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H.B. 29 Enrolled
7 LONG TITLE
8 General Description:
9 This bill modifies the Insurance Code to make various changes related to the regulation
10 of insurance.
11 Highlighted Provisions:
12 This bill:
13 . modifies definition provisions;
14 . addresses annual report to policyholders;
15 . addresses catastrophic coverage of mental health conditions;
16 . amends provisions related to adverse benefit determination review process;
17 . addresses when uniform waiver of coverage forms may be combined or modified;
18 . provides for the establishment of surplus lines producers;
19 . modifies provisions related to inducements;
20 . addresses the regulation of customer service representatives;
21 . modifies definitions related to insurance marketing and licensing;
22 . addresses sharing of commissions;
23 . addresses what constitutes administrative action taken against a person that is to be
24 reported to the commissioner;
25 . clarifies when a line of authority no longer remains in force for a person;
26 . addresses references to the federal Violent Crime Control and Law Enforcement
28 . requires a person who wants to reinstate a voluntarily surrendered license to comply
29 with continuing education requirements;
30 . addresses special requirements for variable contracts lines of authority;
31 . addresses disbursements from certain trust accounts;
32 . modifies language regarding trust obligation for certain money;
33 . addresses payments of claims by administrator;
34 . addresses commissioner's administrative actions;
35 . grants rulemaking authority to the commissioner regarding model regulations
36 related to determining hazardous financial condition of an insurer;
37 . changes dates related to coverage under a pool policy;
38 . addresses education requirements related to bail bond licensing;
39 . addresses filing of forms by bail bond surety companies and surety insurers;
40 . deletes definition of basic benefit plan;
41 . addresses health benefit plan choices;
42 . grants immunity related to good faith communications between insurers or
43 employees of insurers;
44 . increases assessments paid by insurers to fund costs and expenses incurred by the
45 Department of Insurance in the administration, investigation, and enforcement of
46 provisions related to insurance fraud;
47 . addresses reporting by the board of directors of the Utah Defined Contribution Risk
48 Adjuster; and
49 . makes technical and conforming amendments.
50 Money Appropriated in this Bill:
52 Other Special Clauses:
54 Utah Code Sections Affected:
56 31A-1-301, as last amended by Laws of Utah 2011, Chapters 284 and 366
57 31A-2-308, as last amended by Laws of Utah 2009, Chapter 347
58 31A-2-404, as last amended by Laws of Utah 2010, Chapter 10
59 31A-7-302, as enacted by Laws of Utah 1985, Chapter 242
60 31A-22-625, as last amended by Laws of Utah 2011, Chapters 240, 284, 297, 366, and
62 31A-22-629, as last amended by Laws of Utah 2007, Chapter 307
63 31A-22-635, as last amended by Laws of Utah 2011, Chapter 400
64 31A-23a-101, as renumbered and amended by Laws of Utah 2003, Chapter 298
65 31A-23a-102, as last amended by Laws of Utah 2011, Chapter 284
66 31A-23a-103, as renumbered and amended by Laws of Utah 2003, Chapter 298
67 31A-23a-104, as last amended by Laws of Utah 2011, Chapter 337
68 31A-23a-105, as last amended by Laws of Utah 2011, Chapter 337
69 31A-23a-106, as last amended by Laws of Utah 2011, Chapter 284
70 31A-23a-107, as renumbered and amended by Laws of Utah 2003, Chapter 298
71 31A-23a-108, as last amended by Laws of Utah 2005, Chapters 185 and 219
72 31A-23a-109, as last amended by Laws of Utah 2008, Chapter 3
73 31A-23a-111, as last amended by Laws of Utah 2011, Chapter 284
74 31A-23a-113, as last amended by Laws of Utah 2009, Chapter 349
75 31A-23a-115.5, as enacted by Laws of Utah 2011, Chapter 400
76 31A-23a-203, as last amended by Laws of Utah 2011, Chapter 284
77 31A-23a-206, as renumbered and amended by Laws of Utah 2003, Chapter 298
78 31A-23a-301, as enacted by Laws of Utah 2003, Chapter 298
79 31A-23a-302, as last amended by Laws of Utah 2009, Chapter 349
80 31A-23a-402.5, as enacted by Laws of Utah 2011, Chapter 62
81 31A-23a-406, as last amended by Laws of Utah 2011, Chapter 284
82 31A-23a-409, as last amended by Laws of Utah 2011, Chapter 342
83 31A-23a-412, as last amended by Laws of Utah 2011, Chapter 284
84 31A-23a-504, as last amended by Laws of Utah 2011, Chapter 62
85 31A-25-203, as last amended by Laws of Utah 2009, Chapter 349
86 31A-25-306, as enacted by Laws of Utah 1985, Chapter 242
87 31A-26-203, as last amended by Laws of Utah 2009, Chapter 349
88 31A-27-503, as renumbered and amended by Laws of Utah 2007, Chapter 309
89 31A-27a-101, as enacted by Laws of Utah 2007, Chapter 309
90 31A-27a-104, as last amended by Laws of Utah 2009, Chapter 355
91 31A-29-112, as last amended by Laws of Utah 2004, Chapter 2
92 31A-30-103, as last amended by Laws of Utah 2011, Chapters 284 and 400
93 31A-30-109, as last amended by Laws of Utah 2009, Chapter 12
94 31A-30-112, as last amended by Laws of Utah 2011, Chapter 284
95 31A-31-105, as last amended by Laws of Utah 2008, Chapter 150
96 31A-31-108, as last amended by Laws of Utah 2011, Chapter 284
97 31A-35-401.5, as enacted by Laws of Utah 2011, Chapter 179
98 31A-35-607, as last amended by Laws of Utah 2000, Chapter 259
99 31A-41-301, as enacted by Laws of Utah 2008, Chapter 220
100 31A-42-203, as enacted by Laws of Utah 2009, Chapter 12
102 Be it enacted by the Legislature of the state of Utah:
103 Section 1. Section 31A-1-301 is amended to read:
104 31A-1-301. Definitions.
105 As used in this title, unless otherwise specified:
106 (1) (a) "Accident and health insurance" means insurance to provide protection against
107 economic losses resulting from:
108 (i) a medical condition including:
109 (A) a medical care expense; or
110 (B) the risk of disability;
111 (ii) accident; or
112 (iii) sickness.
113 (b) "Accident and health insurance":
114 (i) includes a contract with disability contingencies including:
115 (A) an income replacement contract;
116 (B) a health care contract;
117 (C) an expense reimbursement contract;
118 (D) a credit accident and health contract;
119 (E) a continuing care contract; and
120 (F) a long-term care contract; and
121 (ii) may provide:
122 (A) hospital coverage;
123 (B) surgical coverage;
124 (C) medical coverage;
125 (D) loss of income coverage;
126 (E) prescription drug coverage;
127 (F) dental coverage; or
128 (G) vision coverage.
129 (c) "Accident and health insurance" does not include workers' compensation insurance.
130 (2) "Actuary" is as defined by the commissioner by rule, made in accordance with Title
131 63G, Chapter 3, Utah Administrative Rulemaking Act.
132 (3) "Administrator" is defined in Subsection [
133 (4) "Adult" means an individual who has attained the age of at least 18 years.
134 (5) "Affiliate" means a person who controls, is controlled by, or is under common
135 control with, another person. A corporation is an affiliate of another corporation, regardless of
136 ownership, if substantially the same group of individuals manage the corporations.
137 (6) "Agency" means:
138 (a) a person other than an individual, including a sole proprietorship by which an
139 individual does business under an assumed name; and
140 (b) an insurance organization licensed or required to be licensed under Section
141 31A-23a-301 , 31A-25-207 , or 31A-26-209 .
142 (7) "Alien insurer" means an insurer domiciled outside the United States.
143 (8) "Amendment" means an endorsement to an insurance policy or certificate.
144 (9) "Annuity" means an agreement to make periodical payments for a period certain or
145 over the lifetime of one or more individuals if the making or continuance of all or some of the
146 series of the payments, or the amount of the payment, is dependent upon the continuance of
147 human life.
148 (10) "Application" means a document:
149 (a) (i) completed by an applicant to provide information about the risk to be insured;
151 (ii) that contains information that is used by the insurer to evaluate risk and decide
152 whether to:
153 (A) insure the risk under:
154 (I) the coverage as originally offered; or
155 (II) a modification of the coverage as originally offered; or
156 (B) decline to insure the risk; or
157 (b) used by the insurer to gather information from the applicant before issuance of an
158 annuity contract.
159 (11) "Articles" or "articles of incorporation" means:
160 (a) the original articles;
161 (b) a special law;
162 (c) a charter;
163 (d) an amendment;
164 (e) restated articles;
165 (f) articles of merger or consolidation;
166 (g) a trust instrument;
167 (h) another constitutive document for a trust or other entity that is not a corporation;
169 (i) an amendment to an item listed in Subsections (11)(a) through (h).
170 (12) "Bail bond insurance" means a guarantee that a person will attend court when
171 required, up to and including surrender of the person in execution of a sentence imposed under
172 Subsection 77-20-7 (1), as a condition to the release of that person from confinement.
173 (13) "Binder" is defined in Section 31A-21-102 .
174 (14) "Blanket insurance policy" means a group policy covering a defined class of
176 (a) without individual underwriting or application; and
177 (b) that is determined by definition without designating each person covered.
178 (15) "Board," "board of trustees," or "board of directors" means the group of persons
179 with responsibility over, or management of, a corporation, however designated.
180 (16) "Bona fide office" means a physical office in this state:
181 (a) that is open to the public;
182 (b) that is staffed during regular business hours on regular business days; and
183 (c) at which the public may appear in person to obtain services.
184 (17) "Business entity" means:
185 (a) a corporation;
186 (b) an association;
187 (c) a partnership;
188 (d) a limited liability company;
189 (e) a limited liability partnership; or
190 (f) another legal entity.
191 (18) "Business of insurance" is defined in Subsection [
192 (19) "Business plan" means the information required to be supplied to the
193 commissioner under Subsections 31A-5-204 (2)(i) and (j), including the information required
194 when these subsections apply by reference under:
195 (a) Section 31A-7-201 ;
196 (b) Section 31A-8-205 ; or
197 (c) Subsection 31A-9-205 (2).
198 (20) (a) "Bylaws" means the rules adopted for the regulation or management of a
199 corporation's affairs, however designated.
200 (b) "Bylaws" includes comparable rules for a trust or other entity that is not a
202 (21) "Captive insurance company" means:
203 (a) an insurer:
204 (i) owned by another organization; and
205 (ii) whose exclusive purpose is to insure risks of the parent organization and an
206 affiliated company; or
207 (b) in the case of a group or association, an insurer:
208 (i) owned by the insureds; and
209 (ii) whose exclusive purpose is to insure risks of:
210 (A) a member organization;
211 (B) a group member; or
212 (C) an affiliate of:
213 (I) a member organization; or
214 (II) a group member.
215 (22) "Casualty insurance" means liability insurance.
216 (23) "Certificate" means evidence of insurance given to:
217 (a) an insured under a group insurance policy; or
218 (b) a third party.
219 (24) "Certificate of authority" is included within the term "license."
220 (25) "Claim," unless the context otherwise requires, means a request or demand on an
221 insurer for payment of a benefit according to the terms of an insurance policy.
222 (26) "Claims-made coverage" means an insurance contract or provision limiting
223 coverage under a policy insuring against legal liability to claims that are first made against the
224 insured while the policy is in force.
225 (27) (a) "Commissioner" or "commissioner of insurance" means Utah's insurance
227 (b) When appropriate, the terms listed in Subsection (27)(a) apply to the equivalent
228 supervisory official of another jurisdiction.
229 (28) (a) "Continuing care insurance" means insurance that:
230 (i) provides board and lodging;
231 (ii) provides one or more of the following:
232 (A) a personal service;
233 (B) a nursing service;
234 (C) a medical service; or
235 (D) any other health-related service; and
236 (iii) provides the coverage described in this Subsection (28)(a) under an agreement
238 (A) for the life of the insured; or
239 (B) for a period in excess of one year.
240 (b) Insurance is continuing care insurance regardless of whether or not the board and
241 lodging are provided at the same location as a service described in Subsection (28)(a)(ii).
242 (29) (a) "Control," "controlling," "controlled," or "under common control" means the
243 direct or indirect possession of the power to direct or cause the direction of the management
244 and policies of a person. This control may be:
245 (i) by contract;
246 (ii) by common management;
247 (iii) through the ownership of voting securities; or
248 (iv) by a means other than those described in Subsections (29)(a)(i) through (iii).
249 (b) There is no presumption that an individual holding an official position with another
250 person controls that person solely by reason of the position.
251 (c) A person having a contract or arrangement giving control is considered to have
252 control despite the illegality or invalidity of the contract or arrangement.
253 (d) There is a rebuttable presumption of control in a person who directly or indirectly
254 owns, controls, holds with the power to vote, or holds proxies to vote 10% or more of the
255 voting securities of another person.
256 (30) "Controlled insurer" means a licensed insurer that is either directly or indirectly
257 controlled by a producer.
258 (31) "Controlling person" means a person that directly or indirectly has the power to
259 direct or cause to be directed, the management, control, or activities of a reinsurance
261 (32) "Controlling producer" means a producer who directly or indirectly controls an
263 (33) (a) "Corporation" means an insurance corporation, except when referring to:
264 (i) a corporation doing business:
265 (A) as:
266 (I) an insurance producer;
267 (II) a surplus lines producer;
274 (B) under:
275 (I) Chapter 23a, Insurance Marketing - Licensing Producers, Consultants, and
276 Reinsurance Intermediaries;
277 (II) Chapter 25, Third Party Administrators; or
278 (III) Chapter 26, Insurance Adjusters; or
279 (ii) a noninsurer that is part of a holding company system under Chapter 16, Insurance
280 Holding Companies.
281 (b) "Stock corporation" means a stock insurance corporation.
282 (c) "Mutual" or "mutual corporation" means a mutual insurance corporation.
283 (34) (a) "Creditable coverage" has the same meaning as provided in federal regulations
284 adopted pursuant to the Health Insurance Portability and Accountability Act.
285 (b) "Creditable coverage" includes coverage that is offered through a public health plan
286 such as:
287 (i) the Primary Care Network Program under a Medicaid primary care network
288 demonstration waiver obtained subject to Section 26-18-3 ;
289 (ii) the Children's Health Insurance Program under Section 26-40-106 ; or
290 (iii) the Ryan White Program Comprehensive AIDS Resources Emergency Act, Pub. L.
291 101-381, and Ryan White HIV/AIDS Treatment Modernization Act of 2006, Pub. L. 109-415.
292 (35) "Credit accident and health insurance" means insurance on a debtor to provide
293 indemnity for payments coming due on a specific loan or other credit transaction while the
294 debtor has a disability.
295 (36) (a) "Credit insurance" means insurance offered in connection with an extension of
296 credit that is limited to partially or wholly extinguishing that credit obligation.
297 (b) "Credit insurance" includes:
298 (i) credit accident and health insurance;
299 (ii) credit life insurance;
300 (iii) credit property insurance;
301 (iv) credit unemployment insurance;
302 (v) guaranteed automobile protection insurance;
303 (vi) involuntary unemployment insurance;
304 (vii) mortgage accident and health insurance;
305 (viii) mortgage guaranty insurance; and
306 (ix) mortgage life insurance.
307 (37) "Credit life insurance" means insurance on the life of a debtor in connection with
308 an extension of credit that pays a person if the debtor dies.
309 (38) "Credit property insurance" means insurance:
310 (a) offered in connection with an extension of credit; and
311 (b) that protects the property until the debt is paid.
312 (39) "Credit unemployment insurance" means insurance:
313 (a) offered in connection with an extension of credit; and
314 (b) that provides indemnity if the debtor is unemployed for payments coming due on a:
315 (i) specific loan; or
316 (ii) credit transaction.
317 (40) "Creditor" means a person, including an insured, having a claim, whether:
318 (a) matured;
319 (b) unmatured;
320 (c) liquidated;
321 (d) unliquidated;
322 (e) secured;
323 (f) unsecured;
324 (g) absolute;
325 (h) fixed; or
326 (i) contingent.
327 (41) (a) "Crop insurance" means insurance providing protection against damage to
328 crops from unfavorable weather conditions, fire or lightning, flood, hail, insect infestation,
329 disease, or other yield-reducing conditions or perils that is:
330 (i) provided by the private insurance market; or
331 (ii) subsidized by the Federal Crop Insurance Corporation.
332 (b) "Crop insurance" includes multiperil crop insurance.
334 insurance service and insurance product information:
335 (i) for the customer service representative's:
336 (A) producer; [
337 (B) surplus lines producer; or
339 (ii) to the customer service representative's employer's:
340 (A) customer;
341 (B) client; or
342 (C) organization.
343 (b) A customer service representative may only operate within the scope of authority of
344 the customer service representative's producer, surplus lines producer, or consultant employer.
346 (a) imposed by:
347 (i) statute;
348 (ii) rule; or
349 (iii) order; and
350 (b) by which a required filing or payment must be received by the department.
352 occurrence of a condition precedent, the commissioner is considered to have taken a specific
353 action. If the statute so provides, a condition precedent may be the commissioner's failure to
354 take a specific action.
356 determined by counting the generations separating one person from a common ancestor and
357 then counting the generations to the other person.
361 or totally limits an individual's ability to:
362 (a) perform the duties of:
363 (i) that individual's occupation; or
364 (ii) any occupation for which the individual is reasonably suited by education, training,
365 or experience; or
366 (b) perform two or more of the following basic activities of daily living:
367 (i) eating;
368 (ii) toileting;
369 (iii) transferring;
370 (iv) bathing; or
371 (v) dressing.
375 (a) is incorporated;
376 (b) is organized; or
377 (c) in the case of an alien insurer, enters into the United States.
379 (i) an employee who:
380 (A) works on a full-time basis; and
381 (B) has a normal work week of 30 or more hours; or
382 (ii) a person described in Subsection [
383 (b) "Eligible employee" includes, if the individual is included under a health benefit
384 plan of a small employer:
385 (i) a sole proprietor;
386 (ii) a partner in a partnership; or
387 (iii) an independent contractor.
388 (c) "Eligible employee" does not include, unless eligible under Subsection [
390 (i) an individual who works on a temporary or substitute basis for a small employer;
391 (ii) an employer's spouse; or
392 (iii) a dependent of an employer.
395 (a) an employee; or
396 (b) a dependent of an employee.
398 (i) established or maintained, whether directly or through a trustee, by:
399 (A) one or more employers;
400 (B) one or more labor organizations; or
401 (C) a combination of employers and labor organizations; and
402 (ii) that provides employee benefits paid or contracted to be paid, other than income
403 from investments of the fund:
404 (A) by or on behalf of an employer doing business in this state; or
405 (B) for the benefit of a person employed in this state.
406 (b) "Employee welfare fund" includes a plan funded or subsidized by a user fee or tax
409 to modify the policy or certificate coverage.
411 (a) the first day of coverage; or
412 (b) if there is a waiting period, the first day of the waiting period.
