentence imposed under
186 Subsection 77-20-7 (1), as a condition to the release of that person from confinement.
187 (13) "Binder" is defined in Section 31A-21-102 .
188 (14) "Blanket insurance policy" means a group policy covering a defined class of
190 (a) without individual underwriting or application; and
191 (b) that is determined by definition [
192 (15) "Board," "board of trustees," or "board of directors" means the group of persons
193 with responsibility over, or management of, a corporation, however designated.
194 (16) "Bona fide office" means a physical office in this state:
195 (a) that is open to the public;
196 (b) that is staffed during regular business hours on regular business days; and
197 (c) at which the public may appear in person to obtain services.
199 (a) a corporation;
200 (b) an association;
201 (c) a partnership;
202 (d) a limited liability company;
203 (e) a limited liability partnership; or
204 (f) another legal entity.
207 commissioner under Subsections 31A-5-204 (2)(i) and (j), including the information required
208 when these subsections apply by reference under:
209 (a) Section 31A-7-201 ;
210 (b) Section 31A-8-205 ; or
211 (c) Subsection 31A-9-205 (2).
213 corporation's affairs, however designated.
214 (b) "Bylaws" includes comparable rules for a trust or other entity that is not a
217 (a) an insurer:
218 (i) owned by another organization; and
219 (ii) whose exclusive purpose is to insure risks of the parent organization and an
220 affiliated company; or
221 (b) in the case of a group or association, an insurer:
222 (i) owned by the insureds; and
223 (ii) whose exclusive purpose is to insure risks of:
224 (A) a member organization;
225 (B) a group member; or
226 (C) an affiliate of:
227 (I) a member organization; or
228 (II) a group member.
231 (a) an insured under a group insurance policy; or
232 (b) a third party.
235 on an insurer for payment of a benefit according to the terms of an insurance policy.
237 coverage under a policy insuring against legal liability to claims that are first made against the
238 insured while the policy is in force.
240 insurance commissioner.
241 (b) When appropriate, the terms listed in Subsection [
242 equivalent supervisory official of another jurisdiction.
244 (i) provides board and lodging;
245 (ii) provides one or more of the following:
246 (A) a personal service;
247 (B) a nursing service;
248 (C) a medical service; or
249 (D) any other health-related service; and
250 (iii) provides the coverage described in this Subsection [
251 agreement effective:
252 (A) for the life of the insured; or
253 (B) for a period in excess of one year.
254 (b) Insurance is continuing care insurance regardless of whether or not the board and
255 lodging are provided at the same location as a service described in Subsection [
257 means the direct or indirect possession of the power to direct or cause the direction of the
258 management and policies of a person. This control may be:
259 (i) by contract;
260 (ii) by common management;
261 (iii) through the ownership of voting securities; or
262 (iv) by a means other than those described in Subsections [
263 (b) There is no presumption that an individual holding an official position with another
264 person controls that person solely by reason of the position.
265 (c) A person having a contract or arrangement giving control is considered to have
266 control despite the illegality or invalidity of the contract or arrangement.
267 (d) There is a rebuttable presumption of control in a person who directly or indirectly
268 owns, controls, holds with the power to vote, or holds proxies to vote 10% or more of the
269 voting securities of another person.
271 indirectly controlled by a producer.
273 power to direct or cause to be directed, the management, control, or activities of a reinsurance
276 an insurer.
278 (i) a corporation doing business:
279 (A) as:
280 (I) an insurance producer;
281 (II) a limited line producer;
282 (III) a consultant;
283 (IV) a managing general agent;
284 (V) a reinsurance intermediary;
285 (VI) a third party administrator; or
286 (VII) an adjuster; and
287 (B) under:
288 (I) Chapter 23a, Insurance Marketing - Licensing Producers, Consultants, and
289 Reinsurance Intermediaries;
290 (II) Chapter 25, Third Party Administrators; or
291 (III) Chapter 26, Insurance Adjusters; or
292 (ii) a noninsurer that is part of a holding company system under Chapter 16, Insurance
293 Holding Companies.
294 (b) "Stock corporation" means a stock insurance corporation.
295 (c) "Mutual" or "mutual corporation" means a mutual insurance corporation.
297 regulations adopted pursuant to the Health Insurance Portability and Accountability Act [
299 (b) "Creditable coverage" includes coverage that is offered through a public health plan
300 such as:
301 (i) the Primary Care Network Program under a Medicaid primary care network
302 demonstration waiver obtained subject to Section 26-18-3 ;
303 (ii) the Children's Health Insurance Program under Section 26-40-106 ; or
304 (iii) the Ryan White Program Comprehensive AIDS Resources Emergency Act, Pub. L.
305 101-381, and Ryan White HIV/AIDS Treatment Modernization Act of 2006, Pub. L. 109-415.
307 provide indemnity for payments coming due on a specific loan or other credit transaction while
308 the debtor is disabled.
310 extension of credit that is limited to partially or wholly extinguishing that credit obligation.
311 (b) "Credit insurance" includes:
312 (i) credit accident and health insurance;
313 (ii) credit life insurance;
314 (iii) credit property insurance;
315 (iv) credit unemployment insurance;
316 (v) guaranteed automobile protection insurance;
317 (vi) involuntary unemployment insurance;
318 (vii) mortgage accident and health insurance;
319 (viii) mortgage guaranty insurance; and
320 (ix) mortgage life insurance.
322 with an extension of credit that pays a person if the debtor dies.
324 (a) offered in connection with an extension of credit; and
325 (b) that protects the property until the debt is paid.
327 (a) offered in connection with an extension of credit; and
328 (b) that provides indemnity if the debtor is unemployed for payments coming due on a:
329 (i) specific loan; or
330 (ii) credit transaction.
332 (a) matured;
333 (b) unmatured;
334 (c) liquidated;
335 (d) unliquidated;
336 (e) secured;
337 (f) unsecured;
338 (g) absolute;
339 (h) fixed; or
340 (i) contingent.
342 insurance service and insurance product information:
343 (i) for the customer service representative's:
344 (A) producer; or
345 (B) consultant employer; and
346 (ii) to the customer service representative's employer's:
347 (A) customer;
348 (B) client; or
349 (C) organization.
350 (b) A customer service representative may only operate within the scope of authority of
351 the customer service representative's producer or consultant employer.
353 (a) imposed by:
354 (i) statute;
355 (ii) rule; or
356 (iii) order; and
357 (b) by which a required filing or payment must be received by the department.
359 occurrence of a condition precedent, the commissioner is considered to have taken a specific
360 action. If the statute so provides, a condition precedent may be the commissioner's failure to
361 take a specific action.
363 determined by counting the generations separating one person from a common ancestor and
364 then counting the generations to the other person.
368 or totally limits an individual's ability to:
369 (a) perform the duties of:
370 (i) that individual's occupation; or
371 (ii) any occupation for which the individual is reasonably suited by education, training,
372 or experience; or
373 (b) perform two or more of the following basic activities of daily living:
374 (i) eating;
375 (ii) toileting;
376 (iii) transferring;
377 (iv) bathing; or
378 (v) dressing.
382 (a) is incorporated;
383 (b) is organized; or
384 (c) in the case of an alien insurer, enters into the United States.
386 (i) an employee who:
387 (A) works on a full-time basis; and
388 (B) has a normal work week of 30 or more hours; or
389 (ii) a person described in Subsection [
390 (b) "Eligible employee" includes, if the individual is included under a health benefit
391 plan of a small employer:
392 (i) a sole proprietor;
393 (ii) a partner in a partnership; or
394 (iii) an independent contractor.
395 (c) "Eligible employee" does not include, unless eligible under Subsection [
397 (i) an individual who works on a temporary or substitute basis for a small employer;
398 (ii) an employer's spouse; or
399 (iii) a dependent of an employer.
402 (a) an employee; or
403 (b) a dependent of an employee.
405 (i) established or maintained, whether directly or through a trustee, by:
406 (A) one or more employers;
407 (B) one or more labor organizations; or
408 (C) a combination of employers and labor organizations; and
409 (ii) that provides employee benefits paid or contracted to be paid, other than income
410 from investments of the fund:
411 (A) by or on behalf of an employer doing business in this state; or
412 (B) for the benefit of a person employed in this state.
413 (b) "Employee welfare fund" includes a plan funded or subsidized by a user fee or tax
416 to modify the policy or certificate coverage.
418 (a) the first day of coverage; or
419 (b) if there is a waiting period, the first day of the waiting period.
421 (i) a real estate settlement or real estate closing conducted by a third party pursuant to
422 the requirements of a written agreement between the parties in a real estate transaction; or
423 (ii) a settlement or closing involving:
424 (A) a mobile home;
425 (B) a grazing right;
426 (C) a water right; or
427 (D) other personal property authorized by the commissioner.
428 (b) "Escrow" includes the act of conducting a:
429 (i) real estate settlement; or
430 (ii) real estate closing.
432 (a) an insurance producer with:
433 (i) a title insurance line of authority; and
434 (ii) an escrow subline of authority; or
435 (b) a person defined as an escrow agent in Section 7-22-101 .
437 also excluded.
438 (b) The items listed in a list using the term "excludes" are representative examples for
439 use in interpretation of this title.
441 insurer does not provide insurance coverage, for whatever reason, for one of the following:
442 (a) a specific physical condition;
443 (b) a specific medical procedure;
444 (c) a specific disease or disorder; or
445 (d) a specific prescription drug or class of prescription drugs.
447 (a) written to provide a payment for an expense relating to hospital confinement
448 resulting from illness or injury; and
449 (b) written:
450 (i) as a daily limit for a specific number of days in a hospital; and
451 (ii) to have a one or two day waiting period following a hospitalization.
453 holding a position of public or private trust.
455 (i) submitted to the department as required by and in accordance with applicable
456 statute, rule, or filing order;
457 (ii) received by the department within the time period provided in applicable statute,
458 rule, or filing order; and
459 (iii) accompanied by the appropriate fee in accordance with:
460 (A) Section 31A-3-103 ; or
461 (B) rule.
462 (b) "Filed" does not include a filing that is rejected by the department because it is not
463 submitted in accordance with Subsection [
465 department including:
466 (a) a policy;
467 (b) a rate;
468 (c) a form;
469 (d) a document;
470 (e) a plan;
471 (f) a manual;
472 (g) an application;
473 (h) a report;
474 (i) a certificate;
475 (j) an endorsement;
476 (k) an actuarial certification;
477 (l) a licensee annual statement;
478 (m) a licensee renewal application;
479 (n) an advertisement; or
480 (o) an outline of coverage.
482 insurer agrees to pay a claim submitted to it by the insured for the insured's losses.
484 an alien insurer.
486 (i) a policy;
487 (ii) a certificate;
488 (iii) an application;
489 (iv) an outline of coverage; or
490 (v) an endorsement.
491 (b) "Form" does not include a document specially prepared for use in an individual
494 through a mass marketing arrangement involving a defined class of persons related in some
495 way other than through the purchase of insurance.
497 (a) the general lines of insurance in Subsection [
498 (b) title insurance under one of the following sublines of authority:
499 (i) search, including authority to act as a title marketing representative;
500 (ii) escrow, including authority to act as a title marketing representative; and
501 (iii) title marketing representative only;
502 (c) surplus lines;
503 (d) workers' compensation; and
504 (e) any other line of insurance that the commissioner considers necessary to recognize
505 in the public interest.
507 (a) accident and health;
508 (b) casualty;
509 (c) life;
510 (d) personal lines;
511 (e) property; and
512 (f) variable contracts, including variable life and annuity.
514 that the plan provides medical care:
515 (a) (i) to an employee; or
516 (ii) to a dependent of an employee; and
517 (b) (i) directly;
518 (ii) through insurance reimbursement; or
519 (iii) through another method.
521 that is issued:
522 (i) to a policyholder on behalf of the group; and
523 (ii) for the benefit of a member of the group who is selected under a procedure defined
525 (A) the policy; or
526 (B) an agreement that is collateral to the policy.
527 (b) A group insurance policy may include a member of the policyholder's family or a
530 connection with an extension of credit that pays the difference in amount between the
531 insurance settlement and the balance of the loan if the insured automobile is a total loss.
533 means a policy or certificate that:
534 (i) provides health care insurance;
535 (ii) provides major medical expense insurance; or
536 (iii) is offered as a substitute for hospital or medical expense insurance, such as:
537 (A) a hospital confinement indemnity; or
538 (B) a limited benefit plan.
539 (b) "Health benefit plan" does not include a policy or certificate that:
540 (i) provides benefits solely for:
541 (A) accident;
542 (B) dental;
543 (C) income replacement;
544 (D) long-term care;
545 (E) a Medicare supplement;
546 (F) a specified disease;
547 (G) vision; or
548 (H) a short-term limited duration; or
549 (ii) is offered and marketed as supplemental health insurance.
551 treatment, mitigation, or prevention of a human ailment or impairment:
552 (a) a professional service;
553 (b) a personal service;
554 (c) a facility;
555 (d) equipment;
556 (e) a device;
557 (f) supplies; or
558 (g) medicine.
561 (i) a health care benefit; or
562 (ii) payment of an incurred health care expense.
563 (b) "Health care insurance" or "health insurance" does not include accident and health
564 insurance providing a benefit for:
565 (i) replacement of income;
566 (ii) short-term accident;
567 (iii) fixed indemnity;
568 (iv) credit accident and health;
569 (v) supplements to liability;
570 (vi) workers' compensation;
571 (vii) automobile medical payment;
572 (viii) no-fault automobile;
573 (ix) equivalent self-insurance; or
574 (x) a type of accident and health insurance coverage that is a part of or attached to
575 another type of policy.
576 (77) "Health Insurance Portability and Accountability Act" means the Health Insurance
577 Portability and Accountability Act of 1996, Pub. L. 104-191, 110 Stat. 1936, as amended.
579 insurance written to provide payments to replace income lost from accident or sickness.
581 insured loss.
583 under Section 31A-26-201 who engages in insurance adjusting as a representative of an insurer.
585 Section 31A-15-104 .
588 (a) property in transit on or over land;
589 (b) property in transit over water by means other than boat or ship;
590 (c) bailee liability;
591 (d) fixed transportation property such as bridges, electric transmission systems, radio
592 and television transmission towers and tunnels; and
593 (e) personal and commercial property floaters.
595 (a) an insurer is unable to pay its debts or meet its obligations as the debts and
596 obligations mature;
597 (b) an insurer's total adjusted capital is less than the insurer's mandatory control level
598 RBC under Subsection 31A-17-601 (8)(c); or
599 (c) an insurer is determined to be hazardous under this title.
601 (i) an arrangement, contract, or plan for the transfer of a risk or risks from one or more
602 persons to one or more other persons; or
603 (ii) an arrangement, contract, or plan for the distribution of a risk or risks among a
604 group of persons that includes the person seeking to distribute that person's risk.
605 (b) "Insurance" includes:
606 (i) a risk distributing arrangement providing for compensation or replacement for
607 damages or loss through the provision of a service or a benefit in kind;
608 (ii) a contract of guaranty or suretyship entered into by the guarantor or surety as a
609 business and not as merely incidental to a business transaction; and
610 (iii) a plan in which the risk does not rest upon the person who makes an arrangement,
611 but with a class of persons who have agreed to share the risk.
613 negotiation, or settlement of a claim under an insurance policy other than life insurance or an
614 annuity, on behalf of an insurer, policyholder, or a claimant under an insurance policy.
616 (a) providing health care insurance by an organization that is or is required to be
617 licensed under this title;
618 (b) providing a benefit to an employee in the event of a contingency not within the
619 control of the employee, in which the employee is entitled to the benefit as a right, which
620 benefit may be provided either:
621 (i) by a single employer or by multiple employer groups; or
622 (ii) through one or more trusts, associations, or other entities;
623 (c) providing an annuity:
624 (i) including an annuity issued in return for a gift; and
625 (ii) except an annuity provided by a person specified in Subsections 31A-22-1305 (2)
626 and (3);
627 (d) providing the characteristic services of a motor club as outlined in Subsection
629 (e) providing another person with insurance;
630 (f) making as insurer, guarantor, or surety, or proposing to make as insurer, guarantor,
631 or surety, a contract or policy of title insurance;
632 (g) transacting or proposing to transact any phase of title insurance, including:
633 (i) solicitation;
634 (ii) negotiation preliminary to execution;
635 (iii) execution of a contract of title insurance;
636 (iv) insuring; and
637 (v) transacting matters subsequent to the execution of the contract and arising out of
638 the contract, including reinsurance; [
643 (a) advises another person about insurance needs and coverages;
644 (b) is compensated by the person advised on a basis not directly related to the insurance
645 placed; and
646 (c) except as provided in Section 31A-23a-501 , is not compensated directly or
647 indirectly by an insurer or producer for advice given.
649 affiliated persons, at least one of whom is an insurer.
651 to be licensed under the laws of this state to sell, solicit, or negotiate insurance.
655 directly or indirectly by an insurer for selling, soliciting, or negotiating [
656 of that insurer[
657 (ii) "Producer for the insurer" may be referred to as an "agent."
659 (A) is compensated directly and only by an insurance customer or an insured; and
660 (B) receives no compensation directly or indirectly from an insurer for selling,
661 soliciting, or negotiating [
663 (ii) "Producer for the insured" may be referred to as a "broker."
665 makes a promise in an insurance policy and includes:
666 (i) a policyholder;
667 (ii) a subscriber;
668 (iii) a member; and
669 (iv) a beneficiary.
670 (b) The definition in Subsection [
671 (i) applies only to this title; and
672 (ii) does not define the meaning of this word as used in an insurance policy or
676 (i) a fraternal benefit society;
677 (ii) an issuer of a gift annuity other than an annuity specified in Subsections
678 31A-22-1305 (2) and (3);
679 (iii) a motor club;
680 (iv) an employee welfare plan; and
681 (v) a person purporting or intending to do an insurance business as a principal on that
682 person's own account.