414 (i) a real estate settlement or real estate closing conducted by a third party pursuant to
415 the requirements of a written agreement between the parties in a real estate transaction; or
416 (ii) a settlement or closing involving:
417 (A) a mobile home;
418 (B) a grazing right;
419 (C) a water right; or
420 (D) other personal property authorized by the commissioner.
421 (b) "Escrow" includes the act of conducting a:
422 (i) real estate settlement; or
423 (ii) real estate closing.
425 (a) an insurance producer with:
426 (i) a title insurance line of authority; and
427 (ii) an escrow subline of authority; or
428 (b) a person defined as an escrow agent in Section 7-22-101 .
430 also excluded.
431 (b) The items listed in a list using the term "excludes" are representative examples for
432 use in interpretation of this title.
434 insurer does not provide insurance coverage, for whatever reason, for one of the following:
435 (a) a specific physical condition;
436 (b) a specific medical procedure;
437 (c) a specific disease or disorder; or
438 (d) a specific prescription drug or class of prescription drugs.
440 (a) written to provide a payment for an expense relating to hospital confinement
441 resulting from illness or injury; and
442 (b) written:
443 (i) as a daily limit for a specific number of days in a hospital; and
444 (ii) to have a one or two day waiting period following a hospitalization.
446 holding a position of public or private trust.
448 (i) submitted to the department as required by and in accordance with applicable
449 statute, rule, or filing order;
450 (ii) received by the department within the time period provided in applicable statute,
451 rule, or filing order; and
452 (iii) accompanied by the appropriate fee in accordance with:
453 (A) Section 31A-3-103 ; or
454 (B) rule.
455 (b) "Filed" does not include a filing that is rejected by the department because it is not
456 submitted in accordance with Subsection [
458 department including:
459 (a) a policy;
460 (b) a rate;
461 (c) a form;
462 (d) a document;
463 (e) a plan;
464 (f) a manual;
465 (g) an application;
466 (h) a report;
467 (i) a certificate;
468 (j) an endorsement;
469 (k) an actuarial certification;
470 (l) a licensee annual statement;
471 (m) a licensee renewal application;
472 (n) an advertisement; or
473 (o) an outline of coverage.
475 insurer agrees to pay a claim submitted to it by the insured for the insured's losses.
477 an alien insurer.
479 (i) a policy;
480 (ii) a certificate;
481 (iii) an application;
482 (iv) an outline of coverage; or
483 (v) an endorsement.
484 (b) "Form" does not include a document specially prepared for use in an individual
487 through a mass marketing arrangement involving a defined class of persons related in some
488 way other than through the purchase of insurance.
490 (a) the general lines of insurance in Subsection [
491 (b) title insurance under one of the following sublines of authority:
492 (i) search, including authority to act as a title marketing representative;
493 (ii) escrow, including authority to act as a title marketing representative; and
494 (iii) title marketing representative only;
495 (c) surplus lines;
496 (d) workers' compensation; and
497 (e) any other line of insurance that the commissioner considers necessary to recognize
498 in the public interest.
500 (a) accident and health;
501 (b) casualty;
502 (c) life;
503 (d) personal lines;
504 (e) property; and
505 (f) variable contracts, including variable life and annuity.
507 that the plan provides medical care:
508 (a) (i) to an employee; or
509 (ii) to a dependent of an employee; and
510 (b) (i) directly;
511 (ii) through insurance reimbursement; or
512 (iii) through another method.
514 that is issued:
515 (i) to a policyholder on behalf of the group; and
516 (ii) for the benefit of a member of the group who is selected under a procedure defined
518 (A) the policy; or
519 (B) an agreement that is collateral to the policy.
520 (b) A group insurance policy may include a member of the policyholder's family or a
523 connection with an extension of credit that pays the difference in amount between the
524 insurance settlement and the balance of the loan if the insured automobile is a total loss.
526 means a policy or certificate that:
527 (i) provides health care insurance;
528 (ii) provides major medical expense insurance; or
529 (iii) is offered as a substitute for hospital or medical expense insurance, such as:
530 (A) a hospital confinement indemnity; or
531 (B) a limited benefit plan.
532 (b) "Health benefit plan" does not include a policy or certificate that:
533 (i) provides benefits solely for:
534 (A) accident;
535 (B) dental;
536 (C) income replacement;
537 (D) long-term care;
538 (E) a Medicare supplement;
539 (F) a specified disease;
540 (G) vision; or
541 (H) a short-term limited duration; or
542 (ii) is offered and marketed as supplemental health insurance.
544 treatment, mitigation, or prevention of a human ailment or impairment:
545 (a) a professional service;
546 (b) a personal service;
547 (c) a facility;
548 (d) equipment;
549 (e) a device;
550 (f) supplies; or
551 (g) medicine.
554 (i) a health care benefit; or
555 (ii) payment of an incurred health care expense.
556 (b) "Health care insurance" or "health insurance" does not include accident and health
557 insurance providing a benefit for:
558 (i) replacement of income;
559 (ii) short-term accident;
560 (iii) fixed indemnity;
561 (iv) credit accident and health;
562 (v) supplements to liability;
563 (vi) workers' compensation;
564 (vii) automobile medical payment;
565 (viii) no-fault automobile;
566 (ix) equivalent self-insurance; or
567 (x) a type of accident and health insurance coverage that is a part of or attached to
568 another type of policy.
570 Insurance Portability and Accountability Act of 1996, Pub. L. 104-191, 110 Stat. 1936, as
573 insurance written to provide payments to replace income lost from accident or sickness.
575 insured loss.
577 under Section 31A-26-201 who engages in insurance adjusting as a representative of an insurer.
579 Section 31A-15-104 .
582 (a) property in transit on or over land;
583 (b) property in transit over water by means other than boat or ship;
584 (c) bailee liability;
585 (d) fixed transportation property such as bridges, electric transmission systems, radio
586 and television transmission towers and tunnels; and
587 (e) personal and commercial property floaters.
589 (a) an insurer is unable to pay its debts or meet its obligations as the debts and
590 obligations mature;
591 (b) an insurer's total adjusted capital is less than the insurer's mandatory control level
592 RBC under Subsection 31A-17-601 (8)(c); or
593 (c) an insurer is determined to be hazardous under this title.
595 (i) an arrangement, contract, or plan for the transfer of a risk or risks from one or more
596 persons to one or more other persons; or
597 (ii) an arrangement, contract, or plan for the distribution of a risk or risks among a
598 group of persons that includes the person seeking to distribute that person's risk.
599 (b) "Insurance" includes:
600 (i) a risk distributing arrangement providing for compensation or replacement for
601 damages or loss through the provision of a service or a benefit in kind;
602 (ii) a contract of guaranty or suretyship entered into by the guarantor or surety as a
603 business and not as merely incidental to a business transaction; and
604 (iii) a plan in which the risk does not rest upon the person who makes an arrangement,
605 but with a class of persons who have agreed to share the risk.
607 negotiation, or settlement of a claim under an insurance policy other than life insurance or an
608 annuity, on behalf of an insurer, policyholder, or a claimant under an insurance policy.
610 (a) providing health care insurance by an organization that is or is required to be
611 licensed under this title;
612 (b) providing a benefit to an employee in the event of a contingency not within the
613 control of the employee, in which the employee is entitled to the benefit as a right, which
614 benefit may be provided either:
615 (i) by a single employer or by multiple employer groups; or
616 (ii) through one or more trusts, associations, or other entities;
617 (c) providing an annuity:
618 (i) including an annuity issued in return for a gift; and
619 (ii) except an annuity provided by a person specified in Subsections 31A-22-1305 (2)
620 and (3);
621 (d) providing the characteristic services of a motor club as outlined in Subsection
623 (e) providing another person with insurance;
624 (f) making as insurer, guarantor, or surety, or proposing to make as insurer, guarantor,
625 or surety, a contract or policy of title insurance;
626 (g) transacting or proposing to transact any phase of title insurance, including:
627 (i) solicitation;
628 (ii) negotiation preliminary to execution;
629 (iii) execution of a contract of title insurance;
630 (iv) insuring; and
631 (v) transacting matters subsequent to the execution of the contract and arising out of
632 the contract, including reinsurance;
633 (h) transacting or proposing a life settlement; and
634 (i) doing, or proposing to do, any business in substance equivalent to Subsections
637 (a) advises another person about insurance needs and coverages;
638 (b) is compensated by the person advised on a basis not directly related to the insurance
639 placed; and
640 (c) except as provided in Section 31A-23a-501 , is not compensated directly or
641 indirectly by an insurer or producer for advice given.
643 affiliated persons, at least one of whom is an insurer.
645 to be licensed under the laws of this state to sell, solicit, or negotiate insurance.
646 (b) (i) "Producer for the insurer" means a producer who is compensated directly or
647 indirectly by an insurer for selling, soliciting, or negotiating an insurance product of that
649 (ii) "Producer for the insurer" may be referred to as an "agent."
650 (c) (i) "Producer for the insured" means a producer who:
651 (A) is compensated directly and only by an insurance customer or an insured; and
652 (B) receives no compensation directly or indirectly from an insurer for selling,
653 soliciting, or negotiating an insurance product of that insurer to an insurance customer or
655 (ii) "Producer for the insured" may be referred to as a "broker."
657 makes a promise in an insurance policy and includes:
658 (i) a policyholder;
659 (ii) a subscriber;
660 (iii) a member; and
661 (iv) a beneficiary.
662 (b) The definition in Subsection [
663 (i) applies only to this title; and
664 (ii) does not define the meaning of this word as used in an insurance policy or
668 (i) a fraternal benefit society;
669 (ii) an issuer of a gift annuity other than an annuity specified in Subsections
670 31A-22-1305 (2) and (3);
671 (iii) a motor club;
672 (iv) an employee welfare plan; and
673 (v) a person purporting or intending to do an insurance business as a principal on that
674 person's own account.
675 (b) "Insurer" does not include a governmental entity to the extent the governmental
676 entity is engaged in an activity described in Section 31A-12-107 .
679 (a) offered in connection with an extension of credit; and
680 (b) that provides indemnity if the debtor is involuntarily unemployed for payments
681 coming due on a:
682 (i) specific loan; or
683 (ii) credit transaction.
685 employer who, with respect to a calendar year and to a plan year:
686 (a) employed an average of at least 51 eligible employees on each business day during
687 the preceding calendar year; and
688 (b) employs at least two employees on the first day of the plan year.
690 individual whose enrollment is a late enrollment.
692 enrollment of an individual other than:
693 (a) on the earliest date on which coverage can become effective for the individual
694 under the terms of the plan; or
695 (b) through special enrollment.
697 31A-1-103 , "legal expense insurance" means insurance written to indemnify or pay for a
698 specified legal expense.
699 (b) "Legal expense insurance" includes an arrangement that creates a reasonable
700 expectation of an enforceable right.
701 (c) "Legal expense insurance" does not include the provision of, or reimbursement for,
702 legal services incidental to other insurance coverage.
704 (i) for death, injury, or disability of a human being, or for damage to property,
705 exclusive of the coverages under:
706 (A) Subsection [
707 (B) Subsection [
708 (C) Subsection [
709 (ii) for a medical, hospital, surgical, and funeral benefit to a person other than the
710 insured who is injured, irrespective of legal liability of the insured, when issued with or
711 supplemental to insurance against legal liability for the death, injury, or disability of a human
712 being, exclusive of the coverages under:
713 (A) Subsection [
714 (B) Subsection [
715 (C) Subsection [
716 (iii) for loss or damage to property resulting from an accident to or explosion of a
717 boiler, pipe, pressure container, machinery, or apparatus;
718 (iv) for loss or damage to property caused by:
719 (A) the breakage or leakage of a sprinkler, water pipe, or water container; or
720 (B) water entering through a leak or opening in a building; or
721 (v) for other loss or damage properly the subject of insurance not within another kind
722 of insurance as defined in this chapter, if the insurance is not contrary to law or public policy.
723 (b) "Liability insurance" includes:
724 (i) vehicle liability insurance;
725 (ii) residential dwelling liability insurance; and
726 (iii) making inspection of, and issuing a certificate of inspection upon, an elevator,
727 boiler, machinery, or apparatus of any kind when done in connection with insurance on the
728 elevator, boiler, machinery, or apparatus.
730 in an activity that is part of or related to the insurance business.
731 (b) "License" includes a certificate of authority issued to an insurer.
733 (i) insurance on a human life; and
734 (ii) insurance pertaining to or connected with human life.
735 (b) The business of life insurance includes:
736 (i) granting a death benefit;
737 (ii) granting an annuity benefit;
738 (iii) granting an endowment benefit;
739 (iv) granting an additional benefit in the event of death by accident;
740 (v) granting an additional benefit to safeguard the policy against lapse; and
741 (vi) providing an optional method of settlement of proceeds.
743 (a) is issued for a specific product of insurance; and
744 (b) limits an individual or agency to transact only for that product or insurance.
747 (a) credit life;
748 (b) credit accident and health;
749 (c) credit property;
750 (d) credit unemployment;
751 (e) involuntary unemployment;
752 (f) mortgage life;
753 (g) mortgage guaranty;
754 (h) mortgage accident and health;
755 (i) guaranteed automobile protection; and
756 (j) another form of insurance offered in connection with an extension of credit that:
757 (i) is limited to partially or wholly extinguishing the credit obligation; and
758 (ii) the commissioner determines by rule should be designated as a form of limited line
759 credit insurance.
761 solicits, or negotiates one or more forms of limited line credit insurance coverage to an
762 individual through a master, corporate, group, or individual policy.
764 (a) bail bond;
765 (b) limited line credit insurance;
766 (c) legal expense insurance;
767 (d) motor club insurance;
768 (e) car rental related insurance;
769 (f) travel insurance;
770 (g) crop insurance;
771 (h) self-service storage insurance;
772 (i) guaranteed asset protection waiver; and
773 (j) another form of limited insurance that the commissioner determines by rule should
774 be designated a form of limited line insurance.
776 (a) the lines of insurance listed in Subsection [
777 (b) a customer service representative.
779 limited lines insurance.
781 advertised, marketed, offered, or designated to provide coverage:
782 (i) in a setting other than an acute care unit of a hospital;
783 (ii) for not less than 12 consecutive months for a covered person on the basis of:
784 (A) expenses incurred;
785 (B) indemnity;
786 (C) prepayment; or
787 (D) another method;
788 (iii) for one or more necessary or medically necessary services that are:
789 (A) diagnostic;
790 (B) preventative;
791 (C) therapeutic;
792 (D) rehabilitative;
793 (E) maintenance; or
794 (F) personal care; and
795 (iv) that may be issued by:
796 (A) an insurer;
797 (B) a fraternal benefit society;
798 (C) (I) a nonprofit health hospital; and
799 (II) a medical service corporation;
800 (D) a prepaid health plan;
801 (E) a health maintenance organization; or
802 (F) an entity similar to the entities described in Subsections [
803 through (E) to the extent that the entity is otherwise authorized to issue life or health care
805 (b) "Long-term care insurance" includes:
806 (i) any of the following that provide directly or supplement long-term care insurance:
807 (A) a group or individual annuity or rider; or
808 (B) a life insurance policy or rider;
809 (ii) a policy or rider that provides for payment of benefits on the basis of:
810 (A) cognitive impairment; or
811 (B) functional capacity; or
812 (iii) a qualified long-term care insurance contract.
813 (c) "Long-term care insurance" does not include:
814 (i) a policy that is offered primarily to provide basic Medicare supplement coverage;
815 (ii) basic hospital expense coverage;
816 (iii) basic medical/surgical expense coverage;
817 (iv) hospital confinement indemnity coverage;
818 (v) major medical expense coverage;
819 (vi) income replacement or related asset-protection coverage;
820 (vii) accident only coverage;
821 (viii) coverage for a specified:
822 (A) disease; or
823 (B) accident;
824 (ix) limited benefit health coverage; or
825 (x) a life insurance policy that accelerates the death benefit to provide the option of a
826 lump sum payment:
827 (A) if the following are not conditioned on the receipt of long-term care:
828 (I) benefits; or
829 (II) eligibility; and
830 (B) the coverage is for one or more the following qualifying events:
831 (I) terminal illness;
832 (II) medical conditions requiring extraordinary medical intervention; or
833 (III) permanent institutional confinement.
835 incident to the practice and provision of a medical service other than the practice and provision
836 of a dental service.
840 must be constantly maintained by a stock insurance corporation as required by statute.
842 connection with an extension of credit that provides indemnity for payments coming due on a
843 mortgage while the debtor has a disability.
845 mortgagee or other creditor is indemnified against losses caused by the default of a debtor.
847 connection with an extension of credit that pays if the debtor dies.
849 (a) licensed under:
850 (i) Chapter 5, Domestic Stock and Mutual Insurance Corporations;
851 (ii) Chapter 11, Motor Clubs; or
852 (iii) Chapter 14, Foreign Insurers; and
853 (b) that promises for an advance consideration to provide for a stated period of time
854 one or more:
855 (i) legal services under Subsection 31A-11-102 (1)(b);
856 (ii) bail services under Subsection 31A-11-102 (1)(c); or
857 (iii) (A) trip reimbursement;
858 (B) towing services;
859 (C) emergency road services;
860 (D) stolen automobile services;
861 (E) a combination of the services listed in Subsections [
862 (D); or
863 (F) other services given in Subsections 31A-11-102 (1)(b) through (f).
866 (a) that is issued by an insurer; and
867 (b) under which the financing and delivery of medical care is provided, in whole or in
868 part, through a defined set of providers under contract with the insurer, including the financing
869 and delivery of an item paid for as medical care.
871 not entitled to receive a dividend representing a share of the surplus of the insurer.
873 (a) ships or hulls of ships;
874 (b) goods, freight, cargoes, merchandise, effects, disbursements, profits, money,
875 securities, choses in action, evidences of debt, valuable papers, bottomry, respondentia
876 interests, or other cargoes in or awaiting transit over the oceans or inland waterways;
877 (c) earnings such as freight, passage money, commissions, or profits derived from
878 transporting goods or people upon or across the oceans or inland waterways; or
879 (d) a vessel owner or operator as a result of liability to employees, passengers, bailors,
880 owners of other vessels, owners of fixed objects, customs or other authorities, or other persons
881 in connection with maritime activity.
884 health insurance policy.
886 entitled to receive a dividend representing a share of the surplus of the insurer.
888 relating to the minimum percentage of eligible employees that must be enrolled in relation to
889 the total number of eligible employees of an employer reduced by each eligible employee who
890 voluntarily declines coverage under the plan because the employee:
891 (a) has other group health care insurance coverage; or
892 (b) receives:
893 (i) Medicare, under the Health Insurance for the Aged Act, Title XVIII of the Social
894 Security Amendments of 1965; or
895 (ii) another government health benefit.
897 (a) an individual;
898 (b) a partnership;
899 (c) a corporation;
900 (d) an incorporated or unincorporated association;
901 (e) a joint stock company;
902 (f) a trust;
903 (g) a limited liability company;
904 (h) a reciprocal;
905 (i) a syndicate; or
906 (j) another similar entity or combination of entities acting in concert.
908 coverage sold for primarily noncommercial purposes to:
909 (a) an individual; or
910 (b) a family.
913 (a) the year that is designated as the plan year in:
914 (i) the plan document of a group health plan; or
915 (ii) a summary plan description of a group health plan;
916 (b) if the plan document or summary plan description does not designate a plan year or
917 there is no plan document or summary plan description:
918 (i) the year used to determine deductibles or limits;
919 (ii) the policy year, if the plan does not impose deductibles or limits on a yearly basis;
921 (iii) the employer's taxable year if:
922 (A) the plan does not impose deductibles or limits on a yearly basis; and
923 (B) (I) the plan is not insured; or
924 (II) the insurance policy is not renewed on an annual basis; or
925 (c) in a case not described in Subsection [
927 application that:
928 (i) purports to be an enforceable contract; and
929 (ii) memorializes in writing some or all of the terms of an insurance contract.
930 (b) "Policy" includes a service contract issued by:
931 (i) a motor club under Chapter 11, Motor Clubs;
932 (ii) a service contract provided under Chapter 6a, Service Contracts; and
933 (iii) a corporation licensed under:
934 (A) Chapter 7, Nonprofit Health Service Insurance Corporations; or
935 (B) Chapter 8, Health Maintenance Organizations and Limited Health Plans.
936 (c) "Policy" does not include:
937 (i) a certificate under a group insurance contract; or
938 (ii) a document that does not purport to have legal effect.
940 contract by ownership, premium payment, or otherwise.
942 nonguaranteed elements of a policy of life insurance over a period of years.
944 insurance policy.
946 (a) means a condition that was present before the effective date of coverage, whether or
947 not medical advice, diagnosis, care, or treatment was recommended or received before that day;
949 (b) does not include a condition indicated by genetic information unless an actual
950 diagnosis of the condition by a physician has been made.
952 (b) "Premium" includes, however designated:
953 (i) an assessment;
954 (ii) a membership fee;
955 (iii) a required contribution; or
956 (iv) monetary consideration.
957 (c) (i) "Premium" does not include consideration paid to a third party administrator for
958 the third party administrator's services.
959 (ii) "Premium" includes an amount paid by a third party administrator to an insurer for
960 insurance on the risks administered by the third party administrator.
962 Subsection 31A-5-203 (3).
965 incident to the practice of a profession and provision of a professional service.
967 insurance" means insurance against loss or damage to real or personal property of every kind
968 and any interest in that property:
969 (i) from all hazards or causes; and
970 (ii) against loss consequential upon the loss or damage including vehicle
971 comprehensive and vehicle physical damage coverages.
972 (b) "Property insurance" does not include:
973 (i) inland marine insurance; and
974 (ii) ocean marine insurance.
976 long-term care insurance contract" means:
977 (a) an individual or group insurance contract that meets the requirements of Section
978 7702B(b), Internal Revenue Code; or
979 (b) the portion of a life insurance contract that provides long-term care insurance:
980 (i) (A) by rider; or
981 (B) as a part of the contract; and
982 (ii) that satisfies the requirements of Sections 7702B(b) and (e), Internal Revenue
985 (a) is:
986 (i) organized under the laws of the United States or any state; or
987 (ii) in the case of a United States office of a foreign banking organization, licensed
988 under the laws of the United States or any state;
989 (b) is regulated, supervised, and examined by a United States federal or state authority
990 having regulatory authority over a bank or trust company; and
991 (c) meets the standards of financial condition and standing that are considered
992 necessary and appropriate to regulate the quality of a financial institution whose letters of credit
993 will be acceptable to the commissioner as determined by:
994 (i) the commissioner by rule; or
995 (ii) the Securities Valuation Office of the National Association of Insurance
998 (i) the cost of a given unit of insurance; or
999 (ii) for property or casualty insurance, that cost of insurance per exposure unit either
1000 expressed as:
1001 (A) a single number; or
1002 (B) a pure premium rate, adjusted before the application of individual risk variations
1003 based on loss or expense considerations to account for the treatment of:
1004 (I) expenses;
1005 (II) profit; and
1006 (III) individual insurer variation in loss experience.
1007 (b) "Rate" does not include a minimum premium.
1009 organization" means a person who assists an insurer in rate making or filing by:
1010 (i) collecting, compiling, and furnishing loss or expense statistics;
1011 (ii) recommending, making, or filing rates or supplementary rate information; or
1012 (iii) advising about rate questions, except as an attorney giving legal advice.
1013 (b) "Rate service organization" does not mean:
1014 (i) an employee of an insurer;
1015 (ii) a single insurer or group of insurers under common control;
1016 (iii) a joint underwriting group; or
1017 (iv) an individual serving as an actuarial or legal consultant.
1019 renewal policy premiums:
1020 (a) a manual of rates;
1021 (b) a classification;
1022 (c) a rate-related underwriting rule; and
1023 (d) a rating formula that describes steps, policies, and procedures for determining
1024 initial and renewal policy premiums.
1026 (a) the date delivered to and stamped received by the department, if delivered in
1028 (b) the post mark date, if delivered by mail;
1029 (c) the delivery service's post mark or pickup date, if delivered by a delivery service;
1030 (d) the received date recorded on an item delivered, if delivered by:
1031 (i) facsimile;
1032 (ii) email; or
1033 (iii) another electronic method; or
1034 (e) a date specified in:
1035 (i) a statute;
1036 (ii) a rule; or
1037 (iii) an order.
1039 association of persons:
1040 (a) operating through an attorney-in-fact common to all of the persons; and
1041 (b) exchanging insurance contracts with one another that provide insurance coverage
1042 on each other.
1044 consideration, transfers any portion of the risk it has assumed to another insurer. In referring to
1045 reinsurance transactions, this title sometimes refers to:
1046 (a) the insurer transferring the risk as the "ceding insurer"; and
1047 (b) the insurer assuming the risk as the:
1048 (i) "assuming insurer"; or
1049 (ii) "assuming reinsurer."
1051 authority to assume reinsurance.
1053 liability resulting from or incident to the ownership, maintenance, or use of a residential
1054 dwelling that is a detached single family residence or multifamily residence up to four units.
1056 assumed under a reinsurance contract.
1057 (b) A reinsurer "retrocedes" when the reinsurer reinsures with another insurer part of a
1058 liability assumed under a reinsurance contract.
1060 (a) an insurance policy; or
1061 (b) an insurance certificate.
1063 (i) note;
1064 (ii) stock;
1065 (iii) bond;
1066 (iv) debenture;
1067 (v) evidence of indebtedness;
1068 (vi) certificate of interest or participation in a profit-sharing agreement;
1069 (vii) collateral-trust certificate;
1070 (viii) preorganization certificate or subscription;
1071 (ix) transferable share;
1072 (x) investment contract;
1073 (xi) voting trust certificate;
1074 (xii) certificate of deposit for a security;
1075 (xiii) certificate of interest of participation in an oil, gas, or mining title or lease or in
1076 payments out of production under such a title or lease;
1077 (xiv) commodity contract or commodity option;
1078 (xv) certificate of interest or participation in, temporary or interim certificate for,
1079 receipt for, guarantee of, or warrant or right to subscribe to or purchase any of the items listed
1080 in Subsections [
1081 (xvi) another interest or instrument commonly known as a security.
1082 (b) "Security" does not include:
1083 (i) any of the following under which an insurance company promises to pay money in a
1084 specific lump sum or periodically for life or some other specified period:
1085 (A) insurance;
1086 (B) an endowment policy; or
1087 (C) an annuity contract; or
1088 (ii) a burial certificate or burial contract.
1090 exclusion from coverage in accident and health insurance.
1092 provides for spreading its own risks by a systematic plan.
1093 (b) Except as provided in this Subsection [
1094 include an arrangement under which a number of persons spread their risks among themselves.
1095 (c) "Self-insurance" includes:
1096 (i) an arrangement by which a governmental entity undertakes to indemnify an
1097 employee for liability arising out of the employee's employment; and
1098 (ii) an arrangement by which a person with a managed program of self-insurance and
1099 risk management undertakes to indemnify its affiliates, subsidiaries, directors, officers, or
1100 employees for liability or risk that is related to the relationship or employment.
1101 (d) "Self-insurance" does not include an arrangement with an independent contractor.
1103 (a) by any means;
1104 (b) for money or its equivalent; and
1105 (c) on behalf of an insurance company.
1107 advertised, marketed, offered, or designed to provide coverage that is similar to long-term care
1108 insurance, but that provides coverage for less than 12 consecutive months for each covered
1111 during each of which an individual does not have creditable coverage.
1113 employer who, with respect to a calendar year and to a plan year:
1114 (a) employed an average of at least two employees but not more than 50 eligible
1115 employees on each business day during the preceding calendar year; and
1116 (b) employs at least two employees on the first day of the plan year.
1118 the same meaning as provided in federal regulations adopted pursuant to the Health Insurance
1119 Portability and Accountability Act.
1121 either directly or indirectly through one or more affiliates or intermediaries.
1122 (b) "Wholly owned subsidiary" of a person is a subsidiary of which all of the voting
1123 shares are owned by that person either alone or with its affiliates, except for the minimum
1124 number of shares the law of the subsidiary's domicile requires to be owned by directors or
1127 (a) a guarantee against loss or damage resulting from the failure of a principal to pay or
1128 perform the principal's obligations to a creditor or other obligee;
1129 (b) bail bond insurance; and
1130 (c) fidelity insurance.
1132 and liabilities.
1133 (b) (i) "Permanent surplus" means the surplus of a mutual insurer that is designated by
1134 the insurer as permanent.
1135 (ii) Sections 31A-5-211 , 31A-7-201 , 31A-8-209 , 31A-9-209 , and 31A-14-209 require
1136 that mutuals doing business in this state maintain specified minimum levels of permanent
1138 (iii) Except for assessable mutuals, the minimum permanent surplus requirement is the
1139 same as the minimum required capital requirement that applies to stock insurers.
1140 (c) "Excess surplus" means:
1141 (i) for a life insurer, accident and health insurer, health organization, or property and
1142 casualty insurer as defined in Section 31A-17-601 , the lesser of:
1143 (A) that amount of an insurer's or health organization's total adjusted capital that
1144 exceeds the product of:
1145 (I) 2.5; and
1146 (II) the sum of the insurer's or health organization's minimum capital or permanent
1147 surplus required under Section 31A-5-211 , 31A-9-209 , or 31A-14-205 ; or
1148 (B) that amount of an insurer's or health organization's total adjusted capital that
1149 exceeds the product of:
1150 (I) 3.0; and
1151 (II) the authorized control level RBC as defined in Subsection 31A-17-601 (8)(a); and
1152 (ii) for a monoline mortgage guaranty insurer, financial guaranty insurer, or title insurer
1153 that amount of an insurer's paid-in-capital and surplus that exceeds the product of:
1154 (A) 1.5; and
1155 (B) the insurer's total adjusted capital required by Subsection 31A-17-609 (1).
1157 collects charges or premiums from, or who, for consideration, adjusts or settles claims of
1158 residents of the state in connection with insurance coverage, annuities, or service insurance
1159 coverage, except:
1160 (a) a union on behalf of its members;
1161 (b) a person administering a:
1162 (i) pension plan subject to the federal Employee Retirement Income Security Act of
1164 (ii) governmental plan as defined in Section 414(d), Internal Revenue Code; or
1165 (iii) nonelecting church plan as described in Section 410(d), Internal Revenue Code;
1166 (c) an employer on behalf of the employer's employees or the employees of one or
1167 more of the subsidiary or affiliated corporations of the employer;
1168 (d) an insurer licensed under the following, but only for a line of insurance for which
1169 the insurer holds a license in this state:
1170 (i) Chapter 5, Domestic Stock and Mutual Insurance Corporations;
1171 (ii) Chapter 7, Nonprofit Health Service Insurance Corporations;
1172 (iii) Chapter 8, Health Maintenance Organizations and Limited Health Plans;
1173 (iv) Chapter 9, Insurance Fraternals; or
1174 (v) Chapter 14, Foreign Insurers; [
1175 (e) a person:
1176 (i) licensed or exempt from licensing under:
1177 (A) Chapter 23a, Insurance Marketing - Licensing Producers, Consultants, and
1178 Reinsurance Intermediaries; or
1179 (B) Chapter 26, Insurance Adjusters; and
1180 (ii) whose activities are limited to those authorized under the license the person holds
1181 or for which the person is exempt[
1182 (f) an institution, bank, or financial institution:
1183 (i) that is:
1184 (A) an institution whose deposits and accounts are to any extent insured by a federal
1185 deposit insurance agency, including the Federal Deposit Insurance Corporation or National
1186 Credit Union Administration; or
1187 (B) a bank or other financial institution that is subject to supervision or examination by
1188 a federal or state banking authority; and
1189 (ii) that does not adjust claims without a third party administrator license.
1191 owner of real or personal property or the holder of liens or encumbrances on that property, or
1192 others interested in the property against loss or damage suffered by reason of liens or
1193 encumbrances upon, defects in, or the unmarketability of the title to the property, or invalidity
1194 or unenforceability of any liens or encumbrances on the property.
1196 organization's statutory capital and surplus as determined in accordance with:
1197 (a) the statutory accounting applicable to the annual financial statements required to be
1198 filed under Section 31A-4-113 ; and
1199 (b) another item provided by the RBC instructions, as RBC instructions is defined in
1200 Section 31A-17-601 .
1202 a corporation.
1203 (b) "Trustee," when used in reference to an employee welfare fund, means an
1204 individual, firm, association, organization, joint stock company, or corporation, whether acting
1205 individually or jointly and whether designated by that name or any other, that is charged with
1206 or has the overall management of an employee welfare fund.
1208 insurer" means an insurer:
1209 (i) not holding a valid certificate of authority to do an insurance business in this state;
1211 (ii) transacting business not authorized by a valid certificate.
1212 (b) "Admitted insurer" or "authorized insurer" means an insurer:
1213 (i) holding a valid certificate of authority to do an insurance business in this state; and
1214 (ii) transacting business as authorized by a valid certificate.
1218 from or incident to ownership, maintenance, or use of a land vehicle or aircraft, exclusive of a
1219 vehicle comprehensive or vehicle physical damage coverage under Subsection [
1221 security convertible into a security with a voting right associated with the security.
1223 pass before coverage for an individual, who is otherwise eligible to enroll under the terms of
1224 the health benefit plan, can become effective.
1226 (a) insurance for indemnification of an employer against liability for compensation
1227 based on:
1228 (i) a compensable accidental injury; and
1229 (ii) occupational disease disability;
1230 (b) employer's liability insurance incidental to workers' compensation insurance and
1231 written in connection with workers' compensation insurance; and
1232 (c) insurance assuring to a person entitled to workers' compensation benefits the
1233 compensation provided by law.
1234 Section 2. Section 31A-2-308 is amended to read:
1235 31A-2-308. Enforcement penalties and procedures.
1236 (1) (a) A person who violates any insurance statute or rule or any order issued under
1237 Subsection 31A-2-201 (4) shall forfeit to the state twice the amount of any profit gained from
1238 the violation, in addition to any other forfeiture or penalty imposed.
1239 (b) (i) The commissioner may order an individual producer, surplus line producer,
1240 limited line producer, [
1241 intermediary, adjuster, or insurance consultant who violates an insurance statute or rule to
1242 forfeit to the state not more than $2,500 for each violation.
1243 (ii) The commissioner may order any other person who violates an insurance statute or
1244 rule to forfeit to the state not more than $5,000 for each violation.
1245 (c) (i) The commissioner may order an individual producer, surplus line producer,
1246 limited line producer, [
1247 intermediary, adjuster, or insurance consultant who violates an order issued under Subsection
1248 31A-2-201 (4) to forfeit to the state not more than $2,500 for each violation. Each day the
1249 violation continues is a separate violation.
1250 (ii) The commissioner may order any other person who violates an order issued under
1251 Subsection 31A-2-201 (4) to forfeit to the state not more than $5,000 for each violation. Each
1252 day the violation continues is a separate violation.
1253 (d) The commissioner may accept or compromise any forfeiture under this Subsection
1254 (1) until after a complaint is filed under Subsection (2). After the filing of the complaint, only
1255 the attorney general may compromise the forfeiture.
1256 (2) When a person fails to comply with an order issued under Subsection
1257 31A-2-201 (4), including a forfeiture order, the commissioner may file an action in any court of
1258 competent jurisdiction or obtain a court order or judgment:
1259 (a) enforcing the commissioner's order;
1260 (b) (i) directing compliance with the commissioner's order and restraining further
1261 violation of the order; and
1262 (ii) subjecting the person ordered to the procedures and sanctions available to the court
1263 for punishing contempt if the failure to comply continues; or
1264 (c) imposing a forfeiture in an amount the court considers just, up to $10,000 for each
1265 day the failure to comply continues after the filing of the complaint until judgment is rendered.
1266 (3) (a) The Utah Rules of Civil Procedure govern actions brought under Subsection (2),
1267 except that the commissioner may file a complaint seeking a court-ordered forfeiture under
1268 Subsection (2)(c) no sooner than two weeks after giving written notice of the commissioner's
1269 intention to proceed under Subsection (2)(c).
1270 (b) The commissioner's order issued under Subsection 31A-2-201 (4) may contain a
1271 notice of intention to seek a court-ordered forfeiture if the commissioner's order is disobeyed.
1272 (4) If, after a court order is issued under Subsection (2), the person fails to comply with
1273 the commissioner's order or judgment:
1274 (a) the commissioner may certify the fact of the failure to the court by affidavit; and
1275 (b) the court may, after a hearing following at least five days written notice to the
1276 parties subject to the order or judgment, amend the order or judgment to add the forfeiture or
1277 forfeitures, as prescribed in Subsection (2)(c), until the person complies.
1278 (5) (a) The proceeds of [
1279 expenses, shall be paid into the General Fund.
1280 (b) The expenses of collection shall be credited to the department's budget.
1281 (c) The attorney general's budget shall be credited to the extent the department
1282 reimburses the attorney general's office for its collection expenses under this section.
1283 (6) (a) Forfeitures and judgments under this section bear interest at the rate charged by
1284 the United States Internal Revenue Service for past due taxes on the:
1285 (i) date of entry of the commissioner's order under Subsection (1); or
1286 (ii) date of judgment under Subsection (2).
1287 (b) Interest accrues from the later of the dates described in Subsection (6)(a) until the
1288 forfeiture and accrued interest are fully paid.
1289 (7) A forfeiture may not be imposed under Subsection (2)(c) if:
1290 (a) at the time the forfeiture action is commenced, the person was in compliance with
1291 the commissioner's order; or
1292 (b) the violation of the order occurred during the order's suspension.
1293 (8) The commissioner may seek an injunction as an alternative to issuing an order
1294 under Subsection 31A-2-201 (4).
1295 (9) (a) A person is guilty of a class B misdemeanor if that person:
1296 (i) intentionally violates:
1297 (A) an insurance statute of this state; or
1298 (B) an order issued under Subsection 31A-2-201 (4);
1299 (ii) intentionally permits a person over whom that person has authority to violate:
1300 (A) an insurance statute of this state; or
1301 (B) an order issued under Subsection 31A-2-201 (4); or
1302 (iii) intentionally aids any person in violating:
1303 (A) an insurance statute of this state; or
1304 (B) an order issued under Subsection 31A-2-201 (4).