683 (b) "Insurer" does not include a governmental entity to the extent the governmental
684 entity is engaged in an activity described in Section 31A-12-107 .
687 (a) offered in connection with an extension of credit; and
688 (b) that provides indemnity if the debtor is involuntarily unemployed for payments
689 coming due on a:
690 (i) specific loan; or
691 (ii) credit transaction.
693 employer who, with respect to a calendar year and to a plan year:
694 (a) employed an average of at least 51 eligible employees on each business day during
695 the preceding calendar year; and
696 (b) employs at least two employees on the first day of the plan year.
698 individual whose enrollment is a late enrollment.
700 enrollment of an individual other than:
701 (a) on the earliest date on which coverage can become effective for the individual
702 under the terms of the plan; or
703 (b) through special enrollment.
705 31A-1-103 , "legal expense insurance" means insurance written to indemnify or pay for a
706 specified legal expense.
707 (b) "Legal expense insurance" includes an arrangement that creates a reasonable
708 expectation of an enforceable right.
709 (c) "Legal expense insurance" does not include the provision of, or reimbursement for,
710 legal services incidental to other insurance coverage.
712 (i) for death, injury, or disability of a human being, or for damage to property,
713 exclusive of the coverages under:
714 (A) Subsection [
715 (B) Subsection [
716 (C) Subsection [
717 (ii) for a medical, hospital, surgical, and funeral benefit to a person other than the
718 insured who is injured, irrespective of legal liability of the insured, when issued with or
719 supplemental to insurance against legal liability for the death, injury, or disability of a human
720 being, exclusive of the coverages under:
721 (A) Subsection [
722 (B) Subsection [
723 (C) Subsection [
724 (iii) for loss or damage to property resulting from an accident to or explosion of a
725 boiler, pipe, pressure container, machinery, or apparatus;
726 (iv) for loss or damage to property caused by:
727 (A) the breakage or leakage of a sprinkler, water pipe, or water container; or
728 (B) water entering through a leak or opening in a building; or
729 (v) for other loss or damage properly the subject of insurance not within another kind
730 of insurance as defined in this chapter, if the insurance is not contrary to law or public policy.
731 (b) "Liability insurance" includes:
732 (i) vehicle liability insurance;
733 (ii) residential dwelling liability insurance; and
734 (iii) making inspection of, and issuing a certificate of inspection upon, an elevator,
735 boiler, machinery, or apparatus of any kind when done in connection with insurance on the
736 elevator, boiler, machinery, or apparatus.
738 an activity that is part of or related to the insurance business.
739 (b) "License" includes a certificate of authority issued to an insurer.
741 (i) insurance on a human life; and
742 (ii) insurance pertaining to or connected with human life.
743 (b) The business of life insurance includes:
744 (i) granting a death benefit;
745 (ii) granting an annuity benefit;
746 (iii) granting an endowment benefit;
747 (iv) granting an additional benefit in the event of death by accident;
748 (v) granting an additional benefit to safeguard the policy against lapse; and
749 (vi) providing an optional method of settlement of proceeds.
751 (a) is issued for a specific product of insurance; and
752 (b) limits an individual or agency to transact only for that product or insurance.
755 (a) credit life;
756 (b) credit accident and health;
757 (c) credit property;
758 (d) credit unemployment;
759 (e) involuntary unemployment;
760 (f) mortgage life;
761 (g) mortgage guaranty;
762 (h) mortgage accident and health;
763 (i) guaranteed automobile protection; and
764 (j) another form of insurance offered in connection with an extension of credit that:
765 (i) is limited to partially or wholly extinguishing the credit obligation; and
766 (ii) the commissioner determines by rule should be designated as a form of limited line
767 credit insurance.
769 solicits, or negotiates one or more forms of limited line credit insurance coverage to an
770 individual through a master, corporate, group, or individual policy.
772 (a) bail bond;
773 (b) limited line credit insurance;
774 (c) legal expense insurance;
775 (d) motor club insurance;
776 (e) [
777 (f) travel insurance;
778 (g) crop insurance;
779 (h) self-service storage insurance; [
780 (i) guaranteed asset protection waiver; and
782 should be designated a form of limited line insurance.
784 (a) the lines of insurance listed in Subsection [
785 (b) a customer service representative.
787 limited lines insurance.
789 advertised, marketed, offered, or designated to provide coverage:
790 (i) in a setting other than an acute care unit of a hospital;
791 (ii) for not less than 12 consecutive months for a covered person on the basis of:
792 (A) expenses incurred;
793 (B) indemnity;
794 (C) prepayment; or
795 (D) another method;
796 (iii) for one or more necessary or medically necessary services that are:
797 (A) diagnostic;
798 (B) preventative;
799 (C) therapeutic;
800 (D) rehabilitative;
801 (E) maintenance; or
802 (F) personal care; and
803 (iv) that may be issued by:
804 (A) an insurer;
805 (B) a fraternal benefit society;
806 (C) (I) a nonprofit health hospital; and
807 (II) a medical service corporation;
808 (D) a prepaid health plan;
809 (E) a health maintenance organization; or
810 (F) an entity similar to the entities described in Subsections [
811 through (E) to the extent that the entity is otherwise authorized to issue life or health care
813 (b) "Long-term care insurance" includes:
814 (i) any of the following that provide directly or supplement long-term care insurance:
815 (A) a group or individual annuity or rider; or
816 (B) a life insurance policy or rider;
817 (ii) a policy or rider that provides for payment of benefits on the basis of:
818 (A) cognitive impairment; or
819 (B) functional capacity; or
820 (iii) a qualified long-term care insurance contract.
821 (c) "Long-term care insurance" does not include:
822 (i) a policy that is offered primarily to provide basic Medicare supplement coverage;
823 (ii) basic hospital expense coverage;
824 (iii) basic medical/surgical expense coverage;
825 (iv) hospital confinement indemnity coverage;
826 (v) major medical expense coverage;
827 (vi) income replacement or related asset-protection coverage;
828 (vii) accident only coverage;
829 (viii) coverage for a specified:
830 (A) disease; or
831 (B) accident;
832 (ix) limited benefit health coverage; or
833 (x) a life insurance policy that accelerates the death benefit to provide the option of a
834 lump sum payment:
835 (A) if the following are not conditioned on the receipt of long-term care:
836 (I) benefits; or
837 (II) eligibility; and
838 (B) the coverage is for one or more the following qualifying events:
839 (I) terminal illness;
840 (II) medical conditions requiring extraordinary medical intervention; or
841 (III) permanent institutional confinement.
843 incident to the practice and provision of a medical service other than the practice and provision
844 of a dental service.
848 must be constantly maintained by a stock insurance corporation as required by statute.
850 connection with an extension of credit that provides indemnity for payments coming due on a
851 mortgage while the debtor is disabled.
853 mortgagee or other creditor is indemnified against losses caused by the default of a debtor.
855 connection with an extension of credit that pays if the debtor dies.
857 (a) licensed under:
858 (i) Chapter 5, Domestic Stock and Mutual Insurance Corporations;
859 (ii) Chapter 11, Motor Clubs; or
860 (iii) Chapter 14, Foreign Insurers; and
861 (b) that promises for an advance consideration to provide for a stated period of time
862 one or more:
863 (i) legal services under Subsection 31A-11-102 (1)(b);
864 (ii) bail services under Subsection 31A-11-102 (1)(c); or
865 (iii) (A) trip reimbursement;
866 (B) towing services;
867 (C) emergency road services;
868 (D) stolen automobile services;
869 (E) a combination of the services listed in Subsections [
870 (D); or
871 (F) other services given in Subsections 31A-11-102 (1)(b) through (f).
874 (a) that is issued by an insurer; and
875 (b) under which the financing and delivery of medical care is provided, in whole or in
876 part, through a defined set of providers under contract with the insurer, including the financing
877 and delivery of an item paid for as medical care.
879 not entitled to receive a dividend representing a share of the surplus of the insurer.
881 (a) ships or hulls of ships;
882 (b) goods, freight, cargoes, merchandise, effects, disbursements, profits, money,
883 securities, choses in action, evidences of debt, valuable papers, bottomry, respondentia
884 interests, or other cargoes in or awaiting transit over the oceans or inland waterways;
885 (c) earnings such as freight, passage money, commissions, or profits derived from
886 transporting goods or people upon or across the oceans or inland waterways; or
887 (d) a vessel owner or operator as a result of liability to employees, passengers, bailors,
888 owners of other vessels, owners of fixed objects, customs or other authorities, or other persons
889 in connection with maritime activity.
892 health insurance policy.
894 entitled to receive a dividend representing a share of the surplus of the insurer.
896 relating to the minimum percentage of eligible employees that must be enrolled in relation to
897 the total number of eligible employees of an employer reduced by each eligible employee who
898 voluntarily declines coverage under the plan because the employee:
899 (a) has other group health care insurance coverage; or
900 (b) receives:
901 (i) Medicare, under the Health Insurance for the Aged Act, Title XVIII of the Social
902 Security Amendments of 1965; or
903 (ii) another government health benefit.
905 (a) an individual;
906 (b) a partnership;
907 (c) a corporation;
908 (d) an incorporated or unincorporated association;
909 (e) a joint stock company;
910 (f) a trust;
911 (g) a limited liability company;
912 (h) a reciprocal;
913 (i) a syndicate; or
914 (j) another similar entity or combination of entities acting in concert.
916 coverage sold for primarily noncommercial purposes to:
917 (a) an individual; or
918 (b) a family.
921 (a) the year that is designated as the plan year in:
922 (i) the plan document of a group health plan; or
923 (ii) a summary plan description of a group health plan;
924 (b) if the plan document or summary plan description does not designate a plan year or
925 there is no plan document or summary plan description:
926 (i) the year used to determine deductibles or limits;
927 (ii) the policy year, if the plan does not impose deductibles or limits on a yearly basis;
929 (iii) the employer's taxable year if:
930 (A) the plan does not impose deductibles or limits on a yearly basis; and
931 (B) (I) the plan is not insured; or
932 (II) the insurance policy is not renewed on an annual basis; or
933 (c) in a case not described in Subsection [
935 application that:
936 (i) purports to be an enforceable contract; and
937 (ii) memorializes in writing some or all of the terms of an insurance contract.
938 (b) "Policy" includes a service contract issued by:
939 (i) a motor club under Chapter 11, Motor Clubs;
940 (ii) a service contract provided under Chapter 6a, Service Contracts; and
941 (iii) a corporation licensed under:
942 (A) Chapter 7, Nonprofit Health Service Insurance Corporations; or
943 (B) Chapter 8, Health Maintenance Organizations and Limited Health Plans.
944 (c) "Policy" does not include:
945 (i) a certificate under a group insurance contract; or
946 (ii) a document that does not purport to have legal effect.
948 contract by ownership, premium payment, or otherwise.
950 nonguaranteed elements of a policy of life insurance over a period of years.
952 insurance policy.
954 (a) means a condition that was present before the effective date of coverage, whether or
955 not medical advice, diagnosis, care, or treatment was recommended or received before that day;
957 (b) does not include a condition indicated by genetic information unless an actual
958 diagnosis of the condition by a physician has been made.
960 (b) "Premium" includes, however designated:
961 (i) an assessment;
962 (ii) a membership fee;
963 (iii) a required contribution; or
964 (iv) monetary consideration.
965 (c) (i) "Premium" does not include consideration paid to a third party administrator for
966 the third party administrator's services.
967 (ii) "Premium" includes an amount paid by a third party administrator to an insurer for
968 insurance on the risks administered by the third party administrator.
970 Subsection 31A-5-203 (3).
973 incident to the practice of a profession and provision of a professional service.
975 insurance" means insurance against loss or damage to real or personal property of every kind
976 and any interest in that property:
977 (i) from all hazards or causes; and
978 (ii) against loss consequential upon the loss or damage including vehicle
979 comprehensive and vehicle physical damage coverages.
980 (b) "Property insurance" does not include:
981 (i) inland marine insurance; and
982 (ii) ocean marine insurance.
984 long-term care insurance contract" means:
985 (a) an individual or group insurance contract that meets the requirements of Section
986 7702B(b), Internal Revenue Code; or
987 (b) the portion of a life insurance contract that provides long-term care insurance:
988 (i) (A) by rider; or
989 (B) as a part of the contract; and
990 (ii) that satisfies the requirements of Sections 7702B(b) and (e), Internal Revenue
993 (a) is:
994 (i) organized under the laws of the United States or any state; or
995 (ii) in the case of a United States office of a foreign banking organization, licensed
996 under the laws of the United States or any state;
997 (b) is regulated, supervised, and examined by a United States federal or state authority
998 having regulatory authority over a bank or trust company; and
999 (c) meets the standards of financial condition and standing that are considered
1000 necessary and appropriate to regulate the quality of a financial institution whose letters of credit
1001 will be acceptable to the commissioner as determined by:
1002 (i) the commissioner by rule; or
1003 (ii) the Securities Valuation Office of the National Association of Insurance
1006 (i) the cost of a given unit of insurance; or
1007 (ii) for property or casualty insurance, that cost of insurance per exposure unit either
1008 expressed as:
1009 (A) a single number; or
1010 (B) a pure premium rate, adjusted before the application of individual risk variations
1011 based on loss or expense considerations to account for the treatment of:
1012 (I) expenses;
1013 (II) profit; and
1014 (III) individual insurer variation in loss experience.
1015 (b) "Rate" does not include a minimum premium.
1017 organization" means a person who assists an insurer in rate making or filing by:
1018 (i) collecting, compiling, and furnishing loss or expense statistics;
1019 (ii) recommending, making, or filing rates or supplementary rate information; or
1020 (iii) advising about rate questions, except as an attorney giving legal advice.
1021 (b) "Rate service organization" does not mean:
1022 (i) an employee of an insurer;
1023 (ii) a single insurer or group of insurers under common control;
1024 (iii) a joint underwriting group; or
1025 (iv) an individual serving as an actuarial or legal consultant.
1027 renewal policy premiums:
1028 (a) a manual of rates;
1029 (b) a classification;
1030 (c) a rate-related underwriting rule; and
1031 (d) a rating formula that describes steps, policies, and procedures for determining
1032 initial and renewal policy premiums.
1034 (a) the date delivered to and stamped received by the department, if delivered in
1036 (b) the post mark date, if delivered by mail;
1037 (c) the delivery service's post mark or pickup date, if delivered by a delivery service;
1038 (d) the received date recorded on an item delivered, if delivered by:
1039 (i) facsimile;
1040 (ii) email; or
1041 (iii) another electronic method; or
1042 (e) a date specified in:
1043 (i) a statute;
1044 (ii) a rule; or
1045 (iii) an order.
1047 association of persons:
1048 (a) operating through an attorney-in-fact common to all of the persons; and
1049 (b) exchanging insurance contracts with one another that provide insurance coverage
1050 on each other.
1052 consideration, transfers any portion of the risk it has assumed to another insurer. In referring to
1053 reinsurance transactions, this title sometimes refers to:
1054 (a) the insurer transferring the risk as the "ceding insurer"; and
1055 (b) the insurer assuming the risk as the:
1056 (i) "assuming insurer"; or
1057 (ii) "assuming reinsurer."
1059 authority to assume reinsurance.
1061 liability resulting from or incident to the ownership, maintenance, or use of a residential
1062 dwelling that is a detached single family residence or multifamily residence up to four units.
1064 assumed under a reinsurance contract.
1065 (b) A reinsurer "retrocedes" when the reinsurer reinsures with another insurer part of a
1066 liability assumed under a reinsurance contract.
1068 (a) an insurance policy; or
1069 (b) an insurance certificate.
1071 (i) note;
1072 (ii) stock;
1073 (iii) bond;
1074 (iv) debenture;
1075 (v) evidence of indebtedness;
1076 (vi) certificate of interest or participation in a profit-sharing agreement;
1077 (vii) collateral-trust certificate;
1078 (viii) preorganization certificate or subscription;
1079 (ix) transferable share;
1080 (x) investment contract;
1081 (xi) voting trust certificate;
1082 (xii) certificate of deposit for a security;
1083 (xiii) certificate of interest of participation in an oil, gas, or mining title or lease or in
1084 payments out of production under such a title or lease;
1085 (xiv) commodity contract or commodity option;
1086 (xv) certificate of interest or participation in, temporary or interim certificate for,
1087 receipt for, guarantee of, or warrant or right to subscribe to or purchase any of the items listed
1088 in Subsections [
1089 (xvi) another interest or instrument commonly known as a security.
1090 (b) "Security" does not include:
1091 (i) any of the following under which an insurance company promises to pay money in a
1092 specific lump sum or periodically for life or some other specified period:
1093 (A) insurance;
1094 (B) an endowment policy; or
1095 (C) an annuity contract; or
1096 (ii) a burial certificate or burial contract.
1098 exclusion from coverage in accident and health insurance.
1100 provides for spreading its own risks by a systematic plan.
1102 include an arrangement under which a number of persons spread their risks among themselves.
1104 (i) an arrangement by which a governmental entity undertakes to indemnify an
1105 employee for liability arising out of the employee's employment; and
1106 (ii) an arrangement by which a person with a managed program of self-insurance and
1107 risk management undertakes to indemnify its affiliates, subsidiaries, directors, officers, or
1108 employees for liability or risk that is related to the relationship or employment.
1112 (a) by any means;
1113 (b) for money or its equivalent; and
1114 (c) on behalf of an insurance company.
1116 advertised, marketed, offered, or designed to provide coverage that is similar to long-term care
1117 insurance, but that provides coverage for less than 12 consecutive months for each covered
1120 during each of which an individual does not have creditable coverage.
1122 employer who, with respect to a calendar year and to a plan year:
1123 (a) employed an average of at least two employees but not more than 50 eligible
1124 employees on each business day during the preceding calendar year; and
1125 (b) employs at least two employees on the first day of the plan year.
1127 the same meaning as provided in federal regulations adopted pursuant to the Health Insurance
1128 Portability and Accountability Act [
1130 either directly or indirectly through one or more affiliates or intermediaries.
1131 (b) "Wholly owned subsidiary" of a person is a subsidiary of which all of the voting
1132 shares are owned by that person either alone or with its affiliates, except for the minimum
1133 number of shares the law of the subsidiary's domicile requires to be owned by directors or
1136 (a) a guarantee against loss or damage resulting from the failure of a principal to pay or
1137 perform the principal's obligations to a creditor or other obligee;
1138 (b) bail bond insurance; and
1139 (c) fidelity insurance.
1141 and liabilities.
1142 (b) (i) "Permanent surplus" means the surplus of a mutual insurer that is designated by
1143 the insurer as permanent.
1144 (ii) Sections 31A-5-211 , 31A-7-201 , 31A-8-209 , 31A-9-209 , and 31A-14-209 require
1145 that mutuals doing business in this state maintain specified minimum levels of permanent
1147 (iii) Except for assessable mutuals, the minimum permanent surplus requirement is the
1148 same as the minimum required capital requirement that applies to stock insurers.
1149 (c) "Excess surplus" means:
1150 (i) for a life insurer, accident and health insurer, health organization, or property and
1151 casualty insurer as defined in Section 31A-17-601 , the lesser of:
1152 (A) that amount of an insurer's or health organization's total adjusted capital that
1153 exceeds the product of:
1154 (I) 2.5; and
1155 (II) the sum of the insurer's or health organization's minimum capital or permanent
1156 surplus required under Section 31A-5-211 , 31A-9-209 , or 31A-14-205 ; or
1157 (B) that amount of an insurer's or health organization's total adjusted capital that
1158 exceeds the product of:
1159 (I) 3.0; and
1160 (II) the authorized control level RBC as defined in Subsection 31A-17-601 (8)(a); and
1161 (ii) for a monoline mortgage guaranty insurer, financial guaranty insurer, or title insurer
1162 that amount of an insurer's paid-in-capital and surplus that exceeds the product of:
1163 (A) 1.5; and
1164 (B) the insurer's total adjusted capital required by Subsection 31A-17-609 (1).
1166 collects charges or premiums from, or who, for consideration, adjusts or settles claims of
1167 residents of the state in connection with insurance coverage, annuities, or service insurance
1168 coverage, except:
1169 (a) a union on behalf of its members;
1170 (b) a person administering a:
1171 (i) pension plan subject to the federal Employee Retirement Income Security Act of
1173 (ii) governmental plan as defined in Section 414(d), Internal Revenue Code; or
1174 (iii) nonelecting church plan as described in Section 410(d), Internal Revenue Code;
1175 (c) an employer on behalf of the employer's employees or the employees of one or
1176 more of the subsidiary or affiliated corporations of the employer;
1177 (d) an insurer licensed under [
1178 line of insurance for which the insurer holds a license in this state[
1179 (i) Chapter 5, Domestic Stock and Mutual Insurance Corporations;
1180 (ii) Chapter 7, Nonprofit Health Service Insurance Corporations;
1181 (iii) Chapter 8, Health Maintenance Organizations and Limited Health Plans;
1182 (iv) Chapter 9, Insurance Fraternals; or
1183 (v) Chapter 14, Foreign Insurers; or
1184 (e) a person:
1185 (i) licensed or exempt from licensing under:
1186 (A) Chapter 23a, Insurance Marketing - Licensing Producers, Consultants, and
1187 Reinsurance Intermediaries; or
1188 (B) Chapter 26, Insurance Adjusters; and
1189 (ii) whose activities are limited to those authorized under the license the person holds
1190 or for which the person is exempt.
1192 owner of real or personal property or the holder of liens or encumbrances on that property, or
1193 others interested in the property against loss or damage suffered by reason of liens or
1194 encumbrances upon, defects in, or the unmarketability of the title to the property, or invalidity
1195 or unenforceability of any liens or encumbrances on the property.
1197 organization's statutory capital and surplus as determined in accordance with:
1198 (a) the statutory accounting applicable to the annual financial statements required to be
1199 filed under Section 31A-4-113 ; and
1200 (b) another item provided by the RBC instructions, as RBC instructions is defined in
1201 Section 31A-17-601 .
1203 a corporation.
1204 (b) "Trustee," when used in reference to an employee welfare fund, means an
1205 individual, firm, association, organization, joint stock company, or corporation, whether acting
1206 individually or jointly and whether designated by that name or any other, that is charged with
1207 or has the overall management of an employee welfare fund.
1209 insurer" means an insurer:
1210 (i) not holding a valid certificate of authority to do an insurance business in this state;
1212 (ii) transacting business not authorized by a valid certificate.
1213 (b) "Admitted insurer" or "authorized insurer" means an insurer:
1214 (i) holding a valid certificate of authority to do an insurance business in this state; and
1215 (ii) transacting business as authorized by a valid certificate.
1219 from or incident to ownership, maintenance, or use of a land vehicle or aircraft, exclusive of a
1220 vehicle comprehensive or vehicle physical damage coverage under Subsection [
1222 security convertible into a security with a voting right associated with the security.
1224 pass before coverage for an individual, who is otherwise eligible to enroll under the terms of
1225 the health benefit plan, can become effective.
1227 (a) insurance for indemnification of an employer against liability for compensation
1228 based on:
1229 (i) a compensable accidental injury; and
1230 (ii) occupational disease disability;
1231 (b) employer's liability insurance incidental to workers' compensation insurance and
1232 written in connection with workers' compensation insurance; and
1233 (c) insurance assuring to a person entitled to workers' compensation benefits the
1234 compensation provided by law.
1235 Section 2. Section 31A-2-208 is amended to read:
1236 31A-2-208. Publications.
1237 (1) The commissioner may prepare and distribute books, pamphlets, and other
1238 publications relating to insurance. Except as otherwise provided under this title, the
1240 those desiring to receive [
1241 charged for [
1243 Restricted Account, created in Section 59-9-105 , to be used as provided in Section 59-9-105 .
1244 (2) The commissioner shall have the annual report required in Subsection
1245 31A-2-207 (5) printed:
1246 (a) in a form determined by [
1247 (b) in sufficient numbers to meet [
1248 (3) The commissioner shall publish in [
1249 31A-2-207 (5) an up-to-date chart and explanation of the organization of [
1250 commissioner's office, making clear the allocation of responsibility and authority among the
1251 staff. This [
1253 Section 3. Section 31A-2-212 is amended to read:
1254 31A-2-212. Miscellaneous duties.
1255 (1) Upon issuance of [
1256 person's authority to do business in Utah, and [
1257 commissioner begins a proceeding against [
1258 Receivership Act, the commissioner:
1259 (a) shall notify by mail [
1260 commissioner has record; and
1261 (b) may publish notice of the order or proceeding in any manner the commissioner
1262 considers necessary to protect the rights of the public.
1263 (2) When required for evidence in [
1264 furnish a certificate of [
1265 insurance in Utah on any particular date. The court or other officer shall receive the certificate
1266 of authority in lieu of the commissioner's testimony.
1267 (3) (a) On the request of [
1268 commissioner shall furnish a copy of the insurer's certificate of authority to [
1269 public officer in this state who requires that certificate of authority before accepting a bond.
1270 (b) The public officer described in Subsection (3)(a) shall file the certificate of
1271 authority furnished under Subsection (3)(a).
1272 (c) After a certified copy of a certificate of authority [
1273 officer, it is not necessary, while the certificate of authority remains effective, to attach a copy
1274 of it to any instrument of suretyship filed with that public officer.
1275 (d) Whenever the commissioner revokes the certificate of authority or [
1277 an insurer authorized to do a surety business, the commissioner shall immediately give notice
1278 of that action to each public officer who [
1279 (4) (a) The commissioner shall immediately notify every judge and clerk of [
1280 courts of record in the state when:
1281 (i) an authorized insurer doing a surety business:
1282 (A) files a petition for receivership; or
1283 (B) is in receivership; or
1284 (ii) the commissioner has reason to believe that the authorized insurer doing surety
1286 (A) is in financial difficulty; or
1287 (B) has unreasonably failed to carry out any of its contracts.
1288 (b) Upon the receipt of the notice required by this Subsection (4), it is the duty of the
1289 judges and clerks to notify and require [
1290 bond on which the authorized insurer doing surety business is surety[
1291 new bond with a new surety.
1292 (5) The commissioner shall require an insurer that issues, sells, renews, or offers health
1293 insurance coverage in this state to comply with the Health Insurance Portability and
1294 Accountability Act[
1295 Section 4. Section 31A-3-304 is amended to read:
1296 31A-3-304. Annual fees -- Other taxes or fees prohibited -- Captive Insurance
1297 Restricted Account.
1298 (1) (a) A captive insurance company shall pay an annual fee imposed under this section
1299 to obtain or renew a certificate of authority.
1300 (b) The commissioner shall:
1301 (i) determine the annual fee pursuant to Section 31A-3-103 ; and
1302 (ii) consider whether the annual fee is competitive with fees imposed by other states on
1303 captive insurance companies.
1304 (2) A captive insurance company that fails to pay the fee required by this section is
1305 subject to the relevant sanctions of this title.
1306 (3) (a) Except as provided in Subsection (3)[
1307 Chapter 9, Taxation of Admitted Insurers, [
1309 state that may be [
1313 (i) a fee under this section;
1314 (ii) a fee under Chapter 37, Captive Insurance Companies Act; and
1315 (iii) a fee under Chapter 37a, Special Purpose Financial Captive Insurance Company
1317 (b) The state or a county, city, or town within the state may not levy or collect an
1318 occupation tax or other tax, fee, or charge not described in Subsections (3)(a)(i) through (iii)
1319 against a captive insurance company.
1320 (c) The state may not levy, assess, or collect a withdrawal fee under Section 31A-4-115
1321 against a captive insurance company.
1322 (d) A captive insurance company is subject to real and personal property taxes.
1323 (4) A captive insurance company shall pay the fee imposed by this section to the
1324 commissioner by [
1325 (5) (a) Money received pursuant to [
1326 (3)(a) shall be deposited into the Captive Insurance Restricted Account.
1327 (b) There is created in the General Fund a restricted account known as the "Captive
1328 Insurance Restricted Account."
1329 (c) The Captive Insurance Restricted Account shall consist of the fees [
1331 (d) The commissioner shall administer the Captive Insurance Restricted Account.
1332 Subject to appropriations by the Legislature, the commissioner shall use the money deposited
1333 into the Captive Insurance Restricted Account to:
1334 (i) administer and enforce:
1335 (A) Chapter 37, Captive Insurance Companies Act; and
1336 (B) Chapter 37a, Special Purpose Financial Captive Insurance Company Act; and
1337 (ii) promote the captive insurance industry in Utah.
1338 (e) An appropriation from the Captive Insurance Restricted Account is nonlapsing,
1339 except that at the end of each fiscal year, money received by the commissioner in excess of
1341 Section 5. Section 31A-14-211 is amended to read:
1342 31A-14-211. Restrictions on foreign title insurers.
1343 (1) An authorized foreign title insurer may not insure property in this state except:
1344 (a) through a title insurance producer who is a resident in Utah; or
1345 (b) through a bona fide [
1346 (i) that is under the direction and control of the authorized foreign title insurer [
1348 (ii) for which the authorized foreign title insurer pays the expenses [
1350 (iii) at which a person may request information about title services related to a real
1351 estate transaction for which the person is a party;
1352 (iv) at which a person may deliver written communications to the authorized foreign
1353 title insurer as required by the real estate transaction for which the person is a party; and
1354 (v) at which a person may deliver escrow money related to a real estate transaction for
1355 which the person is a party.
1357 (2) This section does not apply to reinsurance.
1358 Section 6. Section 31A-22-305 is amended to read:
1359 31A-22-305. Uninsured motorist coverage.
1360 (1) As used in this section, "covered persons" includes:
1361 (a) the named insured;
1362 (b) persons related to the named insured by blood, marriage, adoption, or guardianship,
1363 who are residents of the named insured's household, including those who usually make their
1364 home in the same household but temporarily live elsewhere;
1365 (c) any person occupying or using a motor vehicle:
1366 (i) referred to in the policy; or
1367 (ii) owned by a self-insured; and
1368 (d) any person who is entitled to recover damages against the owner or operator of the
1369 uninsured or underinsured motor vehicle because of bodily injury to or death of persons under
1370 Subsection (1)(a), (b), or (c).
1371 (2) As used in this section, "uninsured motor vehicle" includes:
1372 (a) (i) a motor vehicle, the operation, maintenance, or use of which is not covered
1373 under a liability policy at the time of an injury-causing occurrence; or
1374 (ii) (A) a motor vehicle covered with lower liability limits than required by Section
1375 31A-22-304 ; and
1376 (B) the motor vehicle described in Subsection (2)(a)(ii)(A) is uninsured to the extent of
1377 the deficiency;
1378 (b) an unidentified motor vehicle that left the scene of an accident proximately caused
1379 by the motor vehicle operator;
1380 (c) a motor vehicle covered by a liability policy, but coverage for an accident is
1381 disputed by the liability insurer for more than 60 days or continues to be disputed for more than
1382 60 days; or
1383 (d) (i) an insured motor vehicle if, before or after the accident, the liability insurer of
1384 the motor vehicle is declared insolvent by a court of competent jurisdiction; and
1385 (ii) the motor vehicle described in Subsection (2)(d)(i) is uninsured only to the extent
1386 that the claim against the insolvent insurer is not paid by a guaranty association or fund.
1387 (3) (a) Uninsured motorist coverage under Subsection 31A-22-302 (1)(b) provides
1388 coverage for covered persons who are legally entitled to recover damages from owners or
1389 operators of uninsured motor vehicles because of bodily injury, sickness, disease, or death.
1390 (b) For new policies written on or after January 1, 2001, the limits of uninsured
1391 motorist coverage shall be equal to the lesser of the limits of the insured's motor vehicle
1392 liability coverage or the maximum uninsured motorist coverage limits available by the insurer
1393 under the insured's motor vehicle policy, unless the insured purchases coverage in a lesser
1394 amount by signing an acknowledgment form that:
1395 (i) is filed with the department;
1396 (ii) is provided by the insurer;
1397 (iii) waives the higher coverage;
1398 (iv) reasonably explains the purpose of uninsured motorist coverage; and
1399 (v) discloses the additional premiums required to purchase uninsured motorist
1400 coverage with limits equal to the lesser of the limits of the insured's motor vehicle liability
1401 coverage or the maximum uninsured motorist coverage limits available by the insurer under the
1402 insured's motor vehicle policy.
1403 (c) A self-insured, including a governmental entity, may elect to provide uninsured
1404 motorist coverage in an amount that is less than its maximum self-insured retention under
1405 Subsections (3)(b) and (4)(a) by issuing a declaratory memorandum or policy statement from
1406 the chief financial officer or chief risk officer that declares the:
1407 (i) self-insured entity's coverage level; and
1408 (ii) process for filing an uninsured motorist claim.
1409 (d) Uninsured motorist coverage may not be sold with limits that are less than the
1410 minimum bodily injury limits for motor vehicle liability policies under Section 31A-22-304 .
1411 (e) The acknowledgment under Subsection (3)(b) continues for that issuer of the
1412 uninsured motorist coverage until the insured, in writing, requests different uninsured motorist
1413 coverage from the insurer.
1424 (4) (a) (i) Except as provided in Subsection (4)(b), the named insured may reject
1425 uninsured motorist coverage by an express writing to the insurer that provides liability
1426 coverage under Subsection 31A-22-302 (1)(a).
1427 (ii) This rejection shall be on a form provided by the insurer that includes a reasonable
1428 explanation of the purpose of uninsured motorist coverage.
1429 (iii) This rejection continues for that issuer of the liability coverage until the insured in
1430 writing requests uninsured motorist coverage from that liability insurer.
1431 (b) (i) All persons, including governmental entities, that are engaged in the business of,
1432 or that accept payment for, transporting natural persons by motor vehicle, and all school
1433 districts that provide transportation services for their students, shall provide coverage for all
1434 motor vehicles used for that purpose, by purchase of a policy of insurance or by self-insurance,
1435 uninsured motorist coverage of at least $25,000 per person and $500,000 per accident.
1436 (ii) This coverage is secondary to any other insurance covering an injured covered
1438 (c) Uninsured motorist coverage:
1439 (i) is secondary to the benefits provided by Title 34A, Chapter 2, Workers'
1440 Compensation Act;
1441 (ii) may not be subrogated by the workers' compensation insurance carrier;
1442 (iii) may not be reduced by any benefits provided by workers' compensation insurance;
1443 (iv) may be reduced by health insurance subrogation only after the covered person has
1444 been made whole;
1445 (v) may not be collected for bodily injury or death sustained by a person:
1446 (A) while committing a violation of Section 41-1a-1314 ;
1447 (B) who, as a passenger in a vehicle, has knowledge that the vehicle is being operated
1448 in violation of Section 41-1a-1314 ; or
1449 (C) while committing a felony; and
1450 (vi) notwithstanding Subsection (4)(c)(v), may be recovered:
1451 (A) for a person under 18 years of age who is injured within the scope of Subsection
1452 (4)(c)(v) but limited to medical and funeral expenses; or
1453 (B) by a law enforcement officer as defined in Section 53-13-103 , who is injured
1454 within the course and scope of the law enforcement officer's duties.