1305 (b) Unless a specific criminal penalty is provided elsewhere in this title, the person may
1306 be fined not more than:
1307 (i) $10,000 if a corporation; or
1308 (ii) $5,000 if a person other than a corporation.
1309 (c) If the person is an individual, the person may, in addition, be imprisoned for up to
1310 one year.
1311 (d) As used in this Subsection (9), "intentionally" has the same meaning as under
1312 Subsection 76-2-103 (1).
1313 (10) (a) A person who knowingly and intentionally violates Section 31A-4-102 ,
1314 31A-8a-208 , 31A-15-105 , 31A-23a-116 , or 31A-31-111 is guilty of a felony as provided in this
1315 Subsection (10).
1316 (b) When the value of the property, money, or other things obtained or sought to be
1317 obtained in violation of Subsection (10)(a):
1318 (i) is less than $5,000, a person is guilty of a third degree felony; or
1319 (ii) is or exceeds $5,000, a person is guilty of a second degree felony.
1320 (11) (a) After a hearing, the commissioner may, in whole or in part, revoke, suspend,
1321 place on probation, limit, or refuse to renew the licensee's license or certificate of authority:
1322 (i) when a licensee of the department, other than a domestic insurer:
1323 (A) persistently or substantially violates the insurance law; or
1324 (B) violates an order of the commissioner under Subsection 31A-2-201 (4);
1325 (ii) if there are grounds for delinquency proceedings against the licensee under Section
1326 31A-27a-207 ; or
1327 (iii) if the licensee's methods and practices in the conduct of the licensee's business
1328 endanger, or the licensee's financial resources are inadequate to safeguard, the legitimate
1329 interests of the licensee's customers and the public.
1330 (b) Additional license termination or probation provisions for licensees other than
1331 insurers are set forth in Sections 31A-19a-303 , 31A-19a-304 , 31A-23a-111 , 31A-23a-112 ,
1332 31A-25-208 , 31A-25-209 , 31A-26-213 , 31A-26-214 , 31A-35-501 , and 31A-35-503 .
1333 (12) The enforcement penalties and procedures set forth in this section are not
1334 exclusive, but are cumulative of other rights and remedies the commissioner has pursuant to
1335 applicable law.
1336 Section 3. Section 31A-2-404 is amended to read:
1337 31A-2-404. Duties of the commissioner and Title and Escrow Commission.
1338 (1) Notwithstanding the other provisions of this chapter, to the extent provided in this
1339 part, the commissioner shall administer and enforce the provisions in this title related to:
1340 (a) title insurance; and
1341 (b) escrow conducted by a title licensee or title insurer.
1342 (2) The commission shall:
1343 (a) in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, and
1344 subject to Subsection (3), make rules for the administration of the provisions in this title related
1345 to title insurance including rules related to:
1346 (i) rating standards and rating methods for a title licensee, as provided in Section
1347 31A-19a-209 ;
1348 (ii) the licensing for a title licensee, including the licensing requirements of [
1350 (iii) continuing education requirements of Section 31A-23a-202 ;
1351 (iv) examination procedures, after consultation with the commissioner and the
1352 commissioner's test administrator when required by Section 31A-23a-204 ; and
1353 (v) standards of conduct for a title licensee;
1354 (b) concur in the issuance and renewal of a license in accordance with Section
1355 31A-23a-105 or 31A-26-203 ;
1356 (c) in accordance with Section 31A-3-103 , establish, with the concurrence of the
1357 commissioner, the fees imposed by this title on a title licensee;
1358 (d) in accordance with Section 31A-23a-415 determine, after consulting with the
1359 commissioner, the assessment on a title insurer as defined in Section 31A-23a-415 ;
1360 (e) conduct an administrative hearing not delegated by the commission to an
1361 administrative law judge related to the:
1362 (i) licensing of an applicant;
1363 (ii) conduct of a title licensee; or
1364 (iii) approval of a continuing education program required by Section 31A-23a-202 ;
1365 (f) with the concurrence of the commissioner, approve a continuing education program
1366 required by Section 31A-23a-202 ;
1367 (g) with the concurrence of the commissioner, impose a penalty:
1368 (i) under this title related to:
1369 (A) title insurance; or
1370 (B) escrow conducted by a title licensee;
1371 (ii) after investigation by the commissioner in accordance with Part 3, Procedures and
1372 Enforcement; and
1373 (iii) that is enforced by the commissioner;
1374 (h) advise the commissioner on the administration and enforcement of any matter
1375 affecting the title insurance industry;
1376 (i) advise the commissioner on matters affecting the commissioner's budget related to
1377 title insurance; and
1378 (j) perform other duties as provided in this title.
1379 (3) The commission may make a rule under this title only if at the time the commission
1380 files its proposed rule and rule analysis with the Division of Administrative Rules in
1381 accordance with Section 63G-3-301 , the commission provides the Real Estate Commission that
1382 same information.
1383 (4) (a) The commissioner shall annually report the information described in Subsection
1384 (4)(b) in writing to:
1385 (i) the commission; and
1386 (ii) the Business and Labor Interim Committee.
1387 (b) The information required to be reported under this Subsection (4):
1388 (i) may not identify a person; and
1389 (ii) shall include:
1390 (A) the number of complaints the commissioner receives with regard to transactions
1391 involving title insurance or a title licensee during the calendar year immediately proceeding the
1393 (B) the type of complaints described in Subsection (4)(b)(ii)(A); and
1394 (C) for each complaint described in Subsection (4)(b)(ii)(A):
1395 (I) any action taken by the commissioner with regard to the complaint; and
1396 (II) the time-period beginning the day on which a complaint is made and ending the
1397 day on which the commissioner determines it will take no further action with regard to the
1399 Section 4. Section 31A-7-302 is amended to read:
1400 31A-7-302. Annual report to policyholders.
1401 Every insurer organized or operating under this chapter shall send to each policyholder
1402 or electronically post on the insurer's public website an abbreviated annual report which
1403 contains basic financial and operating data, and information about important business and
1404 corporate developments.
1405 Section 5. Section 31A-22-625 is amended to read:
1406 31A-22-625. Catastrophic coverage of mental health conditions.
1407 (1) As used in this section:
1408 (a) (i) "Catastrophic mental health coverage" means coverage in a health benefit plan
1409 that does not impose a lifetime limit, annual payment limit, episodic limit, inpatient or
1410 outpatient service limit, or maximum out-of-pocket limit that places a greater financial burden
1411 on an insured for the evaluation and treatment of a mental health condition than for the
1412 evaluation and treatment of a physical health condition.
1413 (ii) "Catastrophic mental health coverage" may include a restriction on cost sharing
1414 factors, such as deductibles, copayments, or coinsurance, before reaching a maximum
1415 out-of-pocket limit.
1416 (iii) "Catastrophic mental health coverage" may include one maximum out-of-pocket
1417 limit for physical health conditions and another maximum out-of-pocket limit for mental health
1418 conditions, except that if separate out-of-pocket limits are established, the out-of-pocket limit
1419 for mental health conditions may not exceed the out-of-pocket limit for physical health
1421 (b) (i) "50/50 mental health coverage" means coverage in a health benefit plan that
1422 pays for at least 50% of covered services for the diagnosis and treatment of mental health
1424 (ii) "50/50 mental health coverage" may include a restriction on:
1425 (A) episodic limits;
1426 (B) inpatient or outpatient service limits; or
1427 (C) maximum out-of-pocket limits.
1428 (c) "Large employer" is as defined in 42 U.S.C. Sec. 300gg-91.
1429 (d) (i) "Mental health condition" means a condition or disorder involving mental illness
1430 that falls under a diagnostic category listed in the Diagnostic and Statistical Manual, as
1431 periodically revised.
1432 (ii) "Mental health condition" does not include the following when diagnosed as the
1433 primary or substantial reason or need for treatment:
1434 (A) a marital or family problem;
1435 (B) a social, occupational, religious, or other social maladjustment;
1436 (C) a conduct disorder;
1437 (D) a chronic adjustment disorder;
1438 (E) a psychosexual disorder;
1439 (F) a chronic organic brain syndrome;
1440 (G) a personality disorder;
1441 (H) a specific developmental disorder or learning disability; or
1442 (I) an intellectual disability.
1443 (e) "Small employer" is as defined in 42 U.S.C. Sec. 300gg-91.
1444 (2) (a) At the time of purchase and renewal, an insurer shall offer to a small employer
1445 that it insures or seeks to insure a choice between:
1446 (i) (A) catastrophic mental health coverage; or
1447 (B) federally qualified mental health coverage as described in Subsection (3); and
1448 (ii) 50/50 mental health coverage.
1449 (b) In addition to complying with Subsection (2)(a), an insurer may offer to provide:
1450 (i) catastrophic mental health coverage, 50/50 mental health coverage, or both at levels
1451 that exceed the minimum requirements of this section; or
1452 (ii) coverage that excludes benefits for mental health conditions.
1453 (c) A small employer may, at its option, regardless of the employer's previous coverage
1454 for mental health conditions, choose either:
1455 (i) coverage offered under Subsection (2)(a)(i);
1456 (ii) 50/50 mental health coverage; or
1457 (iii) coverage offered under Subsection (2)(b).
1458 (d) An insurer is exempt from the 30% index rating restriction in Section
1459 31A-30-106.1 and, for the first year only that the employer chooses coverage that meets or
1460 exceeds catastrophic mental health coverage [
1461 in Section 31A-30-106.1 , for any small employer with 20 or less enrolled employees who
1462 chooses coverage that meets or exceeds catastrophic mental health coverage.
1463 (3) An insurer shall offer a large employer mental health and substance use disorder
1464 benefit in compliance with Section 2705 of the Public Health Service Act, 42 U.S.C. Sec.
1465 300gg-26, and federal regulations adopted pursuant to that act.
1466 (4) (a) An insurer may provide catastrophic mental health coverage to a small employer
1467 through a managed care organization or system in a manner consistent with Chapter 8, Health
1468 Maintenance Organizations and Limited Health Plans, regardless of whether the insurance
1469 policy uses a managed care organization or system for the treatment of physical health
1471 (b) (i) Notwithstanding any other provision of this title, an insurer may:
1472 (A) establish a closed panel of providers for catastrophic mental health coverage; and
1473 (B) refuse to provide a benefit to be paid for services rendered by a nonpanel provider
1475 (I) the insured is referred to a nonpanel provider with the prior authorization of the
1476 insurer; and
1477 (II) the nonpanel provider agrees to follow the insurer's protocols and treatment
1479 (ii) If an insured receives services from a nonpanel provider in the manner permitted by
1480 Subsection (4)(b)(i)(B), the insurer shall reimburse the insured for not less than 75% of the
1481 average amount paid by the insurer for comparable services of panel providers under a
1482 noncapitated arrangement who are members of the same class of health care providers.
1483 (iii) This Subsection (4)(b) may not be construed as requiring an insurer to authorize a
1484 referral to a nonpanel provider.
1485 (c) To be eligible for catastrophic mental health coverage, a diagnosis or treatment of a
1486 mental health condition shall be rendered:
1487 (i) by a mental health therapist as defined in Section 58-60-102 ; or
1488 (ii) in a health care facility:
1489 (A) licensed or otherwise authorized to provide mental health services pursuant to:
1490 (I) Title 26, Chapter 21, Health Care Facility Licensing and Inspection Act; or
1491 (II) Title 62A, Chapter 2, Licensure of Programs and Facilities; and
1492 (B) that provides a program for the treatment of a mental health condition pursuant to a
1493 written plan.
1494 (5) The commissioner may prohibit an insurance policy that provides mental health
1495 coverage in a manner that is inconsistent with this section.
1496 (6) The commissioner shall:
1497 (a) adopt rules, in accordance with Title 63G, Chapter 3, Utah Administrative
1498 Rulemaking Act, as necessary to ensure compliance with this section; and
1499 (b) provide general figures on the percentage of insurance policies that include:
1500 (i) no mental health coverage;
1501 (ii) 50/50 mental health coverage;
1502 (iii) catastrophic mental health coverage; and
1503 (iv) coverage that exceeds the minimum requirements of this section.
1504 (7) This section may not be construed as discouraging or otherwise preventing an
1505 insurer from providing mental health coverage in connection with an individual insurance
1507 Section 6. Section 31A-22-629 is amended to read:
1508 31A-22-629. Adverse benefit determination review process.
1509 (1) As used in this section:
1510 (a) (i) "Adverse benefit determination" means the:
1511 (A) denial of a benefit;
1512 (B) reduction of a benefit;
1513 (C) termination of a benefit; or
1514 (D) failure to provide or make payment, in whole or in part, for a benefit.
1515 (ii) "Adverse benefit determination" includes:
1516 (A) denial, reduction, termination, or failure to provide or make payment that is based
1517 on a determination of an insured's or a beneficiary's eligibility to participate in a plan;
1518 (B) [
1520 make payment, in whole or in part, for, a benefit resulting from the application of a utilization
1521 review; [
1522 (C) failure to cover an item or service for which benefits are otherwise provided
1523 because it is determined to be:
1524 (I) experimental;
1525 (II) investigational; or
1526 (III) not medically necessary or appropriate.
1527 (b) "Independent review" means a process that:
1528 (i) is a voluntary option for the resolution of an adverse benefit determination;
1529 (ii) is conducted at the discretion of the claimant;
1530 (iii) is conducted by an independent review organization designated by the insurer;
1531 (iv) renders an independent and impartial decision on an adverse benefit determination
1532 submitted by an insured; and
1533 (v) may not require the insured to pay a fee for requesting the independent review.
1534 (c) "Independent review organization" means a person, subject to Subsection (6), who
1535 conducts an independent external review of adverse determinations.
1536 (d) "Insured" is as defined in Section 31A-1-301 and includes a person who is
1537 authorized to act on the insured's behalf.
1538 (e) "Insurer" is as defined in Section 31A-1-301 and includes:
1539 (i) a health maintenance organization; and
1540 (ii) a third party administrator that offers, sells, manages, or administers a health
1541 insurance policy or health maintenance organization contract that is subject to this title.
1542 (f) "Internal review" means the process an insurer uses to review an insured's adverse
1543 benefit determination before the adverse benefit determination is submitted for independent
1545 (2) This section applies generally to health insurance policies, health maintenance
1546 organization contracts, and income replacement or disability income policies.
1547 (3) (a) An insured may submit an adverse benefit determination to the insurer.
1548 (b) The insurer shall conduct an internal review of the insured's adverse benefit
1550 (c) An insured who disagrees with the results of an internal review may submit the
1551 adverse benefit determination for an independent review if the adverse benefit determination
1553 (i) payment of a claim regarding medical necessity; or
1554 (ii) denial of a claim regarding medical necessity.
1555 (4) The commissioner shall adopt rules that establish minimum standards for:
1556 (a) internal reviews;
1557 (b) independent reviews to ensure independence and impartiality;
1558 (c) the types of adverse benefit determinations that may be submitted to an independent
1559 review; and
1560 (d) the timing of the review process, including an expedited review when medically
1562 (5) Nothing in this section may be construed as:
1563 (a) expanding, extending, or modifying the terms of a policy or contract with respect to
1564 benefits or coverage;
1565 (b) permitting an insurer to charge an insured for the internal review of an adverse
1566 benefit determination;
1567 (c) restricting the use of arbitration in connection with or subsequent to an independent
1568 review; or
1569 (d) altering the legal rights of any party to seek court or other redress in connection
1571 (i) an adverse decision resulting from an independent review, except that if the insurer
1572 is the party seeking legal redress, the insurer shall pay for the reasonable attorney fees of the
1573 insured related to the action and court costs; or
1574 (ii) an adverse benefit determination or other claim that is not eligible for submission
1575 to independent review.
1576 (6) (a) An independent review organization in relation to the insurer may not be:
1577 (i) the insurer;
1578 (ii) the health plan;
1579 (iii) the health plan's fiduciary;
1580 (iv) the employer; or
1581 (v) an employee or agent of any one listed in Subsections (6)(a)(i) through (iv).
1582 (b) An independent review organization may not have a material professional, familial,
1583 or financial conflict of interest with:
1584 (i) the health plan;
1585 (ii) an officer, director, or management employee of the health plan;
1586 (iii) the enrollee;
1587 (iv) the enrollee's health care provider;
1588 (v) the health care provider's medical group or independent practice association;
1589 (vi) a health care facility where service would be provided; or
1590 (vii) the developer or manufacturer of the service that would be provided.
1591 Section 7. Section 31A-22-635 is amended to read:
1592 31A-22-635. Uniform application -- Uniform waiver of coverage -- Information
1593 on Health Insurance Exchange.
1594 (1) For purposes of this section, "insurer":
1595 (a) is defined in Subsection 31A-22-634 (1); and
1596 (b) includes the state employee's risk pool under Section 49-20-202 .
1597 (2) (a) Insurers offering a health benefit plan to an individual or small employer shall
1598 use a uniform application form.
1599 (b) The uniform application form:
1600 (i) except for cancer and transplants, may not include questions about an applicant's
1601 health history prior to the previous five years; and
1602 (ii) shall be shortened and simplified in accordance with rules adopted by the
1604 (c) Insurers offering a health benefit plan to a small employer shall use a uniform
1605 waiver of coverage form, which may not include health status related questions other than
1606 pregnancy, and is limited to:
1607 (i) information that identifies the employee;
1608 (ii) proof of the employee's insurance coverage; and
1609 (iii) a statement that the employee declines coverage with a particular employer group.
1610 (3) Notwithstanding the requirements of Subsection (2)(a), the uniform application and
1611 uniform waiver of coverage forms may, if the combination or modification is approved by the
1612 commissioner, be combined or modified to facilitate a more efficient and consumer friendly
1613 experience for:
1614 (a) enrollees using the Health Insurance Exchange [
1616 (b) insurers using electronic applications.
1617 (4) The uniform application form, and uniform waiver form, shall be adopted and
1618 approved by the commissioner in accordance with Title 63G, Chapter 3, Utah Administrative
1619 Rulemaking Act.
1620 (5) (a) An insurer who offers a health benefit plan in either the group or individual
1621 market on the Health Insurance Exchange created in Section 63M-1-2504 , shall:
1622 (i) accept and process an electronic submission of the uniform application or uniform
1623 waiver from the Health Insurance Exchange using the electronic standards adopted pursuant to
1624 Section 63M-1-2506 ;
1625 (ii) if requested, provide the applicant with a copy of the completed application either
1626 by mail or electronically;
1627 (iii) post all health benefit plans offered by the insurer in the defined contribution
1628 arrangement market on the Health Insurance Exchange; and
1629 (iv) post the information required by Subsection (6) on the Health Insurance Exchange
1630 for every health benefit plan the insurer offers on the Health Insurance Exchange.
1631 (b) Except as provided in Subsection (5)(c), an insurer who posts health benefit plans
1632 on the Health Insurance Exchange may not directly or indirectly offer products on the Health
1633 Insurance Exchange that are not health benefit plans.
1634 (c) Notwithstanding Subsection (5)(b), an insurer may offer a health savings account
1635 on the Health Insurance Exchange.
1636 (6) An insurer shall provide the commissioner and the Health Insurance Exchange with
1637 the following information for each health benefit plan submitted to the Health Insurance
1638 Exchange, in the electronic format required by Subsection 63M-1-2506 (1):
1639 (a) plan design, benefits, and options offered by the health benefit plan including state
1640 mandates the plan does not cover;
1641 (b) information and Internet address to online provider networks;
1642 (c) wellness programs and incentives;
1643 (d) descriptions of prescription drug benefits, exclusions, or limitations;
1644 (e) the percentage of claims paid by the insurer within 30 days of the date a claim is
1645 submitted to the insurer for the prior year; and
1646 (f) the claims denial and insurer transparency information developed in accordance
1647 with Subsection 31A-22-613.5 (4).
1648 (7) The [
1649 Exchange the [
1650 a health benefit plan on the Health Insurance Exchange. The solvency rating for each insurer
1651 shall be based on methodology established by the [
1652 administrative rule and shall be updated each calendar year.
1653 (8) (a) The commissioner may request information from an insurer under Section
1654 31A-22-613.5 to verify the data submitted to the [
1655 Health Insurance Exchange.
1656 (b) The commissioner shall regulate any fees charged by insurers to an enrollee for a
1657 uniform application form or electronic submission of the application forms.
1658 Section 8. Section 31A-23a-101 is amended to read:
1659 31A-23a-101. Purposes.
1660 The purposes of this chapter include:
1661 (1) promoting the professional competence of insurance producers, surplus lines
1662 producers, limited line producers, [
1663 general agents, and reinsurance intermediaries;
1664 (2) providing maximum freedom of marketing methods for insurance, consistent with
1665 the interests of the Utah public;
1666 (3) preserving and encouraging competition at the consumer level;
1667 (4) regulating insurance marketing practices in conformity with the general purposes of
1668 this title;
1669 (5) governing the qualifications and procedures for the licensing of insurance
1670 producers, surplus lines producers, limited line producers, [
1671 consultants, managing general agents, and reinsurance intermediaries; and
1672 (6) promoting uniform licensing requirements between the several states.
1673 Section 9. Section 31A-23a-102 is amended to read:
1674 31A-23a-102. Definitions.
1675 As used in this chapter:
1676 (1) "Bail bond producer" [
1684 (2) "Escrow" means a license subline of authority in conjunction with the title
1685 insurance line of authority that allows a person to conduct escrow as defined in Section
1686 31A-1-301 .
1687 (3) "Home state" means a state or territory of the United States or the District of
1688 Columbia in which an insurance producer:
1689 (a) maintains the insurance producer's principal:
1690 (i) place of residence; or
1691 (ii) place of business; and
1692 (b) is licensed to act as an insurance producer.
1693 (4) "Insurer" is as defined in Section 31A-1-301 , except that the following persons or
1694 similar persons are not insurers for purposes of Part 7, Producer Controlled Insurers:
1695 (a) a risk retention group as defined in:
1696 (i) the Superfund Amendments and Reauthorization Act of 1986, Pub. L. No. 99-499;
1697 (ii) the Risk Retention Act, 15 U.S.C. Sec. 3901 et seq.; and
1698 (iii) Chapter 15, Part 2, Risk Retention Groups Act;
1699 (b) a residual market pool;
1700 (c) a joint underwriting authority or association; and
1701 (d) a captive insurer.
1702 (5) "License" is defined in Section 31A-1-301 .
1703 (6) (a) "Managing general agent" means a person that:
1704 (i) manages all or part of the insurance business of an insurer, including the
1705 management of a separate division, department, or underwriting office;
1706 (ii) acts as an agent for the insurer whether it is known as a managing general agent,
1707 manager, or other similar term;
1708 (iii) produces and underwrites an amount of gross direct written premium equal to, or
1709 more than 5% of, the policyholder surplus as reported in the last annual statement of the insurer
1710 in any one quarter or year:
1711 (A) with or without the authority;
1712 (B) separately or together with an affiliate; and
1713 (C) directly or indirectly; and
1714 (iv) (A) adjusts or pays claims in excess of an amount determined by the
1715 commissioner; or
1716 (B) negotiates reinsurance on behalf of the insurer.
1717 (b) Notwithstanding Subsection (6)(a), the following persons may not be considered as
1718 managing general agent for the purposes of this chapter:
1719 (i) an employee of the insurer;
1720 (ii) a United States manager of the United States branch of an alien insurer;
1721 (iii) an underwriting manager that, pursuant to contract:
1722 (A) manages all the insurance operations of the insurer;
1723 (B) is under common control with the insurer;
1724 (C) is subject to Chapter 16, Insurance Holding Companies; and
1725 (D) is not compensated based on the volume of premiums written; and
1726 (iv) the attorney-in-fact authorized by and acting for the subscribers of a reciprocal
1727 insurer or inter-insurance exchange under powers of attorney.
1728 (7) "Negotiate" means the act of conferring directly with or offering advice directly to a
1729 purchaser or prospective purchaser of a particular contract of insurance concerning a
1730 substantive benefit, term, or condition of the contract if the person engaged in that act:
1731 (a) sells insurance; or
1732 (b) obtains insurance from insurers for purchasers.
1733 (8) "Reinsurance intermediary" means:
1734 (a) a reinsurance intermediary-broker; or
1735 (b) a reinsurance intermediary-manager.
1736 (9) "Reinsurance intermediary-broker" means a person other than an officer or
1737 employee of the ceding insurer, firm, association, or corporation who solicits, negotiates, or
1738 places reinsurance cessions or retrocessions on behalf of a ceding insurer without the authority
1739 or power to bind reinsurance on behalf of the insurer.
1740 (10) (a) "Reinsurance intermediary-manager" means a person who:
1741 (i) has authority to bind or who manages all or part of the assumed reinsurance
1742 business of a reinsurer, including the management of a separate division, department, or
1743 underwriting office; and
1744 (ii) acts as an agent for the reinsurer whether the person is known as a reinsurance
1745 intermediary-manager, manager, or other similar term.
1746 (b) Notwithstanding Subsection (10)(a), the following persons may not be considered
1747 reinsurance intermediary-managers for the purpose of this chapter with respect to the reinsurer:
1748 (i) an employee of the reinsurer;
1749 (ii) a United States manager of the United States branch of an alien reinsurer;
1750 (iii) an underwriting manager that, pursuant to contract:
1751 (A) manages all the reinsurance operations of the reinsurer;
1752 (B) is under common control with the reinsurer;
1753 (C) is subject to Chapter 16, Insurance Holding Companies; and
1754 (D) is not compensated based on the volume of premiums written; and
1755 (iv) the manager of a group, association, pool, or organization of insurers that:
1756 (A) engage in joint underwriting or joint reinsurance; and
1757 (B) are subject to examination by the insurance commissioner of the state in which the
1758 manager's principal business office is located.
1759 (11) "Search" means a license subline of authority in conjunction with the title
1760 insurance line of authority that allows a person to issue title insurance commitments or policies
1761 on behalf of a title insurer.
1762 (12) "Sell" means to exchange a contract of insurance:
1763 (a) by any means;
1764 (b) for money or its equivalent; and
1765 (c) on behalf of an insurance company.
1766 (13) "Solicit" means:
1767 (a) attempting to sell insurance;
1768 (b) asking or urging a person to apply for:
1769 (i) a particular kind of insurance; and
1770 (ii) insurance from a particular insurance company;
1771 (c) advertising insurance, including advertising for the purpose of obtaining leads for
1772 the sale of insurance; or
1773 (d) holding oneself out as being in the insurance business.
1774 (14) "Terminate" means:
1775 (a) the cancellation of the relationship between:
1776 (i) an individual licensee or agency licensee and a particular insurer; or
1777 (ii) an individual licensee and a particular agency licensee; or
1778 (b) the termination of:
1779 (i) an individual licensee's or agency licensee's authority to transact insurance on behalf
1780 of a particular insurance company; or
1781 (ii) an individual licensee's authority to transact insurance on behalf of a particular
1782 agency licensee.
1783 (15) "Title marketing representative" means a person who:
1784 (a) represents a title insurer in soliciting, requesting, or negotiating the placing of:
1785 (i) title insurance; or
1786 (ii) escrow services; and
1787 (b) does not have a search or escrow license as provided in Section 31A-23a-106 .
1788 (16) "Uniform application" means the version of the National Association of Insurance
1789 Commissioners' uniform application for resident and nonresident producer licensing at the time
1790 the application is filed.
1791 (17) "Uniform business entity application" means the version of the National
1792 Association of Insurance Commissioners' uniform business entity application for resident and
1793 nonresident business entities at the time the application is filed.
1794 Section 10. Section 31A-23a-103 is amended to read:
1795 31A-23a-103. Requirement of license.
1796 (1) (a) Unless exempted from the licensing requirement under Section 31A-23a-201 or
1797 31A-23a-207 , a person may not perform, offer to perform, or advertise any service as a
1798 producer, surplus lines producer, limited line producer, [
1799 consultant, managing general agent, or reinsurance intermediary in Utah, without a valid
1800 individual or agency license issued under this chapter.
1801 (b) A valid license includes at least one license type and one line of authority
1802 pertaining to that license type.
1803 (c) A person may not utilize the services of another as a producer, surplus lines
1804 producer, limited line producer, [
1805 general agent, or reinsurance intermediary if that person knows or should know that the other
1806 does not have a license as required by law.
1807 (2) This part may not be construed to require an insurer to obtain an insurance producer
1809 (3) An insurance contract is not invalid as a result of a violation of this section.
1810 Section 11. Section 31A-23a-104 is amended to read:
1811 31A-23a-104. Application for individual license -- Application for agency license.
1812 (1) This section applies to an initial or renewal license as a:
1813 (a) producer;
1814 (b) surplus lines producer;
1817 (d) consultant;
1818 (e) managing general agent; or
1819 (f) reinsurance intermediary.
1820 (2) (a) Subject to Subsection (2)(b), to obtain or renew an individual license, an
1821 individual shall:
1822 (i) file an application for an initial or renewal individual license with the commissioner
1823 on forms and in a manner the commissioner prescribes; and
1824 (ii) pay a license fee that is not refunded if the application:
1825 (A) is denied; or
1826 (B) is incomplete when filed and is never completed by the applicant.
1827 (b) An application described in this Subsection (2) shall provide:
1828 (i) information about the applicant's identity;
1829 (ii) the applicant's Social Security number;
1830 (iii) the applicant's personal history, experience, education, and business record;
1831 (iv) whether the applicant is 18 years of age or older;
1832 (v) whether the applicant has committed an act that is a ground for denial, suspension,
1833 or revocation as set forth in Section 31A-23a-105 or 31A-23a-111 ;
1834 (vi) if the application is for a resident individual producer license, certification that the
1835 applicant complies with Section 31A-23a-203.5 ; and
1836 (vii) any other information the commissioner reasonably requires.
1837 (3) The commissioner may require a document reasonably necessary to verify the
1838 information contained in an application filed under this section.
1839 (4) An applicant's Social Security number contained in an application filed under this
1840 section is a private record under Section 63G-2-302 .
1841 (5) (a) Subject to Subsection (5)(b), to obtain or renew an agency license, a person
1843 (i) file an application for an initial or renewal agency license with the commissioner on
1844 forms and in a manner the commissioner prescribes; and
1845 (ii) pay a license fee that is not refunded if the application:
1846 (A) is denied; or
1847 (B) is incomplete when filed and is never completed by the applicant.
1848 (b) An application described in Subsection (5)(a) shall provide:
1849 (i) information about the applicant's identity;
1850 (ii) the applicant's federal employer identification number;
1851 (iii) the designated responsible licensed producer;
1852 (iv) the identity of [
1853 (v) whether the applicant has committed an act that is a ground for denial, suspension,
1854 or revocation as set forth in Section 31A-23a-105 or 31A-23a-111 ; and
1855 (vi) any other information the commissioner reasonably requires.
1856 Section 12. Section 31A-23a-105 is amended to read:
1857 31A-23a-105. General requirements for individual and agency license issuance
1858 and renewal.
1859 (1) (a) The commissioner shall issue or renew a license to a person described in
1860 Subsection (1)(b) to act as:
1861 (i) a producer;
1862 (ii) a surplus lines producer;
1865 (iv) a consultant;
1866 (v) a managing general agent; or
1867 (vi) a reinsurance intermediary.
1868 (b) The commissioner shall issue or renew a license under Subsection (1)(a) to a
1869 person who, as to the license type and line of authority classification applied for under Section
1870 31A-23a-106 :
1871 (i) satisfies the application requirements under Section 31A-23a-104 ;
1872 (ii) satisfies the character requirements under Section 31A-23a-107 ;
1873 (iii) satisfies any applicable continuing education requirements under Section
1874 31A-23a-202 ;
1875 (iv) satisfies any applicable examination requirements under Section 31A-23a-108 ;
1876 (v) satisfies any applicable training period requirements under Section 31A-23a-203 ;
1877 (vi) if an applicant for a resident individual producer license, certifies that, to the extent
1878 applicable, the applicant:
1879 (A) is in compliance with Section 31A-23a-203.5 ; and
1880 (B) will maintain compliance with Section 31A-23a-203.5 during the period for which
1881 the license is issued or renewed;
1882 (vii) has not committed an act that is a ground for denial, suspension, or revocation as
1883 provided in Section 31A-23a-111 ;
1884 (viii) if a nonresident:
1885 (A) complies with Section 31A-23a-109 ; and
1886 (B) holds an active similar license in that person's state of residence;
1887 (ix) if an applicant for a title insurance producer license, satisfies the requirements of
1889 (x) if an applicant for a license to act as a life settlement provider or life settlement
1890 producer, satisfies the requirements of Section 31A-23a-117 ; and
1891 (xi) pays the applicable fees under Section 31A-3-103 .
1892 (2) (a) This Subsection (2) applies to the following persons:
1893 (i) an applicant for a pending:
1894 (A) individual or agency producer license;
1895 (B) surplus lines producer license;
1898 (D) consultant license;
1899 (E) managing general agent license; or
1900 (F) reinsurance intermediary license; or
1901 (ii) a licensed:
1902 (A) individual or agency producer;
1903 (B) surplus lines producer;
1906 (D) consultant;
1907 (E) managing general agent; or
1908 (F) reinsurance intermediary.
1909 (b) A person described in Subsection (2)(a) shall report to the commissioner:
1910 (i) an administrative action taken against the person, including a denial of a new or
1911 renewal license application:
1912 (A) in another jurisdiction; or
1913 (B) by another regulatory agency in this state; and
1914 (ii) a criminal prosecution taken against the person in any jurisdiction.
1915 (c) The report required by Subsection (2)(b) shall:
1916 (i) be filed:
1917 (A) at the time the person files the application for an individual or agency license; and
1918 (B) for an action or prosecution that occurs on or after the day on which the person
1919 files the application:
1920 (I) for an administrative action, within 30 days of the final disposition of the
1921 administrative action; or
1922 (II) for a criminal prosecution, within 30 days of the initial appearance before a court;
1924 (ii) include a copy of the complaint or other relevant legal documents related to the
1925 action or prosecution described in Subsection (2)(b).
1926 (3) (a) The department may require a person applying for a license or for consent to
1927 engage in the business of insurance to submit to a criminal background check as a condition of
1928 receiving a license or consent.
1929 (b) A person, if required to submit to a criminal background check under Subsection
1930 (3)(a), shall:
1931 (i) submit a fingerprint card in a form acceptable to the department; and
1932 (ii) consent to a fingerprint background check by:
1933 (A) the Utah Bureau of Criminal Identification; and
1934 (B) the Federal Bureau of Investigation.
1935 (c) For a person who submits a fingerprint card and consents to a fingerprint
1936 background check under Subsection (3)(b), the department may request:
1937 (i) criminal background information maintained pursuant to Title 53, Chapter 10, Part
1938 2, Bureau of Criminal Identification, from the Bureau of Criminal Identification; and
1939 (ii) complete Federal Bureau of Investigation criminal background checks through the
1940 national criminal history system.
1941 (d) Information obtained by the department from the review of criminal history records
1942 received under this Subsection (3) shall be used by the department for the purposes of:
1943 (i) determining if a person satisfies the character requirements under Section
1944 31A-23a-107 for issuance or renewal of a license;
1945 (ii) determining if a person has failed to maintain the character requirements under
1946 Section 31A-23a-107 ; and
1947 (iii) preventing a person who violates the federal Violent Crime Control and Law
1948 Enforcement Act of 1994, 18 U.S.C. Sec. 1033 [
1949 insurance in the state.
1950 (e) If the department requests the criminal background information, the department
1952 (i) pay to the Department of Public Safety the costs incurred by the Department of
1953 Public Safety in providing the department criminal background information under Subsection
1955 (ii) pay to the Federal Bureau of Investigation the costs incurred by the Federal Bureau
1956 of Investigation in providing the department criminal background information under
1957 Subsection (3)(c)(ii); and
1958 (iii) charge the person applying for a license or for consent to engage in the business of
1959 insurance a fee equal to the aggregate of Subsections (3)(e)(i) and (ii).
1960 (4) To become a resident licensee in accordance with Section 31A-23a-104 and this
1961 section, a person licensed as one of the following in another state who moves to this state shall
1962 apply within 90 days of establishing legal residence in this state:
1963 (a) insurance producer;
1964 (b) surplus lines producer;
1967 (d) consultant;
1968 (e) managing general agent; or
1969 (f) reinsurance intermediary.
1970 (5) (a) The commissioner may deny a license application for a license listed in
1971 Subsection (5)(b) if the person applying for the license, as to the license type and line of
1972 authority classification applied for under Section 31A-23a-106 :
1973 (i) fails to satisfy the requirements as set forth in this section; or
1974 (ii) commits an act that is grounds for denial, suspension, or revocation as set forth in
1975 Section 31A-23a-111 .
1976 (b) This Subsection (5) applies to the following licenses:
1977 (i) producer;
1978 (ii) surplus lines producer;
1981 (iv) consultant;
1982 (v) managing general agent; or
1983 (vi) reinsurance intermediary.
1984 (6) Notwithstanding the other provisions of this section, the commissioner may:
1985 (a) issue a license to an applicant for a license for a title insurance line of authority only
1986 with the concurrence of the Title and Escrow Commission; and
1987 (b) renew a license for a title insurance line of authority only with the concurrence of
1988 the Title and Escrow Commission.
1989 Section 13. Section 31A-23a-106 is amended to read:
1990 31A-23a-106. License types.
1991 (1) (a) A resident or nonresident license issued under this chapter shall be issued under
1992 the license types described under Subsection (2).
1993 (b) A license type and a line of authority pertaining to a license type describe the type
1994 of licensee and the lines of business that a licensee may sell, solicit, or negotiate. A license
1995 type is intended to describe the matters to be considered under any education, examination, and
1996 training required of a license applicant under Sections 31A-23a-108 , 31A-23a-202 , and
1997 31A-23a-203 .