1455 (d) As used in this Subsection (4), "motor vehicle" has the same meaning as under
1456 Section 41-1a-102 .
1457 (5) When a covered person alleges that an uninsured motor vehicle under Subsection
1458 (2)(b) proximately caused an accident without touching the covered person or the motor
1459 vehicle occupied by the covered person, the covered person must show the existence of the
1460 uninsured motor vehicle by clear and convincing evidence consisting of more than the covered
1461 person's testimony.
1462 (6) (a) The limit of liability for uninsured motorist coverage for two or more motor
1463 vehicles may not be added together, combined, or stacked to determine the limit of insurance
1464 coverage available to an injured person for any one accident.
1465 (b) (i) Subsection (6)(a) applies to all persons except a covered person as defined under
1466 Subsection (7)(b)(ii).
1467 (ii) A covered person as defined under Subsection (7)(b)(ii) is entitled to the highest
1468 limits of uninsured motorist coverage afforded for any one motor vehicle that the covered
1469 person is the named insured or an insured family member.
1470 (iii) This coverage shall be in addition to the coverage on the motor vehicle the covered
1471 person is occupying.
1472 (iv) Neither the primary nor the secondary coverage may be set off against the other.
1473 (c) Coverage on a motor vehicle occupied at the time of an accident shall be primary
1474 coverage, and the coverage elected by a person described under Subsections (1)(a) and (b) shall
1475 be secondary coverage.
1476 (7) (a) Uninsured motorist coverage under this section applies to bodily injury,
1477 sickness, disease, or death of covered persons while occupying or using a motor vehicle only if
1478 the motor vehicle is described in the policy under which a claim is made, or if the motor
1479 vehicle is a newly acquired or replacement motor vehicle covered under the terms of the policy.
1480 Except as provided in Subsection (6) or this Subsection (7), a covered person injured in a
1481 motor vehicle described in a policy that includes uninsured motorist benefits may not elect to
1482 collect uninsured motorist coverage benefits from any other motor vehicle insurance policy
1483 under which the person is a covered person.
1484 (b) Each of the following persons may also recover uninsured motorist benefits under
1485 any one other policy in which they are described as a "covered person" as defined in Subsection
1487 (i) a covered person injured as a pedestrian by an uninsured motor vehicle; and
1488 (ii) except as provided in Subsection (7)(c), a covered person injured while occupying
1489 or using a motor vehicle that is not owned, leased, or furnished:
1490 (A) to the covered person;
1491 (B) to the covered person's spouse; or
1492 (C) to the covered person's resident parent or resident sibling.
1493 (c) (i) A covered person may recover benefits from no more than two additional
1494 policies, one additional policy from each parent's household if the covered person is:
1495 (A) a dependent minor of parents who reside in separate households; and
1496 (B) injured while occupying or using a motor vehicle that is not owned, leased, or
1498 (I) to the covered person;
1499 (II) to the covered person's resident parent; or
1500 (III) to the covered person's resident sibling.
1501 (ii) Each parent's policy under this Subsection (7)(c) is liable only for the percentage of
1502 the damages that the limit of liability of each parent's policy of uninsured motorist coverage
1503 bears to the total of both parents' uninsured coverage applicable to the accident.
1504 (d) A covered person's recovery under any available policies may not exceed the full
1505 amount of damages.
1506 (e) A covered person in Subsection (7)(b) is not barred against making subsequent
1507 elections if recovery is unavailable under previous elections.
1508 (f) (i) As used in this section, "interpolicy stacking" means recovering benefits for a
1509 single incident of loss under more than one insurance policy.
1510 (ii) Except to the extent permitted by Subsection (6) and this Subsection (7),
1511 interpolicy stacking is prohibited for uninsured motorist coverage.
1512 (8) (a) When a claim is brought by a named insured or a person described in
1513 Subsection (1) and is asserted against the covered person's uninsured motorist carrier, the
1514 claimant may elect to resolve the claim:
1515 (i) by submitting the claim to binding arbitration; or
1516 (ii) through litigation.
1517 (b) Unless otherwise provided in the policy under which uninsured benefits are
1518 claimed, the election provided in Subsection (8)(a) is available to the claimant only.
1519 (c) Once the claimant has elected to commence litigation under Subsection (8)(a)(ii),
1520 the claimant may not elect to resolve the claim through binding arbitration under this section
1521 without the written consent of the uninsured motorist carrier.
1522 (d) (i) Unless otherwise agreed to in writing by the parties, a claim that is submitted to
1523 binding arbitration under Subsection (8)(a)(i) shall be resolved by a single arbitrator.
1524 (ii) All parties shall agree on the single arbitrator selected under Subsection (8)(d)(i).
1525 (iii) If the parties are unable to agree on a single arbitrator as required under Subsection
1526 (8)(d)(ii), the parties shall select a panel of three arbitrators.
1527 (e) If the parties select a panel of three arbitrators under Subsection (8)(d)(iii):
1528 (i) each side shall select one arbitrator; and
1529 (ii) the arbitrators appointed under Subsection (8)(e)(i) shall select one additional
1530 arbitrator to be included in the panel.
1531 (f) Unless otherwise agreed to in writing:
1532 (i) each party shall pay an equal share of the fees and costs of the arbitrator selected
1533 under Subsection (8)(d)(i); or
1534 (ii) if an arbitration panel is selected under Subsection (8)(d)(iii):
1535 (A) each party shall pay the fees and costs of the arbitrator selected by that party; and
1536 (B) each party shall pay an equal share of the fees and costs of the arbitrator selected
1537 under Subsection (8)(e)(ii).
1538 (g) Except as otherwise provided in this section or unless otherwise agreed to in
1539 writing by the parties, an arbitration proceeding conducted under this section shall be governed
1540 by Title 78B, Chapter 11, Utah Uniform Arbitration Act.
1541 (h) The arbitration shall be conducted in accordance with Rules 26 through 37, 54, and
1542 68 of the Utah Rules of Civil Procedure.
1543 (i) All issues of discovery shall be resolved by the arbitrator or the arbitration panel.
1544 (j) A written decision by a single arbitrator or by a majority of the arbitration panel
1545 shall constitute a final decision.
1546 (k) (i) The amount of an arbitration award may not exceed the uninsured motorist
1547 policy limits of all applicable uninsured motorist policies, including applicable uninsured
1548 motorist umbrella policies.
1549 (ii) If the initial arbitration award exceeds the uninsured motorist policy limits of all
1550 applicable uninsured motorist policies, the arbitration award shall be reduced to an amount
1551 equal to the combined uninsured motorist policy limits of all applicable uninsured motorist
1553 (l) The arbitrator or arbitration panel may not decide the issues of coverage or
1554 extra-contractual damages, including:
1555 (i) whether the claimant is a covered person;
1556 (ii) whether the policy extends coverage to the loss; or
1557 (iii) any allegations or claims asserting consequential damages or bad faith liability.
1558 (m) The arbitrator or arbitration panel may not conduct arbitration on a class-wide or
1559 class-representative basis.
1560 (n) If the arbitrator or arbitration panel finds that the action was not brought, pursued,
1561 or defended in good faith, the arbitrator or arbitration panel may award reasonable attorney fees
1562 and costs against the party that failed to bring, pursue, or defend the claim in good faith.
1563 (o) An arbitration award issued under this section shall be the final resolution of all
1564 claims not excluded by Subsection (8)(l) between the parties unless:
1565 (i) the award was procured by corruption, fraud, or other undue means; or
1566 (ii) either party, within 20 days after service of the arbitration award:
1567 (A) files a complaint requesting a trial de novo in the district court; and
1568 (B) serves the nonmoving party with a copy of the complaint requesting a trial de novo
1569 under Subsection (8)(o)(ii)(A).
1570 (p) (i) Upon filing a complaint for a trial de novo under Subsection (8)(o), the claim
1571 shall proceed through litigation pursuant to the Utah Rules of Civil Procedure and Utah Rules
1572 of Evidence in the district court.
1573 (ii) In accordance with Rule 38, Utah Rules of Civil Procedure, either party may
1574 request a jury trial with a complaint requesting a trial de novo under Subsection (8)(o)(ii)(A).
1575 (q) (i) If the claimant, as the moving party in a trial de novo requested under
1576 Subsection (8)(o), does not obtain a verdict that is at least $5,000 and is at least 20% greater
1577 than the arbitration award, the claimant is responsible for all of the nonmoving party's costs.
1578 (ii) If the uninsured motorist carrier, as the moving party in a trial de novo requested
1579 under Subsection (8)(o), does not obtain a verdict that is at least 20% less than the arbitration
1580 award, the uninsured motorist carrier is responsible for all of the nonmoving party's costs.
1581 (iii) Except as provided in Subsection (8)(q)(iv), the costs under this Subsection (8)(q)
1582 shall include:
1583 (A) any costs set forth in Rule 54(d), Utah Rules of Civil Procedure; and
1584 (B) the costs of expert witnesses and depositions.
1585 (iv) An award of costs under this Subsection (8)(q) may not exceed $2,500.
1586 (r) For purposes of determining whether a party's verdict is greater or less than the
1587 arbitration award under Subsection (8)(q), a court may not consider any recovery or other relief
1588 granted on a claim for damages if the claim for damages:
1589 (i) was not fully disclosed in writing prior to the arbitration proceeding; or
1590 (ii) was not disclosed in response to discovery contrary to the Utah Rules of Civil
1592 (s) If a district court determines, upon a motion of the nonmoving party, that the
1593 moving party's use of the trial de novo process was filed in bad faith in accordance with
1594 Section 78B-5-825 , the district court may award reasonable attorney fees to the nonmoving
1596 (t) Nothing in this section is intended to limit any claim under any other portion of an
1597 applicable insurance policy.
1598 (u) If there are multiple uninsured motorist policies, as set forth in Subsection (7), the
1599 claimant may elect to arbitrate in one hearing the claims against all the uninsured motorist
1601 (9) (a) Within 30 days after a covered person elects to submit a claim for uninsured
1602 motorist benefits to binding arbitration or files litigation, the covered person shall provide to
1603 the uninsured motorist carrier:
1604 (i) a written demand for payment of uninsured motorist coverage benefits, setting forth:
1605 (A) the specific monetary amount of the demand; and
1606 (B) the factual and legal basis and any supporting documentation for the demand;
1607 (ii) a written statement under oath disclosing:
1608 (A) (I) the names and last known addresses of all health care providers who have
1609 rendered health care services to the covered person that are material to the claims for which
1610 uninsured motorist benefits are sought for a period of five years preceding the date of the event
1611 giving rise to the claim for uninsured motorist benefits up to the time the election for
1612 arbitration or litigation has been exercised; and
1613 (II) whether the covered person has seen other health care providers who have rendered
1614 health care services to the covered person, which the covered person claims are immaterial to
1615 the claims for which uninsured motorist benefits are sought, for a period of five years
1616 preceding the date of the event giving rise to the claim for uninsured motorist benefits up to the
1617 time the election for arbitration or litigation has been exercised that have not been disclosed
1618 under Subsection (9)(a)(ii)(A)(I);
1619 (B) (I) the names and last known addresses of all health insurers or other entities to
1620 whom the covered person has submitted claims for health care services or benefits material to
1621 the claims for which uninsured motorist benefits are sought, for a period of five years
1622 preceding the date of the event giving rise to the claim for uninsured motorist benefits up to the
1623 time the election for arbitration or litigation has been exercised; and
1624 (II) whether the identity of any health insurers or other entities to whom the covered
1625 person has submitted claims for health care services or benefits, which the covered person
1626 claims are immaterial to the claims for which uninsured motorist benefits are sought, for a
1627 period of five years preceding the date of the event giving rise to the claim for uninsured
1628 motorist benefits up to the time the election for arbitration or litigation have not been disclosed;
1629 (C) if lost wages, diminished earning capacity, or similar damages are claimed, all
1630 employers of the covered person for a period of five years preceding the date of the event
1631 giving rise to the claim for uninsured motorist benefits up to the time the election for
1632 arbitration or litigation has been exercised;
1633 (D) other documents to reasonably support the claims being asserted; and
1634 (E) all state and federal statutory lienholders including a statement as to whether the
1635 covered person is a recipient of Medicare or Medicaid benefits or Utah Children's Health
1636 Insurance Program benefits under Title 26, Chapter 40, Utah Children's Health Insurance Act,
1637 or if the claim is subject to any other state or federal statutory liens; and
1638 (iii) signed authorizations to allow the uninsured motorist carrier to only obtain records
1639 and billings from the individuals or entities disclosed.
1640 (b) (i) If the uninsured motorist carrier determines that the disclosure of undisclosed
1641 health care providers or health care insurers under Subsection (9)(a)(ii) is reasonably necessary,
1642 the uninsured motorist carrier may:
1643 (A) make a request for the disclosure of the identity of the health care providers or
1644 health care insurers; and
1645 (B) make a request for authorizations to allow the uninsured motorist carrier to only
1646 obtain records and billings from the individuals or entities not disclosed.
1647 (ii) If the covered person does not provide the requested information within 10 days:
1648 (A) the covered person shall disclose, in writing, the legal or factual basis for the
1649 failure to disclose the health care providers or health care insurers; and
1650 (B) either the covered person or the uninsured motorist carrier may request the
1651 arbitrator or arbitration panel to resolve the issue of whether the identities or records are to be
1652 provided if the covered person has elected arbitration.
1653 (iii) The time periods imposed by Subsection (9)(c)(i) are tolled pending resolution of
1654 the dispute concerning the disclosure and production of records of the health care providers or
1655 health care insurers.
1656 (c) (i) An uninsured motorist carrier that receives an election for arbitration or a notice
1657 of filing litigation and the demand for payment of uninsured motorist benefits under Subsection
1658 (9)(a)(i) shall have a reasonable time, not to exceed 60 days from the date of the demand and
1659 receipt of the items specified in Subsections (9)(a)(i) through (iii), to:
1660 (A) provide a written response to the written demand for payment provided for in
1661 Subsection (9)(a)(i);
1662 (B) except as provided in Subsection (9)(c)(i)(C), tender the amount, if any, of the
1663 uninsured motorist carrier's determination of the amount owed to the covered person; and
1664 (C) if the covered person is a recipient of Medicare or Medicaid benefits or Utah
1665 Children's Health Insurance Program benefits under Title 26, Chapter 40, Utah Children's
1666 Health Insurance Act, or if the claim is subject to any other state or federal statutory liens,
1667 tender the amount, if any, of the uninsured motorist carrier's determination of the amount owed
1668 to the covered person less:
1669 (I) if the amount of the state or federal statutory lien is established, the amount of the
1670 lien; or
1671 (II) if the amount of the state or federal statutory lien is not established, two times the
1672 amount of the medical expenses subject to the state or federal statutory lien until such time as
1673 the amount of the state or federal statutory lien is established.
1674 (ii) If the amount tendered by the uninsured motorist carrier under Subsection (9)(c)(i)
1675 is the total amount of the uninsured motorist policy limits, the tendered amount shall be
1676 accepted by the covered person.
1677 (d) A covered person who receives a written response from an uninsured motorist
1678 carrier as provided for in Subsection (9)(c)(i), may:
1679 (i) elect to accept the amount tendered in Subsection (9)(c)(i) as payment in full of all
1680 uninsured motorist claims; or
1681 (ii) elect to:
1682 (A) accept the amount tendered in Subsection (9)(c)(i) as partial payment of all
1683 uninsured motorist claims; and
1684 (B) litigate or arbitrate the remaining claim.
1685 (e) If a covered person elects to accept the amount tendered under Subsection (9)(c)(i)
1686 as partial payment of all uninsured motorist claims, the final award obtained through
1687 arbitration, litigation, or later settlement shall be reduced by any payment made by the
1688 uninsured motorist carrier under Subsection (9)(c)(i).
1689 (f) In an arbitration proceeding on the remaining uninsured claims:
1690 (i) the parties may not disclose to the arbitrator or arbitration panel the amount paid
1691 under Subsection (9)(c)(i) until after the arbitration award has been rendered; and
1692 (ii) the parties may not disclose the amount of the limits of uninsured motorist benefits
1693 provided by the policy.
1694 (g) If the final award obtained through arbitration or litigation is greater than the
1695 average of the covered person's initial written demand for payment provided for in Subsection
1696 (9)(a)(i) and the uninsured motorist carrier's initial written response provided for in Subsection
1697 (9)(c)(i), the uninsured motorist carrier shall pay:
1698 (i) the final award obtained through arbitration or litigation, except that if the award
1699 exceeds the policy limits of the subject uninsured motorist policy by more than $15,000, the
1700 amount shall be reduced to an amount equal to the policy limits plus $15,000; and
1701 (ii) any of the following applicable costs:
1702 (A) any costs as set forth in Rule 54(d), Utah Rules of Civil Procedure;
1703 (B) the arbitrator or arbitration panel's fee; and
1704 (C) the reasonable costs of expert witnesses and depositions used in the presentation of
1705 evidence during arbitration or litigation.
1706 (h) (i) The covered person shall provide an affidavit of costs within five days of an
1707 arbitration award.
1708 (ii) (A) Objection to the affidavit of costs shall specify with particularity the costs to
1709 which the uninsured motorist carrier objects.
1710 (B) The objection shall be resolved by the arbitrator or arbitration panel.
1711 (iii) The award of costs by the arbitrator or arbitration panel under Subsection (9)(g)(ii)
1712 may not exceed $5,000.
1713 (i) (i) A covered person shall disclose all material information, other than rebuttal
1714 evidence, as specified in Subsection (9)(a).
1715 (ii) If the information under Subsection (9)(i)(i) is not disclosed, the covered person
1716 may not recover costs or any amounts in excess of the policy under Subsection (9)(g).
1717 (j) This Subsection (9) does not limit any other cause of action that arose or may arise
1718 against the uninsured motorist carrier from the same dispute.