1998 (2) (a) A producer license type includes the following lines of authority:
1999 (i) life insurance, including a nonvariable contract;
2000 (ii) variable contracts, including variable life and annuity, if the producer has the life
2001 insurance line of authority;
2002 (iii) accident and health insurance, including a contract issued to a policyholder under
2003 Chapter 7, Nonprofit Health Service Insurance Corporations, or Chapter 8, Health Maintenance
2004 Organizations and Limited Health Plans;
2005 (iv) property insurance;
2006 (v) casualty insurance, including a surety or other bond;
2007 (vi) title insurance under one or more of the following categories:
2008 (A) search, including authority to act as a title marketing representative;
2009 (B) escrow, including authority to act as a title marketing representative; and
2010 (C) title marketing representative only; and
2011 (vii) personal lines insurance[
2014 (b) A surplus lines producer license type includes the following lines of authority:
2015 (i) property insurance, if the person holds an underlying producer license with the
2016 property line of insurance; and
2017 (ii) casualty insurance, if the person holds an underlying producer license with the
2018 casualty line of authority.
2021 (i) limited line credit insurance;
2022 (ii) travel insurance;
2023 (iii) motor club insurance;
2024 (iv) car rental related insurance;
2025 (v) legal expense insurance;
2026 (vi) crop insurance;
2027 (vii) self-service storage insurance;
2028 (viii) bail bond producer; and
2029 (ix) guaranteed asset protection waiver.
2041 (d) A consultant license type includes the following lines of authority:
2042 (i) life insurance, including a nonvariable contract;
2043 (ii) variable contracts, including variable life and annuity, if the consultant has the life
2044 insurance line of authority;
2045 (iii) accident and health insurance, including a contract issued to a policyholder under
2046 Chapter 7, Nonprofit Health Service Insurance Corporations, or Chapter 8, Health Maintenance
2047 Organizations and Limited Health Plans;
2048 (iv) property insurance;
2049 (v) casualty insurance, including a surety or other bond; and
2050 (vi) personal lines insurance.
2051 (e) A managing general agent license type includes the following lines of authority:
2052 (i) life insurance, including a nonvariable contract;
2053 (ii) variable contracts, including variable life and annuity, if the managing general
2054 agent has the life insurance line of authority;
2055 (iii) accident and health insurance, including a contract issued to a policyholder under
2056 Chapter 7, Nonprofit Health Service Insurance Corporations, or Chapter 8, Health Maintenance
2057 Organizations and Limited Health Plans;
2058 (iv) property insurance;
2059 (v) casualty insurance, including a surety or other bond; and
2060 (vi) personal lines insurance.
2061 (f) A reinsurance intermediary license type includes the following lines of authority:
2062 (i) life insurance, including a nonvariable contract;
2063 (ii) variable contracts, including variable life and annuity, if the reinsurance
2064 intermediary has the life insurance line of authority;
2065 (iii) accident and health insurance, including a contract issued to a policyholder under
2066 Chapter 7, Nonprofit Health Service Insurance Corporations, or Chapter 8, Health Maintenance
2067 Organizations and Limited Health Plans;
2068 (iv) property insurance;
2069 (v) casualty insurance, including a surety or other bond; and
2070 (vi) personal lines insurance.
2071 (g) A person who holds a license under Subsection (2)(a)[
2072 qualifications necessary to act as a holder of a license under [
2073 Subsection (2)(c), except that the person may not act under Subsection (2)[
2074 (3) (a) The commissioner may by rule recognize other producer, surplus lines producer,
2075 limited line producer, [
2076 reinsurance intermediary lines of authority as to kinds of insurance not listed under Subsections
2077 (2)(a) through (f).
2078 (b) Notwithstanding Subsection (3)(a), for purposes of title insurance the Title and
2079 Escrow Commission may by rule, with the concurrence of the commissioner and subject to
2080 Section 31A-2-404 , recognize other categories for a title insurance producer line of authority
2081 not listed under Subsection (2)(a)(vi).
2082 (4) The variable contracts[
2087 (a) for a producer, licensure by the Financial Industry Regulatory Authority as a:
2088 (i) registered broker-dealer; or
2089 (ii) broker-dealer agent, with a current registration with a broker-dealer; and
2090 (b) for a consultant, registration with the Securities and Exchange Commission or
2091 licensure by the Utah Division of Securities as an:
2092 (i) investment adviser; or
2093 (ii) investment adviser representative, with a current association with an investment
2095 (5) A surplus lines producer is a producer who has a surplus lines [
2097 Section 14. Section 31A-23a-107 is amended to read:
2098 31A-23a-107. Character requirements.
2101 (1) the applicant has the intent in good faith, to engage in the type of business that the
2102 license applied for would permit;
2103 (2) (a) if a natural person, the applicant is competent and trustworthy; or[
2104 (b) if the applicant is an agency[
2105 (i) the partners, directors, or principal officers or persons having comparable powers
2106 are trustworthy[
2107 (ii) that it will transact business in such a way that [
2108 performed by a licensed producer, surplus lines producer, limited line producer, [
2110 performed exclusively by natural persons who are licensed under this chapter to transact that
2111 type of business and designated on the agency's license;
2112 (3) the applicant intends to comply with Section 31A-23a-502 ; and
2113 (4) if a natural person, the applicant is at least 18 years of age.
2114 Section 15. Section 31A-23a-108 is amended to read:
2115 31A-23a-108. Examination requirements.
2116 (1) (a) The commissioner may require applicants for any particular license type under
2117 Section 31A-23a-106 to pass a line of authority examination as a requirement for a license,
2118 except that an examination may not be required of applicants for:
2119 (i) licenses under [
2120 (ii) other limited line license lines of authority recognized by the commissioner or the
2121 Title and Escrow Commission by rule as provided in Subsection 31A-23a-106 (3).
2122 (b) The examination described in Subsection (1)(a):
2123 (i) shall reasonably relate to the line of authority for which it is prescribed; and
2124 (ii) may be administered by the commissioner or as otherwise specified by rule.
2125 (2) The commissioner shall waive the requirement of an examination for a nonresident
2126 applicant who:
2127 (a) applies for an insurance producer license in this state;
2128 (b) has been licensed for the same line of authority in another state; and
2129 (c) (i) is licensed in the state described in Subsection (2)(b) at the time the applicant
2130 applies for an insurance producer license in this state; or
2131 (ii) if the application is received within 90 days of the cancellation of the applicant's
2132 previous license:
2133 (A) the prior state certifies that at the time of cancellation, the applicant was in good
2134 standing in that state; or
2135 (B) the state's producer database records maintained by the National Association of
2136 Insurance Commissioners or the National Association of Insurance Commissioner's affiliates or
2137 subsidiaries, indicates that the producer is or was licensed in good standing for the line of
2138 authority requested.
2139 (3) A nonresident producer licensee who moves to this state and applies for a resident
2140 license within 90 days of establishing legal residence in this state shall be exempt from any line
2141 of authority examination that the producer was authorized on the producer's nonresident
2142 producer license, except where the commissioner determines otherwise by rule.
2143 (4) This section's requirement may only be applied to applicants who are natural
2145 Section 16. Section 31A-23a-109 is amended to read:
2146 31A-23a-109. Nonresident jurisdictional agreement.
2147 (1) (a) If a nonresident license applicant has a valid producer, surplus lines producer,
2148 limited line producer, [
2149 reinsurance intermediary license from the nonresident license applicant's home state and the
2150 conditions of Subsection (1)(b) are met, the commissioner shall:
2151 (i) waive [
2152 (ii) issue the nonresident license applicant a nonresident license.
2153 (b) Subsection (1)(a) applies if:
2154 (i) the nonresident license applicant:
2155 (A) is licensed as a resident in the nonresident license applicant's home state at the time
2156 the nonresident license applicant applies for a nonresident producer, surplus lines producer,
2157 limited line producer, [
2158 reinsurance intermediary license;
2159 (B) has submitted the proper request for licensure;
2160 (C) has submitted to the commissioner:
2161 (I) the application for licensure that the nonresident license applicant submitted to the
2162 applicant's home state; or
2163 (II) a completed uniform application; and
2164 (D) has paid the applicable fees under Section 31A-3-103 ; and
2165 (ii) the nonresident license applicant's license in the applicant's home state is in good
2167 (2) A nonresident applicant applying under Subsection (1) shall in addition to
2168 complying with all license requirements for a license under this chapter execute, in a form
2169 acceptable to the commissioner, an agreement to be subject to the jurisdiction of the Utah
2170 commissioner and courts on any matter related to the applicant's insurance activities in this
2171 state, on the basis of:
2172 (a) service of process under Sections 31A-2-309 and 31A-2-310 ; or
2173 (b) service authorized:
2174 (i) in the Utah Rules of Civil Procedure; or
2175 (ii) under Section 78B-3-206 .
2176 (3) The commissioner may verify a producer's licensing status through the producer
2177 database maintained by:
2178 (a) the National Association of Insurance Commissioners; or
2179 (b) an affiliate or subsidiary of the National Association of Insurance Commissioners.
2180 (4) The commissioner may not assess a greater fee for an insurance license or related
2181 service to a person not residing in this state solely on the fact that the person does not reside in
2182 this state.
2183 Section 17. Section 31A-23a-111 is amended to read:
2184 31A-23a-111. Revocation, suspension, surrender, lapsing, limiting, or otherwise
2185 terminating a license -- Rulemaking for renewal or reinstatement.
2186 (1) A license type issued under this chapter remains in force until:
2187 (a) revoked or suspended under Subsection (5);
2188 (b) surrendered to the commissioner and accepted by the commissioner in lieu of
2189 administrative action;
2190 (c) the licensee dies or is adjudicated incompetent as defined under:
2191 (i) Title 75, Chapter 5, Part 3, Guardians of Incapacitated Persons; or
2192 (ii) Title 75, Chapter 5, Part 4, Protection of Property of Persons Under Disability and
2194 (d) lapsed under Section 31A-23a-113 ; or
2195 (e) voluntarily surrendered.
2196 (2) The following may be reinstated within one year after the day on which the license
2197 is no longer in force:
2198 (a) a lapsed license; or
2199 (b) a voluntarily surrendered license, except that a voluntarily surrendered license may
2200 not be reinstated after the license period in which the license is voluntarily surrendered.
2201 (3) Unless otherwise stated in a written agreement for the voluntary surrender of a
2202 license, submission and acceptance of a voluntary surrender of a license does not prevent the
2203 department from pursuing additional disciplinary or other action authorized under:
2204 (a) this title; or
2205 (b) rules made under this title in accordance with Title 63G, Chapter 3, Utah
2206 Administrative Rulemaking Act.
2207 (4) A line of authority issued under this chapter remains in force until:
2208 (a) the qualifications pertaining to a line of authority are no longer met by the licensee;
2210 (b) the supporting license type:
2211 (i) is revoked or suspended under Subsection (5);
2212 (ii) is surrendered to the commissioner and accepted by the commissioner in lieu of
2213 administrative action;
2220 (c) the licensee dies or is adjudicated incompetent as defined under:
2221 (i) Title 75, Chapter 5, Part 3, Guardians of Incapacitated Persons; or
2222 (ii) Title 75, Chapter 5, Part 4, Protection of Property of Persons Under Disability and
2224 (5) (a) If the commissioner makes a finding under Subsection (5)(b), as part of an
2225 adjudicative proceeding under Title 63G, Chapter 4, Administrative Procedures Act, the
2226 commissioner may:
2227 (i) revoke:
2228 (A) a license; or
2229 (B) a line of authority;
2230 (ii) suspend for a specified period of 12 months or less:
2231 (A) a license; or
2232 (B) a line of authority;
2233 (iii) limit in whole or in part:
2234 (A) a license; or
2235 (B) a line of authority; or
2236 (iv) deny a license application.
2237 (b) The commissioner may take an action described in Subsection (5)(a) if the
2238 commissioner finds that the licensee:
2239 (i) is unqualified for a license or line of authority under Section 31A-23a-104 ,
2240 31A-23a-105 , or 31A-23a-107 ;
2241 (ii) violates:
2242 (A) an insurance statute;
2243 (B) a rule that is valid under Subsection 31A-2-201 (3); or
2244 (C) an order that is valid under Subsection 31A-2-201 (4);
2245 (iii) is insolvent or the subject of receivership, conservatorship, rehabilitation, or other
2246 delinquency proceedings in any state;
2247 (iv) fails to pay a final judgment rendered against the person in this state within 60
2248 days after the day on which the judgment became final;
2249 (v) fails to meet the same good faith obligations in claims settlement that is required of
2250 admitted insurers;
2251 (vi) is affiliated with and under the same general management or interlocking
2252 directorate or ownership as another insurance producer that transacts business in this state
2253 without a license;
2254 (vii) refuses:
2255 (A) to be examined; or
2256 (B) to produce its accounts, records, and files for examination;
2257 (viii) has an officer who refuses to:
2258 (A) give information with respect to the insurance producer's affairs; or
2259 (B) perform any other legal obligation as to an examination;
2260 (ix) provides information in the license application that is:
2261 (A) incorrect;
2262 (B) misleading;
2263 (C) incomplete; or
2264 (D) materially untrue;
2265 (x) violates an insurance law, valid rule, or valid order of another state's insurance
2267 (xi) obtains or attempts to obtain a license through misrepresentation or fraud;
2268 (xii) improperly withholds, misappropriates, or converts money or properties received
2269 in the course of doing insurance business;
2270 (xiii) intentionally misrepresents the terms of an actual or proposed:
2271 (A) insurance contract;
2272 (B) application for insurance; or
2273 (C) life settlement;
2274 (xiv) is convicted of a felony;
2275 (xv) admits or is found to have committed an insurance unfair trade practice or fraud;
2276 (xvi) in the conduct of business in this state or elsewhere:
2277 (A) uses fraudulent, coercive, or dishonest practices; or
2278 (B) demonstrates incompetence, untrustworthiness, or financial irresponsibility;
2279 (xvii) has an insurance license, or its equivalent, denied, suspended, or revoked in
2280 another state, province, district, or territory;
2281 (xviii) forges another's name to:
2282 (A) an application for insurance; or
2283 (B) a document related to an insurance transaction;
2284 (xix) improperly uses notes or another reference material to complete an examination
2285 for an insurance license;
2286 (xx) knowingly accepts insurance business from an individual who is not licensed;
2287 (xxi) fails to comply with an administrative or court order imposing a child support
2289 (xxii) fails to:
2290 (A) pay state income tax; or
2291 (B) comply with an administrative or court order directing payment of state income
2293 (xxiii) violates or permits others to violate the federal Violent Crime Control and Law
2294 Enforcement Act of 1994, 18 U.S.C. Sec. 1033 [
2295 1033 is prohibited from engaging in the business of insurance; or
2296 (xxiv) engages in a method or practice in the conduct of business that endangers the
2297 legitimate interests of customers and the public.
2298 (c) For purposes of this section, if a license is held by an agency, both the agency itself
2299 and any individual designated under the license are considered to be the holders of the license.
2300 (d) If an individual designated under the agency license commits an act or fails to
2301 perform a duty that is a ground for suspending, revoking, or limiting the individual's license,
2302 the commissioner may suspend, revoke, or limit the license of:
2303 (i) the individual;
2304 (ii) the agency, if the agency:
2305 (A) is reckless or negligent in its supervision of the individual; or
2306 (B) knowingly participates in the act or failure to act that is the ground for suspending,
2307 revoking, or limiting the license; or
2308 (iii) (A) the individual; and
2309 (B) the agency if the agency meets the requirements of Subsection (5)(d)(ii).
2310 (6) A licensee under this chapter is subject to the penalties for acting as a licensee
2311 without a license if:
2312 (a) the licensee's license is:
2313 (i) revoked;
2314 (ii) suspended;
2315 (iii) limited;
2316 (iv) surrendered in lieu of administrative action;
2317 (v) lapsed; or
2318 (vi) voluntarily surrendered; and
2319 (b) the licensee:
2320 (i) continues to act as a licensee; or
2321 (ii) violates the terms of the license limitation.
2322 (7) A licensee under this chapter shall immediately report to the commissioner:
2323 (a) a revocation, suspension, or limitation of the person's license in another state, the
2324 District of Columbia, or a territory of the United States;
2325 (b) the imposition of a disciplinary sanction imposed on that person by another state,
2326 the District of Columbia, or a territory of the United States; or
2327 (c) a judgment or injunction entered against that person on the basis of conduct
2329 (i) fraud;
2330 (ii) deceit;
2331 (iii) misrepresentation; or
2332 (iv) a violation of an insurance law or rule.
2333 (8) (a) An order revoking a license under Subsection (5) or an agreement to surrender a
2334 license in lieu of administrative action may specify a time, not to exceed five years, within
2335 which the former licensee may not apply for a new license.
2336 (b) If no time is specified in an order or agreement described in Subsection (8)(a), the
2337 former licensee may not apply for a new license for five years from the day on which the order
2338 or agreement is made without the express approval by the commissioner.
2339 (9) The commissioner shall promptly withhold, suspend, restrict, or reinstate the use of
2340 a license issued under this part if so ordered by a court.
2341 (10) The commissioner shall by rule prescribe the license renewal and reinstatement
2342 procedures in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
2343 Section 18. Section 31A-23a-113 is amended to read:
2344 31A-23a-113. License lapse and voluntary surrender.
2345 (1) (a) A license issued under this chapter shall lapse if the licensee fails to:
2346 (i) pay when due a fee under Section 31A-3-103 ;
2347 (ii) complete continuing education requirements under Section 31A-23a-202 before
2348 submitting the license renewal application;
2349 (iii) submit a completed renewal application as required by Section 31A-23a-104 ;
2350 (iv) submit additional documentation required to complete the licensing process as
2351 related to a specific license type or line of authority; or
2352 (v) maintain an active license in a resident state if the licensee is a nonresident
2354 (b) (i) A licensee whose license lapses due to the following may request an action
2355 described in Subsection (1)(b)(ii):
2356 (A) military service;
2357 (B) voluntary service for a period of time designated by the person for whom the
2358 licensee provides voluntary service; or
2359 (C) some other extenuating circumstances, such as long-term medical disability.
2360 (ii) A licensee described in Subsection (1)(b)(i) may request:
2361 (A) reinstatement of the license no later than one year after the day on which the
2362 license lapses; and
2363 (B) waiver of any of the following imposed for failure to comply with renewal
2365 (I) an examination requirement;
2366 (II) reinstatement fees set under Section 31A-3-103 ;
2367 (III) continuing education requirements; or
2368 (IV) other sanction imposed for failure to comply with renewal procedures.
2369 (2) If a license issued under this chapter is voluntarily surrendered, the license or line
2370 of authority may be reinstated:
2371 (a) during the license period in which the license is voluntarily surrendered; and
2372 (b) no later than one year after the day on which the license is voluntarily surrendered.
2373 (3) A voluntarily surrendered license that is reinstated during the license period set
2374 forth in Subsection (2) may not be reinstated until the person who voluntarily surrendered the
2375 license complies with any applicable continuing education requirements for the period during
2376 which the license was voluntarily surrendered.
2377 Section 19. Section 31A-23a-115.5 is amended to read:
2378 31A-23a-115.5. Use of customer service representative.
2379 A producer, surplus lines producer, or consultant who employs a customer service
2380 representative [
2381 customer service representative. A customer service representative:
2382 (1) may not maintain an office independent of the customer service representative's
2383 licensed producer, surplus lines producer, or consultant employer for the purpose of conducting
2384 insurance activities;
2385 (2) except as provided in Subsection (3), may not sell, solicit, negotiate, or bind
2386 coverage; and
2387 (3) may provide a customer a quote on behalf of the customer service representative's
2388 licensed producer, surplus lines producer, or consultant employer.
2389 Section 20. Section 31A-23a-203 is amended to read:
2390 31A-23a-203. Training period requirements.
2391 (1) A producer is eligible to [
2393 (a) has passed the applicable surplus lines producer examination;
2394 (b) has been a producer with property and casualty lines of authority for at least three
2395 years during the four years immediately preceding the date of application; and
2396 (c) has paid the applicable fee under Section 31A-3-103 .
2397 (2) A person is eligible to become a consultant only if the person has acted in a
2398 capacity that would provide the person with preparation to act as an insurance consultant for a
2399 period aggregating not less than three years during the four years immediately preceding the
2400 date of application.
2401 (3) (a) A resident producer with an accident and health line of authority may only sell
2402 long-term care insurance if the producer:
2403 (i) initially completes a minimum of three hours of long-term care training before
2404 selling long-term care coverage; and
2405 (ii) after completing the training required by Subsection (3)(a)(i), completes a
2406 minimum of three hours of long-term care training during each subsequent two-year licensing
2408 (b) A course taken to satisfy a long-term care training requirement may be used toward
2409 satisfying a producer continuing education requirement.
2410 (c) Long-term care training is not a continuing education requirement to renew a
2411 producer license.
2412 (d) An insurer that issues long-term care insurance shall demonstrate to the
2413 commissioner, upon request, that a producer who is appointed by the insurer and who sells
2414 long-term care insurance coverage is in compliance with this Subsection (3).
2415 (4) The training periods required under this section apply only to an individual
2416 applying for a license under this chapter.
2417 Section 21. Section 31A-23a-206 is amended to read:
2418 31A-23a-206. Special requirements for variable contracts line of authority.
2419 (1) Before applying for a variable contracts line of authority[
2420 (a) a producer [
2423 (b) a consultant shall be licensed under Section 61-1-3 as an:
2424 (i) investment adviser; or
2425 (ii) investment adviser representative.
2426 (2) A producer's or consultant's variable contracts line of authority is revoked on the day
2427 the producer's or consultant's securities related license under Section 61-1-3 is no longer valid.
2428 Section 22. Section 31A-23a-301 is amended to read:
2429 31A-23a-301. Agency license.
2430 An insurance organization shall be licensed as an agency if the insurance organization
2431 acts as:
2432 (1) a producer;
2433 (2) a surplus lines producer;
2438 Section 23. Section 31A-23a-302 is amended to read:
2439 31A-23a-302. Agency designations.
2440 (1) An agency shall designate an individual that has an individual producer, surplus
2441 lines producer, limited line producer, [
2442 general agent, or reinsurance intermediary license to act on the agency's behalf in order for the
2443 licensee to do business for the agency in this state.
2444 (2) An agency shall report to the commissioner, at intervals and in the form the
2445 commissioner establishes by rule:
2446 (a) a new designation; and
2447 (b) a terminated designation.
2448 (3) (a) An agency licensed under this chapter shall report to the commissioner the
2449 cause of termination of a designation if:
2450 (i) the reason for termination is a reason described in Subsection 31A-23a-111 (5)(b);
2452 (ii) the agency has knowledge that the individual licensee is found to have engaged in
2453 an activity described in Subsection 31A-23a-111 (5)(b) by:
2454 (A) a court;
2455 (B) a government body; or
2456 (C) a self-regulatory organization, which the commissioner may define by rule made in
2457 accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
2458 (b) The information provided the commissioner under Subsection (3)(a) is a private
2459 record under Title 63G, Chapter 2, Government Records Access and Management Act.
2460 (c) An agency is immune from civil action, civil penalty, or damages if the agency
2461 complies in good faith with this Subsection (3) in reporting to the commissioner the cause of
2462 termination of a designation.
2463 (d) Notwithstanding any other provision in this section, an agency is not immune from
2464 an action or resulting penalty imposed on the reporting agency as a result of proceedings
2465 brought by or on behalf of the department if the action is based on evidence other than the
2466 report submitted in compliance with this Subsection (3).
2467 (4) An agency licensed under this chapter may act in a capacity for which it is licensed
2468 only through an individual who is licensed under this chapter to act in the same capacity.
2469 (5) An agency licensed under this chapter shall designate and report to the
2470 commissioner in accordance with any rule made by the commissioner the name of the
2471 designated responsible licensed individual who has authority to act on behalf of the agency in
2473 (6) If an agency designates a licensee in reports submitted under Subsection (2) or (5),
2474 there is a rebuttable presumption that the designated licensee acts on behalf of the agency.
2475 (7) (a) When a license is held by an agency, both the agency itself and any individual
2476 designated under the agency license shall be considered to be the holder of the agency license
2477 for purposes of this section.
2478 (b) If an individual designated under the agency license commits an act or fails to
2479 perform a duty that is a ground for suspending, revoking, or limiting the agency license, the
2480 commissioner may suspend, revoke, or limit the license of:
2481 (i) the individual;
2482 (ii) the agency, if the agency:
2483 (A) is reckless or negligent in its supervision of the individual; or
2484 (B) knowingly participates in the act or failure to act that is the ground for suspending,
2485 revoking, or limiting the license; or
2486 (iii) (A) the individual; and
2487 (B) the agency if the agency meets the requirements of Subsection (7)(b)(ii).
2488 Section 24. Section 31A-23a-402.5 is amended to read:
2489 31A-23a-402.5. Inducements.
2490 (1) (a) Except as provided in Subsection (2), a licensee under this title, or an officer or
2491 employee of a licensee, may not induce a person to enter into, continue, or terminate an
2492 insurance contract by offering a benefit that is not:
2493 (i) specified in the insurance contract; or
2494 (ii) directly related to the insurance contract.
2495 (b) An insurer may not make or knowingly allow an agreement of insurance that is not
2496 clearly expressed in the insurance contract to be issued or renewed.
2497 (c) A licensee under this title may not absorb the tax under Section 31A-3-301 .
2498 (2) This section does not apply to a title insurer, a title producer, or an officer or
2499 employee of a title insurer or title producer.
2500 (3) Items not prohibited by Subsection (1) include an insurer:
2501 (a) reducing premiums because of expense savings;
2502 (b) providing to a policyholder or insured one or more incentives, as defined by the
2503 commissioner by rule made in accordance with Title 63G, Chapter 3, Utah Administrative
2504 Rulemaking Act, to participate in a program or activity designed to reduce claims or claim
2505 expenses; or
2506 (c) receiving premiums under an installment payment plan.
2507 (4) Items not prohibited by Subsection (1) include a licensee, or an officer or employee
2508 of a licensee, either directly or through a third party:
2509 (a) engaging in a usual kind of social courtesy if receipt of the social courtesy is not
2510 conditioned on the purchase of a particular insurance product;
2511 (b) extending credit on a premium to the insured:
2512 (i) without interest, for no more than 90 days from the effective date of the insurance
2514 (ii) for interest that is not less than the legal rate under Section 15-1-1 , on the unpaid
2515 balance after the time period described in Subsection (4)(b)(i); and
2516 (iii) except that an installment or payroll deduction payment of premiums on an
2517 insurance contract issued under an insurer's mass marketing program is not considered an
2518 extension of credit for purposes of this Subsection (4)(b);
2519 (c) preparing or conducting a survey that:
2520 (i) is directly related to an accident and health insurance policy purchased from the
2521 licensee; or
2522 (ii) is used by the licensee to assess the benefit needs and preferences of insureds,
2523 employers, or employees directly related to an insurance product sold by the licensee;
2524 (d) providing limited human resource services that are directly related to an insurance
2525 product sold by the licensee, including:
2526 (i) answering questions directly related to:
2527 (A) an employee benefit offering or administration, if the insurance product purchased
2528 from the licensee is accident and health insurance or health insurance; and
2529 (B) employment practices liability, if the insurance product offered by or purchased
2530 from the licensee is property or casualty insurance; and
2531 (ii) providing limited human resource compliance training and education directly
2532 pertaining to an insurance product purchased from the licensee;
2533 (e) providing the following types of information or guidance:
2534 (i) providing guidance directly related to compliance with federal and state laws for an
2535 insurance product purchased from the licensee;
2536 (ii) providing a workshop or seminar addressing an insurance issue that is directly
2537 related to an insurance product purchased from the licensee; or
2538 (iii) providing information regarding:
2539 (A) employee benefit issues;
2540 (B) directly related insurance regulatory and legislative updates; or
2541 (C) similar education about an insurance product sold by the licensee and how the
2542 insurance product interacts with tax law;
2543 (f) preparing or providing a form that is directly related to an insurance product
2544 purchased from, or offered by, the licensee;
2545 (g) preparing or providing documents directly related to a premium only cafeteria plan
2546 within the meaning of Section 125, Internal Revenue Code, or a flexible spending account, but
2547 not providing ongoing administration of a flexible spending account;
2548 (h) providing enrollment and billing assistance, including:
2549 (i) providing benefit statements or new hire insurance benefits packages; and
2550 (ii) providing technology services such as an electronic enrollment platform or
2551 application system;
2552 (i) communicating coverages in writing and in consultation with the insured and
2554 (j) providing employee communication materials and notifications directly related to an
2555 insurance product purchased from a licensee;
2556 (k) providing claims management and resolution to the extent permitted under the
2557 licensee's license;
2558 (l) providing underwriting or actuarial analysis or services;
2559 (m) negotiating with an insurer regarding the placement and pricing of an insurance
2561 (n) recommending placement and coverage options;
2562 (o) providing a health fair or providing assistance or advice on establishing or
2563 operating a wellness program, but not providing any payment for or direct operation of the
2564 wellness program;
2565 (p) providing COBRA and Utah mini-COBRA administration, consultations, and other
2566 services directly related to an insurance product purchased from the licensee;
2567 (q) assisting with a summary plan description;
2568 (r) providing information necessary for the preparation of documents directly related to
2569 the Employee Retirement Income Security Act of 1974, 29 U.S.C. Sec. 1001, et seq., as
2571 (s) providing information or services directly related to the Health Insurance Portability
2572 and Accountability Act of 1996, Pub. L. 104-191, 110 Stat. 1936, as amended, such as services
2573 directly related to health care access, portability, and renewability when offered in connection
2574 with accident and health insurance sold by a licensee;
2575 (t) sending proof of coverage to a third party with a legitimate interest in coverage;
2576 (u) providing information in a form approved by the commissioner and directly related
2577 to determining whether an insurance product sold by the licensee meets the requirements of a
2578 third party contract that requires or references insurance coverage;
2579 (v) facilitating risk management services directly related to the insurance product sold
2580 or offered for sale by the licensee, including:
2581 (i) risk management;
2582 (ii) claims and loss control services; and
2583 (iii) risk assessment consulting;
2584 (w) otherwise providing services that are legitimately part of servicing an insurance
2585 product purchased from a licensee; and
2586 (x) providing other directly related services approved by the department.
2587 (5) An inducement prohibited under Subsection (1) includes a licensee, or an officer or
2588 employee of a licensee:
2589 (a) (i) providing a premium or commission rebate;
2590 (ii) paying the salary of an employee of a person who purchases an insurance product
2591 from the licensee; or
2592 (iii) if the licensee is an insurer, or a third party administrator who contracts with an
2593 insurer, paying the salary for an onsite staff member to perform an act prohibited under
2594 Subsection (5)(b)(xii); or
2595 (b) engaging in one or more of the following unless a fee is paid in accordance with
2596 Subsection (7):
2597 (i) performing background checks of prospective employees;
2598 (ii) providing legal services by a person licensed to practice law;
2599 (iii) performing drug testing that is directly related to an insurance product purchased
2600 from the licensee;
2601 (iv) preparing employer or employee handbooks, except that a licensee may:
2602 (A) provide information for a medical benefit section of an employee handbook;
2603 (B) provide information for the section of an employee handbook directly related to an
2604 employment practices liability insurance product purchased from the licensee; or
2605 (C) prepare or print an employee benefit enrollment guide;
2606 (v) providing job descriptions, postings, and applications for a person that purchases an
2607 employment practices liability insurance product from the licensee;
2608 (vi) providing payroll services;
2609 (vii) providing performance reviews or performance review training;
2610 (viii) providing union advice;
2611 (ix) providing accounting services;
2612 (x) providing data analysis information technology programs, except as provided in
2613 Subsection (4)(h)(ii);
2614 (xi) providing administration of health reimbursement accounts or health savings
2615 accounts; or
2616 (xii) if the licensee is an insurer, or a third party administrator who contracts with an
2617 insurer, the insurer issuing an insurance policy that lists in the insurance policy one or more of
2618 the following prohibited benefits:
2619 (A) performing background checks of prospective employees;
2620 (B) providing legal services by a person licensed to practice law;
2621 (C) performing drug testing that is directly related to an insurance product purchased
2622 from the insurer;
2623 (D) preparing employer or employee handbooks;
2624 (E) providing job descriptions postings, and applications;
2625 (F) providing payroll services;
2626 (G) providing performance reviews or performance review training;
2627 (H) providing union advice;
2628 (I) providing accounting services;
2629 (J) providing discrimination testing; or
2630 (K) providing data analysis information technology programs.
2631 (6) A de minimis gift or meal not to exceed $25 for each individual receiving the gift
2632 or meal is presumed to be a social courtesy not conditioned on the purchase of a particular
2633 insurance product for purposes of Subsection (4)(a).
2634 (7) If as provided under Subsection (5)(b) a licensee is paid a fee to provide an item
2635 listed in Subsection (5)(b), the licensee shall comply with Subsection 31A-23a-501 (2) in
2636 charging the fee, except that the fee paid for the item shall equal or exceed the fair market
2637 value of the item.
2638 Section 25. Section 31A-23a-406 is amended to read:
2639 31A-23a-406. Title insurance producer's business.
2640 (1) A title insurance producer may do escrow involving real property transactions if all
2641 of the following exist:
2642 (a) the title insurance producer is licensed with:
2643 (i) the title line of authority; and
2644 (ii) the escrow subline of authority;
2645 (b) the title insurance producer is appointed by a title insurer authorized to do business
2646 in the state;
2647 (c) the title insurance producer issues one or more of the following as part of the
2649 (i) an owner's policy of title insurance; or
2650 (ii) a lender's policy of title insurance;
2651 (d) money deposited with the title insurance producer in connection with any escrow:
2652 (i) is deposited:
2653 (A) in a federally insured financial institution; and
2654 (B) in a trust account that is separate from all other trust account money that is not
2655 related to real estate transactions;
2656 (ii) is the property of the one or more persons entitled to the money under the
2657 provisions of the escrow; and
2658 (iii) is segregated escrow by escrow in the records of the title insurance producer;
2659 (e) earnings on money held in escrow may be paid out of the escrow account to any
2660 person in accordance with the conditions of the escrow;
2661 (f) the escrow does not require the title insurance producer to hold:
2662 (i) construction money; or
2663 (ii) money held for exchange under Section 1031, Internal Revenue Code; and
2664 (g) the title insurance producer shall maintain a physical office in Utah staffed by a
2665 person with an escrow subline of authority who processes the escrow.
2666 (2) Notwithstanding Subsection (1), a title insurance producer may engage in the
2667 escrow business if:
2668 (a) the escrow involves:
2669 (i) a mobile home;
2670 (ii) a grazing right;
2671 (iii) a water right; or
2672 (iv) other personal property authorized by the commissioner; and
2673 (b) the title insurance producer complies with this section except for Subsection (1)(c).
2674 (3) Money held in escrow:
2675 (a) is not subject to any debts of the title insurance producer;
2676 (b) may only be used to fulfill the terms of the individual escrow under which the
2677 money is accepted; and
2678 (c) may not be used until the conditions of the escrow are met.
2679 (4) Assets or property other than escrow money received by a title insurance producer
2680 in accordance with an escrow shall be maintained in a manner that will:
2681 (a) reasonably preserve and protect the asset or property from loss, theft, or damages;
2683 (b) otherwise comply with the general duties and responsibilities of a fiduciary or
2685 (5) (a) A check from the trust account described in Subsection (1)(d) may not be
2686 drawn, executed, or dated, or money otherwise disbursed unless the segregated escrow account
2687 from which money is to be disbursed contains a sufficient credit balance consisting of collected
2688 and cleared money at the time the check is drawn, executed, or dated, or money is otherwise
2690 (b) As used in this Subsection (5), money is considered to be "collected and cleared,"
2691 and may be disbursed as follows:
2692 (i) cash may be disbursed on the same day the cash is deposited;
2693 (ii) a wire transfer may be disbursed on the same day the wire transfer is deposited; and
2694 (iii) the proceeds of one or more of the following financial instruments may be
2695 disbursed on the same day the financial instruments are deposited if received from a single
2696 party to the real estate transaction and if the aggregate of the financial instruments for the real
2697 estate transaction is less than $10,000:
2698 (A) a cashier's check, certified check, or official check that is drawn on an existing
2699 account at a federally insured financial institution;
2700 (B) a check drawn on the trust account of a principal broker or associate broker
2701 licensed under Title 61, Chapter 2f, Real Estate Licensing and Practices Act, if the title
2702 producer has reasonable and prudent grounds to believe sufficient money will be available
2703 from the trust account on which the check is drawn at the time of disbursement of proceeds
2704 from the title producer's escrow account;
2705 (C) a personal check not to exceed $500 per closing; or
2706 (D) a check drawn on the escrow account of another title producer, if the title producer
2707 in the escrow transaction has reasonable and prudent grounds to believe that sufficient money
2708 will be available for withdrawal from the account upon which the check is drawn at the time of
2709 disbursement of money from the escrow account of the title producer in the escrow
2713 (c) [
2715 (i) within the time limits provided under the Expedited Funds Availability Act, 12
2716 U.S.C. Sec. 4001 et seq., as amended, and related regulations of the Federal Reserve System; or
2717 (ii) upon notification from the financial institution to which the money has been
2718 deposited that final settlement has occurred on the deposited financial instrument.
2719 (6) A title insurance producer shall maintain a record of a receipt or disbursement of
2720 escrow money.
2721 (7) A title insurance producer shall comply with:
2722 (a) Section 31A-23a-409 ;
2723 (b) Title 46, Chapter 1, Notaries Public Reform Act; and
2724 (c) any rules adopted by the Title and Escrow Commission, subject to Section
2725 31A-2-404 , that govern escrows.
2726 (8) If a title insurance producer conducts a search for real estate located in the state, the
2727 title insurance producer shall conduct a minimum mandatory search, as defined by rule made
2728 by the Title and Escrow Commission, subject to Section 31A-2-404 .
2729 Section 26. Section 31A-23a-409 is amended to read:
2730 31A-23a-409. Trust obligation for money collected.
2731 (1) (a) Subject to Subsection (7), a licensee is a trustee for money that is paid to,
2732 received by, or collected by a licensee for forwarding to insurers or to insureds.
2733 (b) (i) Except as provided in Subsection (1)(b)(ii), a licensee may not commingle trust
2734 funds with:
2735 (A) the licensee's own money; or
2736 (B) money held in any other capacity.
2737 (ii) This Subsection (1)(b) does not apply to:
2738 (A) amounts necessary to pay bank charges; and
2739 (B) money paid by insureds and belonging in part to the licensee as a fee or
2741 (c) Except as provided under Subsection (4), a licensee owes to insureds and insurers
2742 the fiduciary duties of a trustee with respect to money to be forwarded to insurers or insureds
2743 through the licensee.
2744 (d) (i) Unless money is sent to the appropriate payee by the close of the next business
2745 day after their receipt, the licensee shall deposit them in an account authorized under
2746 Subsection (2).
2747 (ii) Money deposited under this Subsection (1)(d) shall remain in an account
2748 authorized under Subsection (2) until sent to the appropriate payee.
2749 (2) Money required to be deposited under Subsection (1) shall be deposited:
2750 (a) in a federally insured trust account in a depository institution, as defined in Section
2751 7-1-103 , which:
2752 (i) has an office in this state, if the licensee depositing the money is a resident licensee;
2753 (ii) has federal deposit insurance; and
2754 (iii) is authorized by its primary regulator to engage in the trust business, as defined by
2755 Section 7-5-1 , in this state; or
2756 (b) in some other account, approved by the commissioner by rule or order, providing
2757 safety comparable to federally insured trust accounts.
2758 (3) It is not a violation of Subsection (2)(a) if the amounts in the accounts exceed the
2759 amount of the federal insurance on the accounts.
2760 (4) A trust account into which money is deposited may be interest bearing. The
2761 interest accrued on the account may be paid to the licensee, so long as the licensee otherwise
2762 complies with this section and with the contract with the insurer.
2763 (5) A depository institution or other organization holding trust funds under this section
2764 may not offset or impound trust account funds against debts and obligations incurred by the
2766 (6) A licensee who, not being lawfully entitled to do so, diverts or appropriates any
2767 portion of the money held under Subsection (1) to the licensee's own use, is guilty of theft
2768 under Title 76, Chapter 6, Part 4, Theft. Section 76-6-412 applies in determining the
2769 classification of the offense. Sanctions under Section 31A-2-308 also apply.
2770 (7) A nonresident licensee:
2771 (a) shall comply with Subsection (1)(a) by complying with the trust account
2772 requirements of the nonresident licensee's home state; and
2773 (b) is not required to comply with the other provisions of this section.
2774 Section 27. Section 31A-23a-412 is amended to read:
2775 31A-23a-412. Place of business and residence address -- Records.
2776 (1) (a) A licensee under this chapter shall register and maintain with the commissioner:
2777 (i) the address and telephone numbers of the licensee's principal place of business; and
2778 (ii) a valid business email address at which the commissioner may contact the licensee.
2779 (b) If a licensee is an individual, in addition to complying with Subsection (1)(a) the
2780 individual shall register and maintain with the commissioner the individual's residence address
2781 and telephone number.
2782 (c) A licensee shall notify the commissioner within 30 days of a change of any of the
2783 following required to be registered with the commissioner under this section:
2784 (i) an address;
2785 (ii) a telephone number; or
2786 (iii) a business email address.
2787 (2) (a) Except as provided under Subsection (3), a licensee under this chapter shall
2788 keep at the principal place of business address registered under Subsection (1), separate and
2789 distinct books and records of the transactions consummated under the Utah license.
2790 (b) The books and records described in Subsection (2)(a) shall:
2791 (i) be in an organized form;
2792 (ii) be available to the commissioner for inspection upon reasonable notice; and
2793 (iii) include all of the following:
2794 (A) if the licensee is a producer, surplus lines producer, limited line producer,
2795 consultant, managing general agent, or reinsurance intermediary:
2796 (I) a record of each insurance contract procured by or issued through the licensee, with
2797 the names of insurers and insureds, the amount of premium and commissions or other
2798 compensation, and the subject of the insurance;
2799 (II) the names of any other producers, surplus lines producers, limited line producers,
2800 consultants, managing general agents, or reinsurance intermediaries from whom business is
2801 accepted, and of persons to whom commissions or allowances of any kind are promised or
2802 paid; and
2803 (III) a record of the consumer complaints forwarded to the licensee by an insurance
2805 (B) if the licensee is a consultant, a record of each agreement outlining the work
2806 performed and the fee for the work; and
2807 (C) any additional information which:
2808 (I) is customary for a similar business; or
2809 (II) may reasonably be required by the commissioner by rule.
2810 (3) Subsection (2) is satisfied if the books and records specified in Subsection (2) can
2811 be obtained immediately from a central storage place or elsewhere by on-line computer
2812 terminals located at the registered address.
2813 (4) A licensee who represents only a single insurer satisfies Subsection (2) if the
2814 insurer maintains the books and records pursuant to Subsection (2) at a place satisfying
2815 Subsections (1) and (5).
2816 (5) (a) The books and records maintained under Subsection (2) or Section
2817 31A-23a-413 shall be available for the inspection of the commissioner during [
2818 hours for a period of time after the date of the transaction as specified by the commissioner by
2819 rule, but in no case for less than the current calendar year plus three years.
2820 (b) Discarding books and records after the applicable record retention period has
2821 expired does not place the licensee in violation of a later-adopted longer record retention
2823 Section 28. Section 31A-23a-504 is amended to read:
2824 31A-23a-504. Sharing commissions.
2825 (1) (a) Except as provided in Subsection 31A-15-103 (3), a licensee under this chapter
2826 or an insurer may only pay consideration or reimburse out-of-pocket expenses to a person if the
2827 licensee knows that the person is licensed under this chapter as to the particular type of
2828 insurance to act in Utah as:
2829 (i) a producer;
2830 (ii) a limited line producer;
2835 (b) A person may only accept commission compensation or other compensation as a
2836 person described in Subsections (1)(a)(i) through [
2837 result of an insurance transaction if that person is licensed under this chapter to act as described
2838 in Subsection (1)(a).
2839 (2) (a) Except as provided in Section 31A-23a-501 , a consultant may not pay or receive
2840 a commission or other compensation that is directly or indirectly the result of an insurance
2842 (b) A consultant may share a consultant fee or other compensation received for
2843 consulting services performed within Utah only:
2844 (i) with another consultant licensed under this chapter; and
2845 (ii) to the extent that the other consultant contributed to the services performed.
2846 (3) This section does not prohibit:
2847 (a) the payment of renewal commissions to former licensees under this chapter, former
2848 Title 31, Chapter 17, or their successors in interest under a deferred compensation or agency
2849 sales agreement;
2850 (b) compensation paid to or received by a person for referral of a potential customer
2851 that seeks to purchase or obtain an opinion or advice on an insurance product if:
2852 (i) the person is not licensed to sell insurance;
2853 (ii) the person does not sell or provide opinions or advice on the product; and
2854 (iii) the compensation does not depend on whether the referral results in a purchase or
2855 sale; or
2856 (c) the payment or assignment of a commission, service fee, brokerage, or other
2857 valuable consideration to an agency or a person who does not sell, solicit, or negotiate
2858 insurance in this state, unless the payment would constitute an inducement or commission
2859 rebate under Section 31A-23a-402 or 31A-23a-402.5 .
2860 (4) (a) In selling a policy of title insurance, sharing of commissions under Subsection
2861 (1) may not occur if it will result in:
2862 (i) an unlawful rebate;
2863 (ii) compensation in connection with controlled business; or
2864 (iii) payment of a forwarding fee or finder's fee.
2865 (b) A person may share compensation for the issuance of a title insurance policy only
2866 to the extent that the person contributed to the search and examination of the title or other
2867 services connected with the title insurance policy.
2868 (5) This section does not apply to a bail bond producer or bail enforcement agent as
2869 defined in Section 31A-35-102 .
2870 Section 29. Section 31A-25-203 is amended to read:
2871 31A-25-203. General requirements for license issuance.
2872 (1) The commissioner shall issue a license to act as a third party administrator to a
2873 person who:
2874 (a) satisfies the character requirements under Section 31A-25-204 ;
2875 (b) satisfies the financial responsibility requirement under Section 31A-25-205 ;
2876 (c) has not committed an act that is a ground for denial, suspension, or revocation
2877 provided in Section 31A-25-208 ;
2878 (d) if a nonresident, complies with Section 31A-25-206 ; and
2879 (e) pays the applicable fees under Section 31A-3-103 .
2880 (2) (a) This Subsection (2) applies to the following persons:
2881 (i) an applicant for a third party administrator's license; or
2882 (ii) a licensed third party administrator.
2883 (b) A person described in Subsection (2)(a) shall report to the commissioner:
2884 (i) an administrative action taken against the person, including a denial of a new or
2885 renewal license application:
2886 (A) in another jurisdiction; or
2887 (B) by another regulatory agency in this state; and
2888 (ii) a criminal prosecution taken against the person in any jurisdiction.
2889 (c) The report required by Subsection (2)(b) shall:
2890 (i) be filed:
2891 (A) at the time the person applies for a third party administrator's license; and
2892 (B) if an action or prosecution occurs on or after the day on which the person applies
2893 for a third party administrator license:
2894 (I) for an administrative action, within 30 days of the final disposition of the
2895 administrative action; or
2896 (II) for a criminal prosecution, within 30 days of the initial appearance before a court;
2898 (ii) include a copy of the complaint or other relevant legal documents related to the
2899 action or prosecution described in Subsection (2)(b).
2900 (3) (a) The department may require a person applying for a license or for consent to
2901 engage in the business of insurance to submit to a criminal background check as a condition of
2902 receiving a license or consent.
2903 (b) A person, if required to submit to a criminal background check under Subsection
2904 (3)(a), shall:
2905 (i) submit a fingerprint card in a form acceptable to the department; and
2906 (ii) consent to a fingerprint background check by:
2907 (A) the Utah Bureau of Criminal Identification; and
2908 (B) the Federal Bureau of Investigation.
2909 (c) For a person who submits a fingerprint card and consents to a fingerprint
2910 background check under Subsection (3)(b), the department may request concerning a person
2911 applying for a third party administrator's license:
2912 (i) criminal background information maintained pursuant to Title 53, Chapter 10, Part
2913 2, Bureau of Criminal Identification, from the Bureau of Criminal Identification; and
2914 (ii) complete Federal Bureau of Investigation criminal background checks through the
2915 national criminal history system.
2916 (d) Information obtained by the department from the review of criminal history records
2917 received under this Subsection (3) shall be used by the department for the purposes of:
2918 (i) determining if a person satisfies the character requirements under Section
2919 31A-25-204 for issuance or renewal of a license;
2920 (ii) determining if a person has failed to maintain the character requirements under
2921 Section 31A-25-204 ; and
2922 (iii) preventing a person who violates the federal Violent Crime Control and Law
2923 Enforcement Act of 1994, 18 U.S.C. [
2924 business of insurance in the state.
2925 (e) If the department requests the criminal background information, the department
2927 (i) pay to the Department of Public Safety the costs incurred by the Department of
2928 Public Safety in providing the department criminal background information under Subsection
2930 (ii) pay to the Federal Bureau of Investigation the costs incurred by the Federal Bureau
2931 of Investigation in providing the department criminal background information under
2932 Subsection (3)(c)(ii); and
2933 (iii) charge the person applying for a license or for consent to engage in the business of
2934 insurance a fee equal to the aggregate of Subsections (3)(e)(i) and (ii).
2935 (4) The commissioner may deny a license application to act as a third party
2936 administrator to a person who:
2937 (a) fails to satisfy the requirements of this section; or
2938 (b) commits an act that is a ground for denial, suspension, or revocation provided in
2939 Section 31A-25-208 .
2940 Section 30. Section 31A-25-306 is amended to read:
2941 31A-25-306. Payments by administrator.
2943 collected on behalf of the insurer [
2945 Section 31. Section 31A-26-203 is amended to read:
2946 31A-26-203. Adjuster's license required.
2947 (1) The commissioner shall issue a license to act as an independent adjuster or public
2948 adjuster to a person who, as to the license classification applied for under Section 31A-26-204 :
2949 (a) satisfies the character requirements under Section 31A-26-205 ;
2950 (b) satisfies the applicable continuing education requirements under Section
2951 31A-26-206 ;
2952 (c) satisfies the applicable examination requirements under Section 31A-26-207 ;
2953 (d) has not committed an act that is a ground for denial, suspension, or revocation
2954 provided for in Section 31A-26-213 ;
2955 (e) if a nonresident, complies with Section 31A-26-208 ; and
2956 (f) pays the applicable fees under Section 31A-3-103 .
2957 (2) (a) This Subsection (2) applies to the following persons:
2958 (i) an applicant for:
2959 (A) an independent adjuster's license; or
2960 (B) a public adjuster's license;
2961 (ii) a licensed independent adjuster; or
2962 (iii) a licensed public adjuster.
2963 (b) A person described in Subsection (2)(a) shall report to the commissioner:
2964 (i) an administrative action taken against the person, including a denial of a new or
2965 renewal license application:
2966 (A) in another jurisdiction; or
2967 (B) by another regulatory agency in this state; and
2968 (ii) a criminal prosecution taken against the person in any jurisdiction.
2969 (c) The report required by Subsection (2)(b) shall:
2970 (i) be filed:
2971 (A) at the time the person applies for an adjustor's license; and
2972 (B) if an action or prosecution occurs on or after the day on which the person applies
2973 for an adjustor's license:
2974 (I) for an administrative action, within 30 days of the final disposition of the
2975 administrative action; or
2976 (II) for a criminal prosecution, within 30 days of the initial appearance before a court;
2978 (ii) include a copy of the complaint or other relevant legal documents related to the
2979 action or prosecution described in Subsection (2)(b).
2980 (3) (a) The department may require a person applying for a license or for consent to
2981 engage in the business of insurance to submit to a criminal background check as a condition of
2982 receiving a license or consent.
2983 (b) A person, if required to submit to a criminal background check under Subsection
2984 (3)(a), shall:
2985 (i) submit a fingerprint card in a form acceptable to the department; and
2986 (ii) consent to a fingerprint background check by:
2987 (A) the Utah Bureau of Criminal Identification; and
2988 (B) the Federal Bureau of Investigation.
2989 (c) For a person who submits a fingerprint card and consents to a fingerprint
2990 background check under Subsection (3)(b), the department may request concerning a person
2991 applying for an independent or public adjuster's license:
2992 (i) criminal background information maintained pursuant to Title 53, Chapter 10, Part
2993 2, Bureau of Criminal Identification, from the Bureau of Criminal Identification; and
2994 (ii) complete Federal Bureau of Investigation criminal background checks through the
2995 national criminal history system.
2996 (d) Information obtained by the department from the review of criminal history records
2997 received under this Subsection (3) shall be used by the department for the purposes of:
2998 (i) determining if a person satisfies the character requirements under Section
2999 31A-26-205 for issuance or renewal of a license;
3000 (ii) determining if a person has failed to maintain the character requirements under
3001 Section 31A-26-205 ; and
3002 (iii) preventing a person who violates the federal Violent Crime Control and Law
3003 Enforcement Act of 1994, 18 U.S.C. [
3004 business of insurance in the state.
3005 (e) If the department requests the criminal background information, the department
3007 (i) pay to the Department of Public Safety the costs incurred by the Department of
3008 Public Safety in providing the department criminal background information under Subsection
3010 (ii) pay to the Federal Bureau of Investigation the costs incurred by the Federal Bureau
3011 of Investigation in providing the department criminal background information under
3012 Subsection (3)(c)(ii); and
3013 (iii) charge the person applying for a license or for consent to engage in the business of
3014 insurance a fee equal to the aggregate of Subsections (3)(e)(i) and (ii).
3015 (4) The commissioner may deny a license application to act as an independent adjuster
3016 or public adjuster to a person who, as to the license classification applied for under Section
3017 31A-26-204 :
3018 (a) fails to satisfy the requirements in this section; or
3019 (b) commits an act that is a ground for denial, suspension, or revocation provided for in
3020 Section 31A-26-213 .
3021 (5) Notwithstanding the other provisions of this section, the commissioner may:
3022 (a) issue a license to an applicant for a license for a title insurance classification only
3023 with the concurrence of the Title and Escrow Commission; or
3024 (b) renew a license for a title insurance classification only with the concurrence of the
3025 Title and Escrow Commission.
3026 Section 32. Section 31A-27-503 is amended to read:
3027 31A-27-503. Commissioner's administrative actions.
3028 (1) (a) The commissioner may take an action described in Subsection (1)(b) whenever
3029 the commissioner has reasonable cause to believe, and determines after a hearing that an
3031 (i) has committed or engaged in an act, practice, or transaction that would subject the
3032 insurer to a formal delinquency proceeding under Chapter 27a, Insurer Receivership Act;
3033 (ii) is committing or engaging in an act, practice, or transaction that would subject the
3034 insurer to a formal delinquency proceeding under Chapter 27a, Insurer Receivership Act;
3035 (iii) is about to commit or engage in an act, practice, or transaction that would subject
3036 the insurer to a formal delinquency proceeding under Chapter 27a, Insurer Receivership Act;
3038 (iv) is in or is about to be in a condition that would subject the insurer to a formal
3039 delinquency proceeding under Chapter 27a, Insurer Receivership Act[
3040 (v) is in hazardous financial condition or potentially hazardous financial condition, as
3041 defined by rule made under Subsection 31A-27a-101 (3)(c).
3042 (b) If the conditions of Subsection (1)(a) are met, the commissioner may make and
3043 serve upon the insurer and any other persons whose action or forbearance from action is
3044 reasonably necessary, those orders, other than a seizure order under Section 31A-27a-201 , that
3045 are reasonably necessary to correct, eliminate, or remedy the act, practice, transaction, or
3046 condition described in Subsection (1)(a).
3047 (c) The commissioner may issue an order for the insurer to submit to supervision by a
3048 supervisor appointed by the commissioner until the act, practice, transaction, or condition that
3049 is the ground for the order has been halted or corrected.
3050 (2) (a) The commissioner may make and serve an order issued under Subsection (1)
3051 without notice and before a hearing if:
3052 (i) the conditions of Subsection (1) are satisfied; and
3053 (ii) it appears to the commissioner that irreparable harm to the property or business of
3054 the insurer or to the interests of its policyholders, creditors, or the public may occur unless the
3055 commissioner issues, with immediate effect, the order.
3056 (b) The commissioner shall serve the insurer with an order described in this Subsection
3057 (2) and a notice of agency action, containing a statement of the reasons why irreparable harm is
3058 threatened unless the order is issued with immediate effect.
3059 (3) (a) If the commissioner issues an order for supervision of an insurer under
3060 Subsection (1) or (2), the commissioner shall:
3061 (i) notify the insurer that the insurer is under the supervision of the commissioner; and
3062 (ii) explain the reasons for that supervision.
3063 (b) During the period of supervision, the commissioner may prohibit the insurer from
3064 doing any of the following, without the prior approval of the commissioner or a supervisor
3065 appointed by the commissioner:
3066 (i) transferring any of its assets or its business in force;
3067 (ii) withdrawing funds from any of its bank accounts;
3068 (iii) lending any of its funds;
3069 (iv) investing any of its funds;
3070 (v) transferring any of its property;
3071 (vi) incurring any debt, obligation, or liability other than in the ordinary and usual
3072 course of business; or
3073 (vii) entering into any new reinsurance contract or treaty.