1719 (k) The provisions of this Subsection (9) only apply to motor vehicle accidents that
1720 occur on or after March 30, 2010.
1721 Section 7. Section 31A-22-607 is amended to read:
1722 31A-22-607. Grace period.
1723 (1) [
1724 contain one or more clauses providing for a grace period for premium payment only of:
1725 (i) at least 15 days for a weekly or monthly premium [
1726 (ii) 30 days for [
1727 policy, for each premium after the first premium payment. [
1728 (b) An insurer may elect to include a grace period that is longer than 15 days for a
1729 weekly or monthly [
1731 force during [
1733 individual or franchise accident and health insurance policy continues in force with no gap in
1736 expires, the [
1737 terminated as of the last date for which the premium [
1739 individual or franchise accident and health insurance policy be discontinued.
1740 (2) [
1741 for a grace period of at least 30 days, unless the policyholder gives written notice of
1742 discontinuance [
1743 terms. [
1744 (b) A group or blanket accident and health insurance policy is in force during a grace
1746 (c) If an insurer does not receive payment before a grace period expires, the group or
1747 blanket accident and health insurance policy is terminated as of the last day of the grace period.
1748 (d) A group or blanket accident and health insurance policy may provide for payment
1749 of a pro rata premium for the period the group or blanket accident and health insurance policy
1750 is in effect during [
1751 (3) If [
1752 health insurance policy, [
1753 provided in the accident and health insurance policy, be cut off by compliance with the notice
1754 provision under Subsection 31A-21-303 (4)(b).
1755 Section 8. Section 31A-22-610.6 is amended to read:
1756 31A-22-610.6. Special enrollment for individuals receiving premium assistance.
1757 (1) As used in this section:
1758 (a) "Premium assistance" means assistance under Title 26, Chapter 18, Medical
1759 Assistance Act, in the payment of premium.
1760 (b) "Qualified beneficiary" means an individual who is approved to receive premium
1762 (2) Subject to the other provisions in this section, an individual may enroll under this
1763 section at a time outside of an employer health benefit plan open enrollment period, regardless
1764 of previously waiving coverage, if the individual is:
1765 (a) a qualified beneficiary who is eligible for coverage as an employee under the
1766 employer health benefit plan; or
1767 (b) a dependent of the qualified beneficiary who is eligible for coverage under the
1768 employer health benefit plan.
1769 (3) To be eligible to enroll outside of an open enrollment period, an individual
1770 described in Subsection (2) shall enroll in the employer health benefit plan by no later than 30
1771 days from the day on which the qualified beneficiary receives initial written notification, after
1772 July 1, 2008, that the qualified beneficiary is eligible to receive premium assistance.
1773 (4) An individual described in Subsection (2) may enroll under this section only in an
1774 employer health benefit plan that is available at the time of enrollment to similarly situated
1775 eligible employees or dependents of eligible employees.
1776 (5) Coverage under an employer health benefit plan for an individual described in
1777 Subsection (2) may begin as soon as the first day of the month immediately following
1778 enrollment of the individual in accordance with this section.
1779 (6) This section does not modify any requirement related to premiums that applies
1780 under an employer health benefit plan to a similarly situated eligible employee or dependent of
1781 an eligible employee under the employer health benefit plan.
1782 (7) An employer health benefit plan may require an individual described in Subsection
1783 (2) to satisfy a preexisting condition waiting period that:
1784 (a) is allowed under the Health Insurance Portability and Accountability Act [
1786 (b) is not longer than 12 months.
1787 Section 9. Section 31A-22-614.5 is amended to read:
1788 31A-22-614.5. Uniform claims processing -- Electronic exchange of health
1790 (1) (a) Except as provided in Subsection (1)(c), all insurers offering health insurance
1791 shall use a uniform claim form and uniform billing and claim codes.
1792 (b) Beginning January 1, 2011, all health benefit plans, and dental and vision plans,
1793 shall provide for the electronic exchange of uniform:
1794 (i) eligibility and coverage information; and
1795 (ii) coordination of benefits information.
1796 (c) For purposes of Subsection (1)(a), "health insurance" does not include a policy or
1797 certificate that provides benefits solely for:
1798 (i) income replacement; or
1799 (ii) long-term care.
1800 (2) (a) The uniform electronic standards and information required in Subsection (1)
1801 shall be adopted and approved by the commissioner in accordance with Title 63G, Chapter 3,
1802 Utah Administrative Rulemaking Act.
1803 (b) When adopting rules under this section the commissioner:
1804 (i) shall:
1805 (A) consult with national and state organizations involved with the standardized
1806 exchange of health data, and the electronic exchange of health data, to develop the standards
1807 for the use and electronic exchange of uniform:
1808 (I) claim forms;
1809 (II) billing and claim codes;
1810 (III) insurance eligibility and coverage information; and
1811 (IV) coordination of benefits information; and
1812 (B) meet federal mandatory minimum standards following the adoption of national
1813 requirements for transaction and data elements in the federal Health Insurance Portability and
1814 Accountability Act [
1815 (ii) may not require an insurer or administrator to use a specific software product or
1816 vendor; and
1817 (iii) may require an insurer who participates in the all payer database created under
1818 Section 26-33a-106.1 to allow data regarding demographic and insurance coverage information
1819 to be electronically shared with the state's designated secure health information master person
1820 index to be used:
1821 (A) in compliance with data security standards established by:
1822 (I) the federal Health Insurance Portability and Accountability Act [
1824 (II) the electronic commerce agreements established in a business associate agreement;
1826 (B) for the purpose of coordination of health benefit plans.
1827 (3) (a) The commissioner shall coordinate the administrative rules adopted under the
1828 provisions of this section with the administrative rules adopted by the Department of Health for
1829 the implementation of the standards for the electronic exchange of clinical health information
1830 under Section 26-1-37 . The department shall establish procedures for developing the rules
1831 adopted under this section, which ensure that the Department of Health is given the opportunity
1832 to comment on proposed rules.
1833 (b) (i) The commissioner may provide information to health care providers regarding
1834 resources available to a health care provider to verify whether a health care provider's practice
1835 management software system meets the uniform electronic standards for data exchange
1836 required by this section.
1837 (ii) The commissioner may provide the information described in Subsection (3)(b)(i)
1838 by partnering with:
1839 (A) a not-for-profit, broad based coalition of state health care insurers and health care
1840 providers who are involved in the electronic exchange of the data required by this section; or
1841 (B) some other person that the commissioner determines is appropriate to provide the
1842 information described in Subsection (3)(b)(i).
1843 (c) The commissioner shall regulate any fees charged by insurers to the providers for:
1844 (i) uniform claim forms;
1845 (ii) electronic billing; or
1846 (iii) the electronic exchange of clinical health information permitted by Section
1847 26-1-37 .
1848 Section 10. Section 31A-22-618.5 is amended to read:
1849 31A-22-618.5. Health benefit plan offerings.
1850 (1) The purpose of this section is to increase the range of health benefit plans available
1851 in the small group, small employer group, large group, and individual insurance markets.
1852 (2) A health maintenance organization that is subject to Chapter 8, Health Maintenance
1853 Organizations and Limited Health Plans:
1854 (a) shall offer to potential purchasers at least one health benefit plan that is subject to
1855 the requirements of Chapter 8, Health Maintenance Organizations and Limited Health Plans;
1857 (b) may offer to a potential purchaser one or more health benefit plans that:
1858 (i) are not subject to one or more of the following:
1859 (A) the limitations on insured indemnity benefits in Subsection 31A-8-105 (4);
1860 (B) the limitation on point of service products in Subsections 31A-8-408 (3) through
1862 (C) except as provided in Subsection (2)(b)(ii), basic health care services as defined in
1863 Section 31A-8-101 ; or
1864 (D) coverage mandates enacted after January 1, 2009 that are not required by federal
1865 law, provided that the insurer offers one plan under Subsection (2)(a) that covers the mandate
1866 enacted after January 1, 2009; and
1867 (ii) when offering a health plan under this section, provide coverage for an emergency
1868 medical condition as required by Section 31A-22-627 as follows:
1869 (A) within the organization's service area, covered services shall include health care
1870 services from non-affiliated providers when medically necessary to stabilize an emergency
1871 medical condition; and
1872 (B) outside the organization's service area, covered services shall include medically
1873 necessary health care services for the treatment of an emergency medical condition that are
1874 immediately required while the enrollee is outside the geographic limits of the organization's
1875 service area.
1876 (3) An insurer that offers a health benefit plan that is not subject to Chapter 8, Health
1877 Maintenance Organizations and Limited Health Plans:
1878 (a) notwithstanding Subsection 31A-22-617 (2), may offer a health benefit plan that
1879 groups providers into the following reimbursement levels:
1880 (i) tier one contracted providers;
1881 (ii) tier two contracted providers who the insurer must reimburse at least 75% of tier
1882 one providers; and
1883 (iii) one or more tiers of non-contracted providers; and
1884 (b) notwithstanding Subsection 31A-22-617 (9) may offer a health benefit plan that is
1885 not subject to Section 31A-22-618 ;
1886 (c) beginning July 1, 2012, may offer [
1887 plans that:
1888 (i) are not subject to Subsection 31A-22-617 (2); and
1889 (ii) are subject to the reimbursement requirements in Section 31A-8-501 ;
1890 (d) when offering a health plan under this Subsection (3), shall provide coverage of
1891 emergency care services as required by Section 31A-22-627 by providing coverage at a
1892 reimbursement level of at least 75% of [
1893 contracted provider category; and
1894 (e) are not subject to coverage mandates enacted after January 1, 2009 that are not
1895 required by federal law, provided that an insurer offers one plan that covers a mandate enacted
1896 after January 1, 2009.
1897 (4) Section 31A-8-106 does not prohibit the offer of a health benefit plan under
1898 Subsection (2)(b).
1899 (5) (a) Any difference in price between a health benefit plan offered under Subsections
1900 (2)(a) and (b) shall be based on actuarially sound data.
1901 (b) Any difference in price between a health benefit plan offered under Subsections
1902 (3)(a) and (b) shall be based on actuarially sound data.
1903 (6) Nothing in this section limits the number of health benefit plans that an insurer may
1905 Section 11. Section 31A-22-625 is amended to read:
1906 31A-22-625. Catastrophic coverage of mental health conditions.
1907 (1) As used in this section:
1908 (a) (i) "Catastrophic mental health coverage" means coverage in a health benefit plan
1909 that does not impose a lifetime limit, annual payment limit, episodic limit, inpatient or
1910 outpatient service limit, or maximum out-of-pocket limit that places a greater financial burden
1911 on an insured for the evaluation and treatment of a mental health condition than for the
1912 evaluation and treatment of a physical health condition.
1913 (ii) "Catastrophic mental health coverage" may include a restriction on cost sharing
1914 factors, such as deductibles, copayments, or coinsurance, before reaching a maximum
1915 out-of-pocket limit.
1916 (iii) "Catastrophic mental health coverage" may include one maximum out-of-pocket
1917 limit for physical health conditions and another maximum out-of-pocket limit for mental health
1918 conditions, except that if separate out-of-pocket limits are established, the out-of-pocket limit
1919 for mental health conditions may not exceed the out-of-pocket limit for physical health
1921 (b) (i) "50/50 mental health coverage" means coverage in a health benefit plan that
1922 pays for at least 50% of covered services for the diagnosis and treatment of mental health
1924 (ii) "50/50 mental health coverage" may include a restriction on:
1925 (A) episodic limits;
1926 (B) inpatient or outpatient service limits; or
1927 (C) maximum out-of-pocket limits.
1928 (c) "Large employer" is as defined in 42 U.S.C. Sec. 300gg-91.
1929 (d) (i) "Mental health condition" means a condition or disorder involving mental illness
1930 that falls under a diagnostic category listed in the Diagnostic and Statistical Manual, as
1931 periodically revised.
1932 (ii) "Mental health condition" does not include the following when diagnosed as the
1933 primary or substantial reason or need for treatment:
1934 (A) a marital or family problem;
1935 (B) a social, occupational, religious, or other social maladjustment;
1936 (C) a conduct disorder;
1937 (D) a chronic adjustment disorder;
1938 (E) a psychosexual disorder;
1939 (F) a chronic organic brain syndrome;
1940 (G) a personality disorder;
1941 (H) a specific developmental disorder or learning disability; or
1942 (I) mental retardation.
1943 (e) "Small employer" is as defined in 42 U.S.C. Sec. 300gg-91.
1944 (2) (a) At the time of purchase and renewal, an insurer shall offer to a small employer
1945 that it insures or seeks to insure a choice between catastrophic mental health coverage and
1946 50/50 mental health coverage.
1947 (b) In addition to complying with Subsection (2)(a), an insurer may offer to provide:
1948 (i) catastrophic mental health coverage, 50/50 mental health coverage, or both at levels
1949 that exceed the minimum requirements of this section; or
1950 (ii) coverage that excludes benefits for mental health conditions.
1951 (c) A small employer may, at its option, choose either catastrophic mental health
1952 coverage, 50/50 mental health coverage, or coverage offered under Subsection (2)(b),
1953 regardless of the employer's previous coverage for mental health conditions.
1954 (d) An insurer is exempt from the 30% index rating restriction in Section
1955 31A-30-106.1 and, for the first year only that catastrophic mental health coverage is chosen, the
1956 15% annual adjustment restriction in Section 31A-30-106.1 , for any small employer with 20 or
1957 less enrolled employees who chooses coverage that meets or exceeds catastrophic mental
1958 health coverage.
1959 (3) An insurer shall offer a large employer mental health and substance use disorder
1960 benefit in compliance with Section 2705 of the Public Health Service Act, 42 U.S.C. Sec.
1962 (4) (a) An insurer may provide catastrophic mental health coverage to a small employer
1963 through a managed care organization or system in a manner consistent with Chapter 8, Health
1964 Maintenance Organizations and Limited Health Plans, regardless of whether the insurance
1965 policy uses a managed care organization or system for the treatment of physical health
1967 (b) (i) Notwithstanding any other provision of this title, an insurer may:
1968 (A) establish a closed panel of providers for catastrophic mental health coverage; and
1969 (B) refuse to provide a benefit to be paid for services rendered by a nonpanel provider
1971 (I) the insured is referred to a nonpanel provider with the prior authorization of the
1972 insurer; and
1973 (II) the nonpanel provider agrees to follow the insurer's protocols and treatment
1975 (ii) If an insured receives services from a nonpanel provider in the manner permitted by
1976 Subsection (4)(b)(i)(B), the insurer shall reimburse the insured for not less than 75% of the
1977 average amount paid by the insurer for comparable services of panel providers under a
1978 noncapitated arrangement who are members of the same class of health care providers.
1979 (iii) This Subsection (4)(b) may not be construed as requiring an insurer to authorize a
1980 referral to a nonpanel provider.
1981 (c) To be eligible for catastrophic mental health coverage, a diagnosis or treatment of a
1982 mental health condition must be rendered:
1983 (i) by a mental health therapist as defined in Section 58-60-102 ; or
1984 (ii) in a health care facility:
1985 (A) licensed or otherwise authorized to provide mental health services pursuant to:
1986 (I) Title 26, Chapter 21, Health Care Facility Licensing and Inspection Act; or
1987 (II) Title 62A, Chapter 2, Licensure of Programs and Facilities; and
1988 (B) that provides a program for the treatment of a mental health condition pursuant to a
1989 written plan.
1990 (5) The commissioner may prohibit an insurance policy that provides mental health
1991 coverage in a manner that is inconsistent with this section.
1992 (6) The commissioner shall:
1993 (a) adopt rules, in accordance with Title 63G, Chapter 3, Utah Administrative
1994 Rulemaking Act, as necessary to ensure compliance with this section; and
1995 (b) provide general figures on the percentage of insurance policies that include:
1996 (i) no mental health coverage;
1997 (ii) 50/50 mental health coverage;
1998 (iii) catastrophic mental health coverage; and
1999 (iv) coverage that exceeds the minimum requirements of this section.
2000 (7) This section may not be construed as discouraging or otherwise preventing an
2001 insurer from providing mental health coverage in connection with an individual insurance
2003 (8) This section shall be repealed in accordance with Section 63I-1-231 .
2004 Section 12. Section 31A-22-701 is amended to read:
2005 31A-22-701. Groups eligible for group or blanket insurance.
2006 (1) As used in this section, "association group" means a lawfully formed association of
2007 individuals or business entities that:
2008 (a) purchases insurance on a group basis on behalf of members; and
2009 (b) is formed and maintained in good faith for purposes other than obtaining insurance.
2010 (2) A group [
2011 (a) a group:
2012 (i) to which a group life insurance policy may be issued under Sections 31A-22-502 ,
2013 31A-22-503 , 31A-22-504 , 31A-22-506 , 31A-22-507 , and 31A-22-509 ; and
2014 (ii) that is formed [
2015 good faith for a purpose other than obtaining insurance;
2016 (b) an association group that:
2017 (i) has been actively in existence for at least five years;
2018 (ii) has a constitution and bylaws;
2019 (iii) is formed and maintained in good faith for purposes other than obtaining
2021 (iv) does not condition membership in the association group on any health
2022 status-related factor relating to an individual, including an employee of an employer or a
2023 dependent of an employee;
2024 (v) makes accident and health insurance coverage offered through the association
2025 group available to all members regardless of any health status-related factor relating to the
2026 members or individuals eligible for coverage through a member; [
2027 (vi) does not make accident and health insurance coverage offered through the
2028 association group available other than in connection with a member of the association group;
2030 (vii) is actuarially sound; or
2031 (c) a group specifically authorized by the commissioner under Section 31A-22-509 ,
2032 upon a finding that:
2033 (i) authorization is not contrary to the public interest;
2034 (ii) the [
2035 (iii) formation of the proposed group may result in economies of scale in acquisition,
2036 administrative, marketing, and brokerage costs;
2037 (iv) the insurance policy, insurance certificate, or other indicia of coverage that will be
2038 offered to the proposed group is substantially equivalent to insurance policies that are
2039 otherwise available to similar groups;
2040 (v) the group would not present hazards of adverse selection; [
2041 (vi) the premiums for the insurance policy and any contributions by or on behalf of the
2042 insured persons are reasonable in relation to the benefits provided[
2043 (vii) the group is formed and maintained in good faith for a purpose other than
2044 obtaining insurance.
2045 (3) A blanket accident and health insurance policy:
2046 (a) covers a defined class of persons;
2047 (b) may not be offered or underwritten on an individual basis;
2048 (c) shall cover only a group that is:
2049 (i) actuarially sound; and
2050 (ii) formed and maintained in good faith for a purpose other than obtaining insurance;
2052 (d) may [
2054 as policyholder, covering persons who may become passengers as defined by reference to
2057 or guests, as defined by reference to specified hazards incident to any activities of the
2061 jurisdictional unit, as policyholder, covering students, teachers, or employees;
2063 branch of one of those organizations, as policyholder, covering [
2064 participants as defined by reference to specified hazards incident to the activities sponsored or
2065 supervised by the policyholder;
2067 policyholder, covering members, campers, employees, officials, or supervisors;
2069 organization, as policyholder, covering [
2070 reference to specified hazards incident to activities sponsored, supervised, or participated in by
2071 the policyholder;
2074 bylaws and [
2075 obtaining insurance, as policyholder, covering [
2076 defined by reference to specified hazards incident to the activities or operations sponsored or
2077 supervised by the policyholder; and
2081 properly eligible for blanket accident and health insurance.
2082 (4) The judgment of the commissioner may be exercised on the basis of:
2083 (a) individual risks;
2084 (b) a class of risks; or
2085 (c) both Subsections (4)(a) and (b).
2086 Section 13. Section 31A-22-716 is amended to read:
2087 31A-22-716. Required provision for notice of termination.
2088 (1) Every policy for group or blanket accident and health coverage issued or renewed
2089 after July 1, 1990, shall include a provision that obligates the policyholder to give 30 days prior
2090 written notice of termination to each employee or group member and to notify each employee
2091 or group member of his rights to continue coverage upon termination.
2092 (2) An insurer's monthly notice to the policyholder of premium payments due shall
2093 include a statement of the policyholder's obligations as set forth in Subsection (1). Insurers
2094 shall provide a sample notice to the policyholder at least once a year.
2095 (3) For the purpose of compliance with federal law and the Health Insurance Portability
2096 and Accountability Act[
2097 insurers, and student health plans must provide a certificate of creditable coverage to each
2098 covered person upon the person's termination from the plan as soon as reasonably possible.
2099 Section 14. Section 31A-22-721 is amended to read:
2100 31A-22-721. A health benefit plan for a plan sponsor -- Discontinuance and
2102 (1) Except as otherwise provided in this section, a health benefit plan for a plan
2103 sponsor is renewable and continues in force:
2104 (a) with respect to all eligible employees and dependents; and
2105 (b) at the option of the plan sponsor.
2106 (2) A health benefit plan for a plan sponsor may be discontinued or nonrenewed:
2107 (a) for a network plan, if:
2108 (i) there is no longer any enrollee under the group health plan who lives, resides, or
2109 works in:
2110 (A) the service area of the insurer; or
2111 (B) the area for which the insurer is authorized to do business; and
2112 (ii) in the case of the small employer market, the insurer applies the same criteria the
2113 insurer would apply in denying enrollment in the plan under Subsection 31A-30-108 (7); or
2114 (b) for coverage made available in the small or large employer market only through an
2115 association, if:
2116 (i) the employer's membership in the association ceases; and
2117 (ii) the coverage is terminated uniformly without regard to any health status-related
2118 factor relating to any covered individual.
2119 (3) A health benefit plan for a plan sponsor may be discontinued if:
2120 (a) a condition described in Subsection (2) exists;
2121 (b) the plan sponsor fails to pay premiums or contributions in accordance with the
2122 terms of the contract;
2123 (c) the plan sponsor:
2124 (i) performs an act or practice that constitutes fraud; or
2125 (ii) makes an intentional misrepresentation of material fact under the terms of the
2127 (d) the insurer:
2128 (i) elects to discontinue offering a particular health benefit product delivered or issued
2129 for delivery in this state;
2130 (ii) (A) provides notice of the discontinuation in writing:
2131 (I) to each plan sponsor, employee, and dependent of a plan sponsor or employee; and
2132 (II) at least 90 days before the date the coverage will be discontinued;
2133 (B) provides notice of the discontinuation in writing:
2134 (I) to the commissioner; and
2135 (II) at least three working days prior to the date the notice is sent to the affected plan
2136 sponsors, employees, and dependents of plan sponsors or employees;
2137 (C) offers to each plan sponsor, on a guaranteed issue basis, the option to purchase any
2138 other health benefit products currently being offered:
2139 (I) by the insurer in the market; or
2140 (II) in the case of a large employer, any other health benefit plan currently being
2141 offered in that market; and
2142 (D) in exercising the option to discontinue that product and in offering the option of
2143 coverage in this section, the insurer acts uniformly without regard to:
2144 (I) the claims experience of a plan sponsor;
2145 (II) any health status-related factor relating to any covered participant or beneficiary; or
2146 (III) any health status-related factor relating to a new participant or beneficiary who
2147 may become eligible for coverage; or
2148 (e) the insurer:
2149 (i) elects to discontinue all of the insurer's health benefit plans:
2150 (A) in the small employer market; or
2151 (B) the large employer market; or
2152 (C) both the small and large employer markets; and
2153 (ii) (A) provides notice of the discontinuance in writing:
2154 (I) to each plan sponsor, employee, or dependent of a plan sponsor or an employee; and
2155 (II) at least 180 days before the date the coverage will be discontinued;
2156 (B) provides notice of the discontinuation in writing:
2157 (I) to the commissioner in each state in which an affected insured individual is known
2158 to reside; and
2159 (II) at least 30 business days prior to the date the notice is sent to the affected plan
2160 sponsors, employees, and dependents of a plan sponsor or employee;
2161 (C) discontinues and nonrenews all plans issued or delivered for issuance in the
2162 market; and
2163 (D) provides a plan of orderly withdrawal as required by Section 31A-4-115 .
2164 (4) A large employer health benefit plan may be discontinued or nonrenewed:
2165 (a) if a condition described in Subsection (2) exists; or
2166 (b) for noncompliance with the insurer's:
2167 (i) minimum participation requirements; or
2168 (ii) employer contribution requirements.
2169 (5) A small employer health benefit plan may be discontinued or nonrenewed:
2170 (a) if a condition described in Subsection (2) exists; or
2171 (b) for noncompliance with the insurer's employer contribution requirements.
2172 (6) A small employer health benefit plan may be nonrenewed:
2173 (a) if a condition described in Subsection (2) exists; or
2174 (b) for noncompliance with the insurer's minimum participation requirements.
2175 (7) (a) Except as provided in Subsection (7)(d), an eligible employee may be
2176 discontinued if after issuance of coverage the eligible employee:
2177 (i) engages in an act or practice that constitutes fraud in connection with the coverage;
2179 (ii) makes an intentional misrepresentation of material fact in connection with the
2181 (b) An eligible employee that is discontinued under Subsection (7)(a) may reenroll:
2182 (i) 12 months after the date of discontinuance; and
2183 (ii) if the plan sponsor's coverage is in effect at the time the eligible employee applies
2184 to reenroll.
2185 (c) At the time the eligible employee's coverage is discontinued under Subsection
2186 (7)(a), the insurer shall notify the eligible employee of the right to reenroll when coverage is
2188 (d) An eligible employee may not be discontinued under this Subsection (7) because of
2189 a fraud or misrepresentation that relates to health status.
2190 (8) (a) Except as provided in Subsection (8)(b), an insurer that elects to discontinue
2191 offering a health benefit plan under Subsection (3)(e) shall be prohibited from writing new
2192 business in such market in this state for a period of five years beginning on the date of
2193 discontinuation of the last coverage that is discontinued.
2194 (b) The commissioner may waive the prohibition under Subsection (8)(a) when the
2195 commissioner finds that waiver is in the public interest:
2196 (i) to promote competition; or
2197 (ii) to resolve inequity in the marketplace.
2198 (9) If an insurer is doing business in one established geographic service area of the
2199 state, this section applies only to the insurer's operations in that geographic service area.
2200 (10) An insurer may modify a health benefit plan for a plan sponsor only:
2201 (a) at the time of coverage renewal; and
2202 (b) if the modification is effective uniformly among all plans with a particular product
2203 or service.
2204 (11) For purposes of this section, a reference to "plan sponsor" includes a reference to
2205 the employer:
2206 (a) with respect to coverage provided to an employer member of the association; and
2207 (b) if the health benefit plan is made available by an insurer in the employer market
2208 only through:
2209 (i) an association;
2210 (ii) a trust; or
2211 (iii) a discretionary group.
2212 (12) (a) A small employer that, after purchasing a health benefit plan in the small group
2213 market, employs on average more than 50 eligible employees on each business day in a
2214 calendar year may continue to renew the health benefit plan purchased in the small group
2216 (b) A large employer that, after purchasing a health benefit plan in the large group
2217 market, employs on average less than 51 eligible employees on each business day in a calendar
2218 year may continue to renew the health benefit plan purchased in the large group market.
2219 (13) An insurer offering employer sponsored health benefit plans shall comply with the
2220 Health Insurance Portability and Accountability Act, [
2222 Section 15. Section 31A-22-723 is amended to read:
2223 31A-22-723. Conversion from group coverage.
2224 (1) Notwithstanding Subsection 31A-1-103 (3)(f), and except as provided in Subsection
2225 (3), [
2226 title, or Title 49, Chapter 20, Public Employees' Benefit and Insurance Program Act, shall
2227 provide that a person whose insurance under the group policy has been terminated is entitled to
2228 choose a converted individual policy in accordance with this section and Section 31A-22-724 .
2229 (2) A person who has lost group coverage may elect conversion coverage with the
2230 insurer that provided prior group coverage if the person:
2231 (a) has been continuously covered for a period of three months by the group policy or
2232 the group's preceding policies immediately prior to termination;
2233 (b) has exhausted either:
2234 (i) Utah mini-COBRA coverage as required in Section 31A-22-722 ;
2235 (ii) federal COBRA coverage; or
2236 (iii) alternative coverage under Section 31A-22-724 ;
2237 (c) has not acquired or is not covered under any other group coverage that covers [
2238 preexisting conditions, including maternity, if the coverage exists; and
2239 (d) resides in the insurer's service area.
2240 (3) This section does not apply if the person's prior group coverage:
2241 (a) is a stand alone policy that only provides one of the following:
2242 (i) catastrophic benefits;
2243 (ii) aggregate stop loss benefits;
2244 (iii) specific stop loss benefits;
2245 (iv) benefits for specific diseases;
2246 (v) accidental injuries only;
2247 (vi) dental; or
2248 (vii) vision;
2249 (b) is an income replacement policy;
2250 (c) was terminated because the insured:
2251 (i) failed to pay any required individual contribution;
2252 (ii) performed an act or practice that constitutes fraud in connection with the coverage;
2254 (iii) made intentional misrepresentation of material fact under the terms of coverage; or
2255 (d) was terminated pursuant to Subsection 31A-8-402.3 (2)(a), 31A-22-721 (2)(a), or
2256 31A-30-107 (2)(a).
2257 (4) (a) The [
2258 individual conversion policy within 30 days of the insurer receiving notice of, the insured's
2259 termination of coverage to:
2260 (i) the terminated insured;
2261 (ii) the ex-spouse; or
2262 (iii) in the case of the death of the insured:
2263 (A) the surviving spouse; and
2264 (B) the guardian of any dependents, if different from a surviving spouse.
2265 (b) The notification required by Subsection (4)(a) shall:
2266 (i) be sent by first class mail;
2267 (ii) contain the name, address, and telephone number of the insurer that will provide
2268 the conversion coverage; and
2269 (iii) be sent to the insured's last-known address as shown on the records of the
2270 employer of:
2271 (A) the insured;
2272 (B) the ex-spouse; and
2273 (C) if the policy terminates by reason of the death of the insured to:
2274 (I) the surviving spouse; and
2275 (II) the guardian of any dependents, if different from a surviving spouse.
2276 (5) (a) An insurer is not required to issue a converted policy [
2277 benefits in excess of those provided under the group policy from which conversion is made.
2278 (b) Except as provided in Subsection (5)(c), if the conversion is made from a health
2279 benefit plan, the employee or member shall be offered[
2282 (c) If the benefit levels required under Subsection (5)(b) exceed the benefit levels
2283 provided under the group policy, the conversion policy may offer benefits [
2284 substantially similar to those provided under the group policy.
2285 (6) Written application for [
2286 paid to the insurer no later than [
2288 (7) [
2289 (8) (a) The initial premium for the converted policy for the first 12 months and
2290 subsequent renewal premiums shall be determined in accordance with premium rates
2291 applicable to age, class of risk of the person, and the type and amount of insurance provided.
2292 (b) The initial premium for the first 12 months may not be raised based on pregnancy
2293 of a covered insured.
2294 (c) The premium for converted policies shall be payable monthly or quarterly as
2295 required by the insurer for the policy form and plan selected, unless another mode or premium
2296 payment is mutually agreed upon.
2297 (9) [
2298 group policy terminates.
2299 (10) (a) A newly issued converted policy covers the employee or the member and must
2300 also cover [
2302 (b) The only dependents that may be added after the policy has been issued are children
2303 and dependents as required by Section 31A-22-610 and Subsections 31A-22-610.5 (6) and (7).
2304 (c) At the option of the insurer, a separate converted policy may be issued to cover
2306 (11) (a) To the extent [
2307 conversion policy shall provide maternity benefits equal to the lesser of the maternity benefits
2308 of the group policy or the conversion policy until termination of a pregnancy that exists on the
2309 date of conversion if one of the following is pregnant on the date of the conversion:
2310 (i) the insured;
2311 (ii) a spouse of the insured; or
2312 (iii) a dependent of the insured.
2313 (b) [
2314 that occurs after the date of conversion.
2315 (12) Except as provided in this Subsection (12), a converted policy is renewable with
2316 respect to [
2317 insured. An insured may be terminated from a converted policy for the following reasons:
2318 (a) a dependent is no longer eligible under the converted policy;
2319 (b) for a network plan, if the individual no longer lives, resides, or works in:
2320 (i) the insured's service area; or
2321 (ii) the area for which the covered carrier is authorized to do business;
2322 (c) the individual fails to pay premiums or contributions in accordance with the terms
2323 of the converted policy, including any timeliness requirements;
2324 (d) the individual performs an act or practice that constitutes fraud in connection with
2325 the coverage;
2326 (e) the individual makes an intentional misrepresentation of material fact under the
2327 terms of the coverage; or
2328 (f) coverage is terminated uniformly without regard to any health status-related factor
2329 relating to any covered individual.
2330 (13) Conditions pertaining to health may not be used as a basis for classification under
2331 this section.
2332 (14) An insurer is only required to offer a conversion policy that complies with
2333 Subsection 31A-22-724 (1)(b) and, notwithstanding Sections 31A-8-402.5 and 31A-30-107.1 ,
2334 may discontinue any other conversion policy if:
2335 (a) the discontinued conversion policy is discontinued uniformly without regard to
2337 (b) [
2338 notice of the discontinuation of the existing conversion policy;
2339 (c) the [
2340 complies with Subsection 31A-22-724 (1)(b); and
2341 (d) the [
2342 (15) This section does not apply to a blanket accident and health insurance policy
2343 issued under Section 31A-22-701 .
2344 Section 16. Section 31A-23a-102 is amended to read:
2345 31A-23a-102. Definitions.
2346 As used in this chapter:
2347 (1) "Bail bond producer" means a person who:
2348 (a) is appointed by:
2349 (i) a surety insurer that issues bail bonds; or
2350 (ii) a bail bond surety company licensed under Chapter 35, Bail Bond Act;
2351 (b) is designated to execute or countersign undertakings of bail in connection with a
2352 judicial proceeding; and
2353 (c) receives or is promised money or other things of value for engaging in an act
2354 described in Subsection (1)(b).
2355 (2) "Escrow" means a license subline of authority in conjunction with the title
2356 insurance line of authority that allows a person to conduct escrow as defined in Section
2357 31A-1-301 .
2358 (3) "Home state" means a state or territory of the United States or the District of
2359 Columbia in which an insurance producer:
2360 (a) maintains the insurance producer's principal:
2361 (i) place of residence; or
2362 (ii) place of business; and
2363 (b) is licensed to act as an insurance producer.
2364 (4) "Insurer" is as defined in Section 31A-1-301 , except that the following persons or
2365 similar persons are not insurers for purposes of Part 7, Producer Controlled Insurers:
2366 (a) a risk retention group as defined in:
2367 (i) the Superfund Amendments and Reauthorization Act of 1986, Pub. L. No. 99-499;
2368 (ii) the Risk Retention Act, 15 U.S.C. Sec. 3901 et seq.; and
2369 (iii) Chapter 15, Part 2, Risk Retention Groups Act;
2370 (b) a residual market pool;
2371 (c) a joint underwriting authority or association; and
2372 (d) a captive insurer.
2373 (5) "License" is defined in Section 31A-1-301 .
2374 (6) (a) "Managing general agent" means a person that:
2375 (i) manages all or part of the insurance business of an insurer, including the
2376 management of a separate division, department, or underwriting office;
2377 (ii) acts as an agent for the insurer whether it is known as a managing general agent,
2378 manager, or other similar term;
2379 (iii) produces and underwrites an amount of gross direct written premium equal to, or
2380 more than 5% of, the policyholder surplus as reported in the last annual statement of the insurer
2381 in any one quarter or year:
2382 (A) with or without the authority;
2383 (B) separately or together with an affiliate; and
2384 (C) directly or indirectly; and
2385 (iv) (A) adjusts or pays claims in excess of an amount determined by the
2386 commissioner; or
2387 (B) negotiates reinsurance on behalf of the insurer.
2388 (b) Notwithstanding Subsection (6)(a), the following persons may not be considered as
2389 managing general agent for the purposes of this chapter:
2390 (i) an employee of the insurer;
2391 (ii) a United States manager of the United States branch of an alien insurer;
2392 (iii) an underwriting manager that, pursuant to contract:
2393 (A) manages all the insurance operations of the insurer;
2394 (B) is under common control with the insurer;
2395 (C) is subject to Chapter 16, Insurance Holding Companies; and
2396 (D) is not compensated based on the volume of premiums written; and
2397 (iv) the attorney-in-fact authorized by and acting for the subscribers of a reciprocal
2398 insurer or inter-insurance exchange under powers of attorney.
2399 (7) "Negotiate" means the act of conferring directly with or offering advice directly to a
2400 purchaser or prospective purchaser of a particular contract of insurance concerning a
2401 substantive benefit, term, or condition of the contract if the person engaged in that act:
2402 (a) sells insurance; or
2403 (b) obtains insurance from insurers for purchasers.
2404 (8) "Reinsurance intermediary" means:
2405 (a) a reinsurance intermediary-broker; or
2406 (b) a reinsurance intermediary-manager.
2407 (9) "Reinsurance intermediary-broker" means a person other than an officer or
2408 employee of the ceding insurer, firm, association, or corporation who solicits, negotiates, or
2409 places reinsurance cessions or retrocessions on behalf of a ceding insurer without the authority
2410 or power to bind reinsurance on behalf of the insurer.
2411 (10) (a) "Reinsurance intermediary-manager" means a person who:
2412 (i) has authority to bind or who manages all or part of the assumed reinsurance
2413 business of a reinsurer, including the management of a separate division, department, or
2414 underwriting office; and
2415 (ii) acts as an agent for the reinsurer whether the person is known as a reinsurance
2416 intermediary-manager, manager, or other similar term.
2417 (b) Notwithstanding Subsection (10)(a), the following persons may not be considered
2418 reinsurance intermediary-managers for the purpose of this chapter with respect to the reinsurer:
2419 (i) an employee of the reinsurer;
2420 (ii) a United States manager of the United States branch of an alien reinsurer;
2421 (iii) an underwriting manager that, pursuant to contract:
2422 (A) manages all the reinsurance operations of the reinsurer;
2423 (B) is under common control with the reinsurer;
2424 (C) is subject to Chapter 16, Insurance Holding Companies; and
2425 (D) is not compensated based on the volume of premiums written; and
2426 (iv) the manager of a group, association, pool, or organization of insurers that:
2427 (A) engage in joint underwriting or joint reinsurance; and
2428 (B) are subject to examination by the insurance commissioner of the state in which the
2429 manager's principal business office is located.
2430 (11) "Search" means a license subline of authority in conjunction with the title
2431 insurance line of authority that allows a person to issue title insurance commitments or policies
2432 on behalf of a title insurer.
2433 (12) "Sell" means to exchange a contract of insurance:
2434 (a) by any means;
2435 (b) for money or its equivalent; and
2436 (c) on behalf of an insurance company.
2437 (13) "Solicit" means:
2438 (a) attempting to sell insurance;
2439 (b) asking or urging a person to apply for:
2440 (i) a particular kind of insurance; and
2441 (ii) insurance from a particular insurance company;
2442 (c) advertising insurance, including advertising for the purpose of obtaining leads for
2443 the sale of insurance; or
2444 (d) holding oneself out as being in the insurance business.
2445 (14) "Terminate" means:
2446 (a) the cancellation of the relationship between:
2447 (i) an individual licensee or agency licensee and a particular insurer; or
2448 (ii) an individual licensee and a particular agency licensee; or
2449 (b) the termination of:
2450 (i) an individual licensee's or agency licensee's authority to transact insurance on behalf
2451 of a particular insurance company; or
2452 (ii) an individual licensee's authority to transact insurance on behalf of a particular
2453 agency licensee.
2454 (15) "Title marketing representative" means a person who:
2455 (a) represents a title insurer in soliciting, requesting, or negotiating the placing of:
2456 (i) title insurance; or
2457 (ii) escrow services; and
2458 (b) does not have a search or escrow license as provided in Section 31A-23a-106 .
2459 (16) "Uniform application" means the version of the National Association of Insurance
2461 licensing at the time the application is filed.
2462 (17) "Uniform business entity application" means the version of the National
2463 Association of Insurance [
2464 for resident and nonresident business entities at the time the application is filed.
2465 Section 17. Section 31A-23a-106 is amended to read:
2466 31A-23a-106. License types.
2467 (1) (a) A resident or nonresident license issued under this chapter shall be issued under
2468 the license types described under Subsection (2).
2469 (b) A license type and a line of authority pertaining to a license type describe the type
2470 of licensee and the lines of business that a licensee may sell, solicit, or negotiate. A license type
2471 is intended to describe the matters to be considered under any education, examination, and
2472 training required of a license applicant under Sections 31A-23a-108 , 31A-23a-202 , and
2473 31A-23a-203 .
2474 (2) (a) A producer license type includes the following lines of authority:
2475 (i) life insurance, including a nonvariable contract;
2476 (ii) variable contracts, including variable life and annuity, if the producer has the life
2477 insurance line of authority;
2478 (iii) accident and health insurance, including a contract issued to a policyholder under
2479 Chapter 7, Nonprofit Health Service Insurance Corporations, or Chapter 8, Health Maintenance
2480 Organizations and Limited Health Plans;
2481 (iv) property insurance;
2482 (v) casualty insurance, including a surety or other bond;
2483 (vi) title insurance under one or more of the following categories:
2484 (A) search, including authority to act as a title marketing representative;
2485 (B) escrow, including authority to act as a title marketing representative; and
2486 (C) title marketing representative only;
2487 (vii) personal lines insurance; and
2488 (viii) surplus lines, if the producer has the property or casualty or both lines of
2490 (b) A limited line producer license type includes the following limited lines of
2492 (i) limited line credit insurance;
2493 (ii) travel insurance;
2494 (iii) motor club insurance;
2495 (iv) car rental related insurance;
2496 (v) legal expense insurance;
2497 (vi) crop insurance;
2498 (vii) self-service storage insurance; [
2499 (viii) bail bond producer[
2500 (ix) guaranteed asset protection waiver.
2501 (c) A customer service representative license type includes the following lines of
2502 authority, if held by the customer service representative's employer producer:
2503 (i) life insurance, including a nonvariable contract;
2504 (ii) accident and health insurance, including a contract issued to a policyholder under
2505 Chapter 7, Nonprofit Health Service Insurance Corporations, or Chapter 8, Health Maintenance
2506 Organizations and Limited Health Plans;
2507 (iii) property insurance;
2508 (iv) casualty insurance, including a surety or other bond;
2509 (v) personal lines insurance; and
2510 (vi) surplus lines, if the employer producer has the property or casualty or both lines of
2512 (d) A consultant license type includes the following lines of authority:
2513 (i) life insurance, including a nonvariable contract;
2514 (ii) variable contracts, including variable life and annuity, if the consultant has the life
2515 insurance line of authority;
2516 (iii) accident and health insurance, including a contract issued to a policyholder under
2517 Chapter 7, Nonprofit Health Service Insurance Corporations, or Chapter 8, Health Maintenance
2518 Organizations and Limited Health Plans;
2519 (iv) property insurance;
2520 (v) casualty insurance, including a surety or other bond; and
2521 (vi) personal lines insurance.
2522 (e) A managing general agent license type includes the following lines of authority:
2523 (i) life insurance, including a nonvariable contract;
2524 (ii) variable contracts, including variable life and annuity, if the managing general
2525 agent has the life insurance line of authority;
2526 (iii) accident and health insurance, including a contract issued to a policyholder under
2527 Chapter 7, Nonprofit Health Service Insurance Corporations, or Chapter 8, Health Maintenance
2528 Organizations and Limited Health Plans;
2529 (iv) property insurance;
2530 (v) casualty insurance, including a surety or other bond; and
2531 (vi) personal lines insurance.
2532 (f) A reinsurance intermediary license type includes the following lines of authority:
2533 (i) life insurance, including a nonvariable contract;
2534 (ii) variable contracts, including variable life and annuity, if the reinsurance
2535 intermediary has the life insurance line of authority;
2536 (iii) accident and health insurance, including a contract issued to a policyholder under
2537 Chapter 7, Nonprofit Health Service Insurance Corporations, or Chapter 8, Health Maintenance
2538 Organizations and Limited Health Plans;
2539 (iv) property insurance;
2540 (v) casualty insurance, including a surety or other bond; and
2541 (vi) personal lines insurance.
2542 (g) A [
2543 (2)(a), (d), (e), [
2544 under Subsections (2)(b) and (c), except that the person may not act under Subsection
2545 (2)(b)(viii) or (ix).
2546 (3) (a) The commissioner may by rule recognize other producer, limited line producer,
2547 customer service representative, consultant, managing general agent, or reinsurance
2548 intermediary lines of authority as to kinds of insurance not listed under Subsections (2)(a)
2549 through (f).
2550 (b) Notwithstanding Subsection (3)(a), for purposes of title insurance the Title and
2551 Escrow Commission may by rule, with the concurrence of the commissioner and subject to
2552 Section 31A-2-404 , recognize other categories for a title insurance producer line of authority
2553 not listed under Subsection (2)(a)(vi).
2554 (4) The variable contracts, including variable life and annuity line of authority requires:
2555 (a) licensure as a registered agent or broker by the [
2557 (b) current registration with a securities broker-dealer.
2558 (5) A surplus lines producer is a producer who has a surplus lines line of authority.
2559 Section 18. Section 31A-23a-111 is amended to read:
2560 31A-23a-111. Revocation, suspension, surrender, lapsing, limiting, or otherwise
2561 terminating a license -- Rulemaking for renewal or reinstatement.
2562 (1) A license type issued under this chapter remains in force until:
2563 (a) revoked or suspended under Subsection (5);
2564 (b) surrendered to the commissioner and accepted by the commissioner in lieu of
2565 administrative action;
2566 (c) the licensee dies or is adjudicated incompetent as defined under:
2567 (i) Title 75, Chapter 5, Part 3, Guardians of Incapacitated Persons; or
2568 (ii) Title 75, Chapter 5, Part 4, Protection of Property of Persons Under Disability and
2570 (d) lapsed under Section 31A-23a-113 ; or
2571 (e) voluntarily surrendered.
2572 (2) The following may be reinstated within one year after the day on which the license
2573 is no longer in force:
2574 (a) a lapsed license; or
2575 (b) a voluntarily surrendered license, except that a voluntarily surrendered license may
2576 not be reinstated after the license period in which the license is voluntarily surrendered.
2577 (3) Unless otherwise stated in [
2578 license, submission and acceptance of a voluntary surrender of a license does not prevent the
2579 department from pursuing additional disciplinary or other action authorized under:
2580 (a) this title; or
2581 (b) rules made under this title in accordance with Title 63G, Chapter 3, Utah
2582 Administrative Rulemaking Act.
2583 (4) A line of authority issued under this chapter remains in force until:
2584 (a) the qualifications pertaining to a line of authority are no longer met by the licensee;
2586 (b) the supporting license type:
2587 (i) is revoked or suspended under Subsection (5);
2588 (ii) is surrendered to the commissioner and accepted by the commissioner in lieu of
2589 administrative action;
2590 (iii) the licensee dies or is adjudicated incompetent as defined under:
2591 (A) Title 75, Chapter 5, Part 3, Guardians of Incapacitated Persons; or
2592 (B) Title 75, Chapter 5, Part 4, Protection of Property of Persons Under Disability and
2594 (iv) lapsed under Section 31A-23a-113 ; or
2595 (v) voluntarily surrendered.
2596 (5) (a) If the commissioner makes a finding under Subsection (5)(b), as part of an
2597 adjudicative proceeding under Title 63G, Chapter 4, Administrative Procedures Act, the
2598 commissioner may:
2599 (i) revoke:
2600 (A) a license; or
2601 (B) a line of authority;
2602 (ii) suspend for a specified period of 12 months or less:
2603 (A) a license; or
2604 (B) a line of authority;
2605 (iii) limit in whole or in part:
2606 (A) a license; or
2607 (B) a line of authority; or
2608 (iv) deny a license application.
2609 (b) The commissioner may take an action described in Subsection (5)(a) if the
2610 commissioner finds that the licensee:
2611 (i) is unqualified for a license or line of authority under Section 31A-23a-104 ,
2612 31A-23a-105 , or 31A-23a-107 ;
2613 (ii) violates:
2614 (A) an insurance statute;
2615 (B) a rule that is valid under Subsection 31A-2-201 (3); or
2616 (C) an order that is valid under Subsection 31A-2-201 (4);
2617 (iii) is insolvent or the subject of receivership, conservatorship, rehabilitation, or other
2618 delinquency proceedings in any state;
2619 (iv) fails to pay a final judgment rendered against the person in this state within 60
2620 days after the day on which the judgment became final;
2621 (v) fails to meet the same good faith obligations in claims settlement that is required of
2622 admitted insurers;
2623 (vi) is affiliated with and under the same general management or interlocking
2624 directorate or ownership as another insurance producer that transacts business in this state
2625 without a license;
2626 (vii) refuses:
2627 (A) to be examined; or
2628 (B) to produce its accounts, records, and files for examination;
2629 (viii) has an officer who refuses to:
2630 (A) give information with respect to the insurance producer's affairs; or
2631 (B) perform any other legal obligation as to an examination;
2632 (ix) provides information in the license application that is:
2633 (A) incorrect;
2634 (B) misleading;
2635 (C) incomplete; or
2636 (D) materially untrue;
2637 (x) violates an insurance law, valid rule, or valid order of another state's insurance
2639 (xi) obtains or attempts to obtain a license through misrepresentation or fraud;
2640 (xii) improperly withholds, misappropriates, or converts money or properties received
2641 in the course of doing insurance business;
2642 (xiii) intentionally misrepresents the terms of an actual or proposed:
2643 (A) insurance contract;
2644 (B) application for insurance; or
2645 (C) life settlement;
2646 (xiv) is convicted of a felony;
2647 (xv) admits or is found to have committed an insurance unfair trade practice or fraud;
2648 (xvi) in the conduct of business in this state or elsewhere:
2649 (A) uses fraudulent, coercive, or dishonest practices; or
2650 (B) demonstrates incompetence, untrustworthiness, or financial irresponsibility;
2651 (xvii) has an insurance license, or its equivalent, denied, suspended, or revoked in
2652 another state, province, district, or territory;
2653 (xviii) forges another's name to:
2654 (A) an application for insurance; or
2655 (B) a document related to an insurance transaction;
2656 (xix) improperly uses notes or another reference material to complete an examination
2657 for an insurance license;
2658 (xx) knowingly accepts insurance business from an individual who is not licensed;
2659 (xxi) fails to comply with an administrative or court order imposing a child support
2661 (xxii) fails to:
2662 (A) pay state income tax; or
2663 (B) comply with an administrative or court order directing payment of state income
2665 (xxiii) violates or permits others to violate the federal Violent Crime Control and Law
2666 Enforcement Act of 1994, 18 U.S.C. [
2667 (xxiv) engages in a method or practice in the conduct of business that endangers the
2668 legitimate interests of customers and the public.
2669 (c) For purposes of this section, if a license is held by an agency, both the agency itself
2670 and any individual designated under the license are considered to be the holders of the license.
2671 (d) If an individual designated under the agency license commits an act or fails to
2672 perform a duty that is a ground for suspending, revoking, or limiting the individual's license,
2673 the commissioner may suspend, revoke, or limit the license of:
2674 (i) the individual;
2675 (ii) the agency, if the agency:
2676 (A) is reckless or negligent in its supervision of the individual; or
2677 (B) knowingly participates in the act or failure to act that is the ground for suspending,
2678 revoking, or limiting the license; or
2679 (iii) (A) the individual; and
2680 (B) the agency if the agency meets the requirements of Subsection (5)(d)(ii).
2681 (6) A licensee under this chapter is subject to the penalties for acting as a licensee
2682 without a license if:
2683 (a) the licensee's license is:
2684 (i) revoked;
2685 (ii) suspended;
2686 (iii) limited;
2687 (iv) surrendered in lieu of administrative action;
2688 (v) lapsed; or
2689 (vi) voluntarily surrendered; and
2690 (b) the licensee:
2691 (i) continues to act as a licensee; or
2692 (ii) violates the terms of the license limitation.
2693 (7) A licensee under this chapter shall immediately report to the commissioner:
2694 (a) a revocation, suspension, or limitation of the person's license in another state, the
2695 District of Columbia, or a territory of the United States;
2696 (b) the imposition of a disciplinary sanction imposed on that person by another state,
2697 the District of Columbia, or a territory of the United States; or
2698 (c) a judgment or injunction entered against that person on the basis of conduct
2700 (i) fraud;
2701 (ii) deceit;
2702 (iii) misrepresentation; or
2703 (iv) a violation of an insurance law or rule.
2704 (8) (a) An order revoking a license under Subsection (5) or an agreement to surrender a
2705 license in lieu of administrative action may specify a time, not to exceed five years, within
2706 which the former licensee may not apply for a new license.
2707 (b) If no time is specified in an order or agreement described in Subsection (8)(a), the
2708 former licensee may not apply for a new license for five years from the day on which the order
2709 or agreement is made without the express approval by the commissioner.
2710 (9) The commissioner shall promptly withhold, suspend, restrict, or reinstate the use of
2711 a license issued under this part if so ordered by a court.
2712 (10) The commissioner shall by rule prescribe the license renewal and reinstatement
2713 procedures in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
2714 Section 19. Section 31A-23a-202 is amended to read:
2715 31A-23a-202. Continuing education requirements.
2716 (1) Pursuant to this section, the commissioner shall by rule prescribe the continuing
2717 education requirements for a producer and a consultant.
2718 (2) (a) The commissioner may not state a continuing education requirement in terms of
2719 formal education.
2720 (b) The commissioner may state a continuing education requirement in terms of
2722 (c) Insurance-related formal education may be a substitute, in whole or in part, for
2724 (3) (a) The commissioner shall impose continuing education requirements in
2725 accordance with a two-year licensing period in which the licensee meets the requirements of
2726 this Subsection (3).
2727 (b) (i) Except as provided in this section, the continuing education requirements shall
2729 (A) that a licensee complete 24 credit hours of continuing education for every two-year
2730 licensing period;
2731 (B) that 3 of the 24 credit hours described in Subsection (3)(b)(i)(A) be ethics courses;
2733 (C) that the licensee complete at least half of the required hours through classroom
2734 hours of insurance-related instruction.
2735 (ii) [
2736 education in accordance with Subsection (3)(b)(i)[
2737 (A) classroom attendance;
2742 (iii) (A) Notwithstanding Subsections (3)(b)(i)(A) and (B), a title insurance producer is
2743 required to complete 12 credit hours of continuing education for every two-year licensing
2744 period, with 3 of the credit hours being ethics courses unless the title insurance producer is
2745 licensed in this state as a title insurance producer for 20 or more consecutive years.
2746 (B) If a title insurance producer is licensed in this state as a title insurance producer for
2747 20 or more consecutive years, the title insurance producer is required to complete 6 credit hours
2748 of continuing education for every two-year licensing period, with 3 of the credit hours being
2749 ethics courses.
2750 (C) Notwithstanding Subsection (3)(b)(iii)(A) or (B), a title insurance producer is
2751 considered to have met the continuing education requirements imposed under Subsection
2752 (3)(b)(iii)(A) or (B) if the title insurance producer:
2753 (I) is an active member in good standing with the Utah State Bar;
2754 (II) is in compliance with the continuing education requirements of the Utah State Bar;
2756 (III) if requested by the department, provides the department evidence that the title
2757 insurance producer complied with the continuing education requirements of the Utah State Bar.
2758 (c) A licensee may obtain continuing education hours at any time during the two-year
2759 licensing period.
2760 (d) (i) A licensee is exempt from continuing education requirements under this section
2762 (A) the licensee was first licensed before April 1, 1978;
2763 (B) the license does not have a continuous lapse for a period of more than one year,
2764 except for a license for which the licensee has had an exemption approved before May 11,
2768 (ii) If the department approves the exemption under Subsection (3)(d)(i), the licensee is
2769 not required to apply again for the exemption.
2770 (e) In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, the
2771 commissioner shall, by rule:
2772 (i) publish a list of insurance professional designations whose continuing education
2773 requirements can be used to meet the requirements for continuing education under Subsection
2775 (ii) authorize a continuing education provider or a state or national professional
2776 producer or consultant association to:
2777 (A) offer a qualified program for a license type or line of authority on a geographically
2778 accessible basis; and
2779 (B) collect a reasonable fee for funding and administration of a continuing education
2780 program, subject to the review and approval of the commissioner; and
2781 (iii) provide that membership by a producer or consultant in a state or national
2782 professional producer or consultant association is considered a substitute for the equivalent of
2783 two hours for each year during which the producer or consultant is a member of the
2784 professional association, except that the commissioner may not give more than two hours of
2785 continuing education credit in a year regardless of the number of professional associations of
2786 which the producer or consultant is a member.
2787 (f) A fee permitted under Subsection (3)(e)(ii)(B) that is charged for attendance at a
2788 professional producer or consultant association program may be less for an association
2789 member, on the basis of the member's affiliation expense, but shall preserve the right of a
2790 nonmember to attend without affiliation.
2791 (4) The commissioner shall approve a continuing education provider or continuing
2792 education course that satisfies the requirements of this section.
2793 (5) In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, the
2794 commissioner shall by rule set the processes and procedures for continuing education provider
2795 registration and course approval.
2796 (6) The requirements of this section apply only to a producer or consultant who is an
2798 (7) A nonresident producer or consultant is considered to have satisfied this state's
2799 continuing education requirements if the nonresident producer or consultant satisfies the
2800 nonresident producer's or consultant's home state's continuing education requirements for a
2801 licensed insurance producer or consultant.
2802 (8) A producer or consultant subject to this section shall keep documentation of
2803 completing the continuing education requirements of this section for two years after the end of
2804 the two-year licensing period to which the continuing education applies.
2805 Section 20. Section 31A-23a-203 is amended to read:
2806 31A-23a-203. Training period requirements.
2807 (1) A producer is eligible to add the surplus lines of authority to the person's producer's
2808 license if the producer:
2809 (a) has passed the applicable examination;
2810 (b) has been a producer with property and casualty lines of authority for at least three
2811 years during the four years immediately preceding the date of application; and
2812 (c) has paid the applicable fee under Section 31A-3-103 .
2813 (2) A person is eligible to become a consultant only if the person has acted in a
2814 capacity that would provide the person with preparation to act as an insurance consultant for a
2815 period aggregating not less than three years during the four years immediately preceding the
2816 date of application.
2817 (3) (a) A resident producer with an accident and health line of authority may only sell
2818 long-term care insurance if the producer:
2819 (i) initially completes a minimum of three hours of long-term care training before
2820 selling long-term care coverage; and
2821 (ii) after completing the training required by Subsection (3)(a)(i), completes a
2822 minimum of three hours of long-term care training during each subsequent two-year licensing
2824 (b) A course taken to satisfy a long-term care training requirement may be used toward
2825 satisfying a producer continuing education requirement.
2826 (c) Long-term care training is not a continuing education requirement to renew a
2827 producer license.
2828 (d) An insurer that issues long-term care insurance shall demonstrate to the
2829 commissioner, upon request, that a producer who is appointed by the insurer and who sells
2830 long-term care insurance coverage is in compliance with this Subsection (3).
2832 applying for a license under this chapter.
2833 Section 21. Section 31A-23a-204 is amended to read:
2834 31A-23a-204. Special requirements for title insurance producers and agencies.
2835 A title insurance producer, including an agency, shall be licensed in accordance with
2836 this chapter, with the additional requirements listed in this section.
2837 (1) (a) A person that receives a new license under this title as a title insurance agency,
2838 shall at the time of licensure be owned or managed by [
2839 least one individual who is licensed for at least three of the five years immediately [
2840 preceding the date on which the title insurance agency applies for a license with both:
2841 (i) a search line of authority; and
2842 (ii) an escrow line of authority.
2843 (b) A title insurance agency subject to Subsection (1)(a) may comply with Subsection
2844 (1)(a) by having the title insurance agency owned or managed by:
2845 (i) one or more individuals who are licensed with the search line of authority for the
2846 time period provided in Subsection (1)(a); and
2847 (ii) one or more individuals who are licensed with the escrow line of authority for the
2848 time period provided in Subsection (1)(a).
2849 (c) A person licensed as a title insurance agency shall at all times during the term of
2850 licensure be owned or managed by at least one individual who is licensed for at least three
2851 years within the preceding five-year period with both:
2852 (i) a search line of authority; and
2853 (ii) an escrow line of authority.
2855 exempt an attorney with real estate experience from the experience requirements in Subsection
2857 (2) (a) A title insurance agency or producer appointed by an insurer shall maintain:
2858 (i) a fidelity bond;
2859 (ii) a professional liability insurance policy; or
2860 (iii) a financial protection:
2861 (A) equivalent to that described in Subsection (2)(a)(i) or (ii); and
2862 (B) that the commissioner considers adequate.
2863 (b) The bond, insurance, or financial protection required by this Subsection (2):
2864 (i) shall be supplied under a contract approved by the commissioner to provide
2865 protection against the improper performance of any service in conjunction with the issuance of
2866 a contract or policy of title insurance; and
2867 (ii) be in a face amount no less than $50,000.
2868 (c) The Title and Escrow Commission may by rule, subject to Section 31A-2-404 ,
2869 exempt title insurance producers from the requirements of this Subsection (2) upon a finding
2870 that, and only so long as, the required policy or bond is generally unavailable at reasonable
2872 (3) A title insurance agency or producer appointed by an insurer may maintain a
2873 reserve fund to the extent monies were deposited before July 1, 2008, and not withdrawn to the
2874 income of the title insurance producer.
2875 (4) An examination for licensure shall include questions regarding the search and
2876 examination of title to real property.
2877 (5) A title insurance producer may not perform the functions of escrow unless the title
2878 insurance producer has been examined on the fiduciary duties and procedures involved in those
2880 (6) The Title and Escrow Commission shall adopt rules, subject to Section 31A-2-404 ,
2881 after consulting with the department and the department's test administrator, establishing an
2882 examination for a license that will satisfy this section.
2883 (7) A license may be issued to a title insurance producer who has qualified:
2884 (a) to perform only searches and examinations of title as specified in Subsection (4);
2885 (b) to handle only escrow arrangements as specified in Subsection (5); or
2886 (c) to act as a title marketing representative.
2887 (8) (a) A person licensed to practice law in Utah is exempt from the requirements of
2888 Subsections (2) and (3) if that person issues 12 or less policies in any 12-month period.
2889 (b) In determining the number of policies issued by a person licensed to practice law in
2890 Utah for purposes of Subsection (8)(a), if the person licensed to practice law in Utah issues a
2891 policy to more than one party to the same closing, the person is considered to have issued only
2892 one policy.
2893 (9) A person licensed to practice law in Utah, whether exempt under Subsection (8) or
2894 not, shall maintain a trust account separate from a law firm trust account for all title and real
2895 estate escrow transactions.
2896 Section 22. Section 31A-23a-406 is amended to read:
2897 31A-23a-406. Title insurance producer's business.
2898 (1) A title insurance producer may do escrow involving real property transactions if all
2899 of the following exist:
2900 (a) the title insurance producer is licensed with:
2901 (i) the title line of authority; and
2902 (ii) the escrow subline of authority;
2903 (b) the title insurance producer is appointed by a title insurer authorized to do business
2904 in the state;
2905 (c) the title insurance producer issues one or more of the following [
2906 part of the transaction:
2907 (i) an owner's policy of title insurance; or
2908 (ii) a lender's policy of title insurance;
2909 (d) [
2910 any escrow:
2914 money that is not related to real estate transactions; [
2916 under the provisions of the escrow; and
2919 (e) earnings on [
2920 any person in accordance with the conditions of the escrow; [
2921 (f) the escrow does not require the title insurance producer to hold:
2922 (i) construction [
2923 (ii) [
2925 (g) if the title insurance producer with an escrow subline of authority conducts a
2926 closing, the title insurance producer is physically present with a borrower, seller, or purchaser
2927 involving real estate that is the subject of the real estate transaction.
2928 (2) Notwithstanding Subsection (1), a title insurance producer may engage in the
2929 escrow business if:
2930 (a) the escrow involves:
2931 (i) a mobile home;
2932 (ii) a grazing right;
2933 (iii) a water right; or
2934 (iv) other personal property authorized by the commissioner; and
2935 (b) the title insurance producer complies with [
2936 except for [
2937 (3) [
2938 (a) [
2939 (b) may only be used to fulfill the terms of the individual escrow under which the
2941 (c) may not be used until [
2942 (4) Assets or property other than escrow [
2943 producer in accordance with an escrow shall be maintained in a manner that will:
2944 (a) reasonably preserve and protect the asset or property from loss, theft, or damages;
2946 (b) otherwise comply with [
2948 (5) (a) A check from the trust account described in Subsection (1)(d) may not be
2949 drawn, executed, or dated, or [
2950 account from which [
2951 consisting of collected [
2952 or dated, or [
2953 (b) As used in this Subsection (5), [
2954 and cleared," and may be disbursed as follows:
2955 (i) cash may be disbursed on the same day the cash is deposited;
2956 (ii) a wire transfer may be disbursed on the same day the wire transfer is deposited; and
2973 (iii) the proceeds of one or more of the following financial instruments may be
2974 disbursed on the same day the financial instruments are deposited if received from a single
2975 party to the real estate transaction and if the aggregate of the financial instruments for the real
2976 estate transaction is less than $10,000:
2977 (A) a cashier's check, certified check, or official check that is drawn on an existing
2978 account at a federally insured financial institution;
2979 (B) a check drawn on the trust account of a principal broker or associate broker
2980 licensed under Title 61, Chapter 2f, Real Estate Licensing and Practices Act, if the title
2981 producer has reasonable and prudent grounds to believe sufficient money will be available
2982 from the trust account on which the check is drawn at the time of disbursement of proceeds
2983 from the title producer's escrow account;
2984 (C) a personal check not to exceed $500 per closing;
2985 (D) a check drawn on the escrow account of another title producer, if the title producer
2986 in the escrow transaction has reasonable and prudent grounds to believe that sufficient money
2987 will be available for withdrawal from the account upon which the check is drawn at the time of
2988 disbursement of money from the escrow account of the title producer in the escrow transaction;
2990 (E) a check issued by a farm credit service authorized under the Farm Credit Act of
2991 1971, 12 U.S.C. Sec. 2001 et seq., as amended.
2992 (c) Money received from a financial instrument described in Subsection (5)(b)(iii)(B)
2993 or (C) may be disbursed:
2994 (i) within the time limits provided under the Expedited Funds Availability Act, 12
2995 U.S.C. Sec. 4001 et seq., as amended, and related regulations of the Federal Reserve System; or
2996 (ii) upon notification from the financial institution to which the money has been
2997 deposited that final settlement has occurred on the deposited financial instrument.
2998 (6) [
3000 (7) [
3001 (a) Section 31A-23a-409 ;
3002 (b) Title 46, Chapter 1, Notaries Public Reform Act; and
3003 (c) any rules adopted by the Title and Escrow Commission, subject to Section
3004 31A-2-404 , that govern escrows.
3005 (8) If a title insurance producer conducts a search for real estate located in the state, the
3006 title insurance producer shall conduct a minimum mandatory search, as defined by rule made
3007 by the Title and Escrow Commission, subject to Section 31A-2-404 .
3008 Section 23. Section 31A-23a-408 is amended to read:
3009 31A-23a-408. Representations of agency.
3011 insurer unless a written agency contract is in effect giving the person authority from the insurer
3012 and the insurer [
3013 Section 24. Section 31A-23a-412 is amended to read:
3014 31A-23a-412. Place of business and residence address -- Records.
3015 (1) (a) [
3017 (i) the address and telephone numbers of [
3019 (ii) a valid business email address at which the commissioner may contact the licensee.
3020 (b) If [
3021 the individual shall [
3022 residence address and telephone number.
3023 (c) A licensee shall notify the commissioner within 30 days of [
3024 the following required to be registered with the commissioner under this section:
3025 (i) an address [
3026 (ii) a telephone number[
3027 (iii) a business email address.
3028 (2) (a) Except as provided under Subsection (3), [
3029 shall keep at the principal place of business address registered under Subsection (1), separate
3030 and distinct books and records of [
3031 (b) The books and records described in Subsection (2)(a) shall:
3032 (i) be in an organized form;
3033 (ii) be available to the commissioner for inspection upon reasonable notice; and
3034 (iii) include all of the following:
3035 (A) if the licensee is a producer, limited line producer, consultant, managing general
3036 agent, or reinsurance intermediary:
3037 (I) a record of each insurance contract procured by or issued through the licensee, with
3038 the names of insurers and insureds, the amount of premium and commissions or other
3039 compensation, and the subject of the insurance;
3040 (II) the names of any other producers, limited line producers, consultants, managing
3041 general agents, or reinsurance intermediaries from whom business is accepted, and of persons
3042 to whom commissions or allowances of any kind are promised or paid; and
3043 (III) a record of [
3044 insurance regulator;
3045 (B) if the licensee is a consultant, a record of each agreement outlining the work
3046 performed and the fee for the work; and
3047 (C) any additional information which:
3048 (I) is customary for a similar business; or
3049 (II) may reasonably be required by the commissioner by rule.
3050 (3) Subsection (2) is satisfied if the books and records specified in Subsection (2) can
3051 be obtained immediately from a central storage place or elsewhere by on-line computer
3052 terminals located at the registered address.
3053 (4) A licensee who represents only a single insurer satisfies Subsection (2) if the
3054 insurer maintains the books and records pursuant to Subsection (2) at a place satisfying
3055 Subsections (1) and (5).
3056 (5) (a) The books and records maintained under Subsection (2) or Section
3057 31A-23a-413 shall be available for the inspection of the commissioner during all business
3058 hours for a period of time after the date of the transaction as specified by the commissioner by
3059 rule, but in no case for less than the current calendar year plus three years.
3060 (b) Discarding books and records after the applicable record retention period has
3061 expired does not place the licensee in violation of a later-adopted longer record retention
3063 Section 25. Section 31A-23a-415 is amended to read:
3064 31A-23a-415. Assessment on title insurance agencies or title insurers -- Account
3066 (1) For purposes of this section:
3067 (a) "Premium" is as defined in Subsection 59-9-101 (3).
3068 (b) "Title insurer" means a person:
3069 (i) making any contract or policy of title insurance as:
3070 (A) insurer;
3071 (B) guarantor; or
3072 (C) surety;
3073 (ii) proposing to make any contract or policy of title insurance as: