2
3
4
5
6
7 LONG TITLE
8 Committee Note:
9 The Business and Labor Interim Committee recommended this bill.
10 Legislative Vote: 16 voting for 0 voting against 5 absent
11 General Description:
12 This bill amends the Insurance Code.
13 Highlighted Provisions:
14 This bill:
15 ▸ amends definitions;
16 ▸ defines terms;
17 ▸ modifies provisions regarding Title and Escrow Commission meetings;
18 ▸ amends required disclosures for a service contract and vehicle protection product
19 warranty;
20 ▸ amends provisions related to the registration of insurers;
21 ▸ requires a large insurance holding company to submit to the Insurance Department a
22 Group Capital Calculation and Liquidity Stress Test results;
23 ▸ amends provisions regarding the standards and management of an insurer within a
24 holding company system;
25 ▸ amends provisions related to the confidentiality of certain information obtained by
26 the Utah Insurance Commissioner (commissioner);
27 ▸ allows an unearned premium reserve fund to be released in accordance with the
28 standards of the National Association of Insurance Commissioners;
29 ▸ amends provisions regarding title insurance;
30 ▸ amends insurance form requirements;
31 ▸ amends provisions regarding insurance policy renewal notification requirements;
32 ▸ amends provisions related to an arbitration decision's resolution of a claim under an
33 underinsured motorist policy;
34 ▸ amends provisions related to accident and health insurance;
35 ▸ enacts provisions related to the renewal, cancellation, and modification of a group
36 accident and health insurance plan;
37 ▸ allows the commissioner to take action against a license of an insurance producer
38 who fails to pay a final judgment rendered against the insurance producer by a court
39 outside of this state;
40 ▸ makes an affiliate of an insolvent insurer subject to Title 31A, Chapter 27a, Insurer
41 Receivership Act;
42 ▸ amends provisions related to a defense to a claim by a receiver;
43 ▸ amends provisions related to a bail bond agency's required financial statements;
44 ▸ provides a sunset date for provisions of this bill, subject to review;
45 ▸ amends the criminal offense of fraudulent insurance act; and
46 ▸ makes technical and conforming changes.
47 Money Appropriated in this Bill:
48 None
49 Other Special Clauses:
50 None
51 Utah Code Sections Affected:
52 AMENDS:
53 26-61a-201, as last amended by Laws of Utah 2021, Chapters 17 and further amended
54 by Revisor Instructions, Laws of Utah 2021, Chapters 337, 337, and 350
55 26-61a-204, as last amended by Laws of Utah 2021, Chapter 350
56 31A-1-301, as last amended by Laws of Utah 2021, Second Special Session, Chapter 4
57 31A-2-403, as last amended by Laws of Utah 2020, Chapters 32, 352, and 373
58 31A-6a-104, as last amended by Laws of Utah 2020, Chapter 32
59 31A-16-105, as last amended by Laws of Utah 2017, Chapter 168
60 31A-16-106, as last amended by Laws of Utah 2015, Chapter 244
61 31A-16-109, as last amended by Laws of Utah 2019, Chapter 193
62 31A-17-408, as last amended by Laws of Utah 2001, Chapter 116
63 31A-17-601, as last amended by Laws of Utah 2020, Chapter 32
64 31A-19a-209, as last amended by Laws of Utah 2015, Chapters 312 and 330
65 31A-21-201, as last amended by Laws of Utah 2021, Chapter 252
66 31A-21-303, as last amended by Laws of Utah 2020, Chapter 292
67 31A-22-305.3, as last amended by Laws of Utah 2020, Chapter 145
68 31A-22-602, as last amended by Laws of Utah 2021, Chapter 252
69 31A-22-627, as last amended by Laws of Utah 2021, Chapter 252
70 31A-23a-111, as last amended by Laws of Utah 2020, Chapter 32
71 31A-27a-104, as last amended by Laws of Utah 2013, Chapter 319
72 31A-27a-111, as last amended by Laws of Utah 2018, Chapter 319
73 31A-30-103, as last amended by Laws of Utah 2019, Chapter 193
74 31A-35-404, as last amended by Laws of Utah 2021, Chapter 252
75 58-13-2.5, as enacted by Laws of Utah 2009, Chapter 14
76 63I-1-231, as last amended by Laws of Utah 2019, Chapter 136
77 76-6-521, as last amended by Laws of Utah 2019, Chapter 193
78 ENACTS:
79 31A-22-727, Utah Code Annotated 1953
80 REPEALS:
81 31A-17-519, as last amended by Laws of Utah 2019, Chapter 193
82
83 Be it enacted by the Legislature of the state of Utah:
84 Section 1. Section 26-61a-201 is amended to read:
85 26-61a-201. Medical cannabis patient card -- Medical cannabis guardian card --
86 Conditional medical cannabis card -- Application -- Fees -- Studies.
87 (1) (a) The department shall, within 15 days after the day on which an individual who
88 satisfies the eligibility criteria in this section or Section 26-61a-202 submits an application in
89 accordance with this section or Section 26-61a-202:
90 (i) issue a medical cannabis patient card to an individual described in Subsection
91 (2)(a);
92 (ii) issue a medical cannabis guardian card to an individual described in Subsection
93 (2)(b);
94 (iii) issue a provisional patient card to a minor described in Subsection (2)(c); and
95 (iv) issue a medical cannabis caregiver card to an individual described in Subsection
96 26-61a-202(4).
97 (b) (i) Beginning on the earlier of September 1, 2021, or the date on which the
98 electronic verification system is functionally capable of facilitating a conditional medical
99 cannabis card under this Subsection (1)(b), upon the entry of a recommending medical
100 provider's medical cannabis recommendation for a patient in the state electronic verification
101 system, either by the provider or the provider's employee or by a medical cannabis pharmacy
102 medical provider or medical cannabis pharmacy in accordance with Subsection
103 26-61a-501(11)(a), the department shall issue to the patient an electronic conditional medical
104 cannabis card, in accordance with this Subsection (1)(b).
105 (ii) A conditional medical cannabis card is valid for the lesser of:
106 (A) 60 days; or
107 (B) the day on which the department completes the department's review and issues a
108 medical cannabis card under Subsection (1)(a), denies the patient's medical cannabis card
109 application, or revokes the conditional medical cannabis card under Subsection (8).
110 (iii) The department may issue a conditional medical cannabis card to an individual
111 applying for a medical cannabis patient card for which approval of the Compassionate Use
112 Board is not required.
113 (iv) An individual described in Subsection (1)(b)(iii) has the rights, restrictions, and
114 obligations under law applicable to a holder of the medical cannabis card for which the
115 individual applies and for which the department issues the conditional medical cannabis card.
116 (2) (a) An individual is eligible for a medical cannabis patient card if:
117 (i) (A) the individual is at least 21 years old; or
118 (B) the individual is 18, 19, or 20 years old, the individual petitions the Compassionate
119 Use Board under Section 26-61a-105, and the Compassionate Use Board recommends
120 department approval of the petition;
121 (ii) the individual is a Utah resident;
122 (iii) the individual's recommending medical provider recommends treatment with
123 medical cannabis in accordance with Subsection (4);
124 (iv) the individual signs an acknowledgment stating that the individual received the
125 information described in Subsection (8); and
126 (v) the individual pays to the department a fee in an amount that, subject to Subsection
127 26-61a-109(5), the department sets in accordance with Section 63J-1-504.
128 (b) (i) An individual is eligible for a medical cannabis guardian card if the individual:
129 (A) is at least 18 years old;
130 (B) is a Utah resident;
131 (C) is the parent or legal guardian of a minor for whom the minor's qualified medical
132 provider recommends a medical cannabis treatment, the individual petitions the Compassionate
133 Use Board under Section 26-61a-105, and the Compassionate Use Board recommends
134 department approval of the petition;
135 (D) the individual signs an acknowledgment stating that the individual received the
136 information described in Subsection (9);
137 (E) pays to the department a fee in an amount that, subject to Subsection
138 26-61a-109(5), the department sets in accordance with Section 63J-1-504, plus the cost of the
139 criminal background check described in Section 26-61a-203; and
140 (F) the individual has not been convicted of a misdemeanor or felony drug distribution
141 offense under either state or federal law, unless the individual completed any imposed sentence
142 six months or more before the day on which the individual applies for a medical cannabis
143 guardian card.
144 (ii) The department shall notify the Department of Public Safety of each individual that
145 the department registers for a medical cannabis guardian card.
146 (c) (i) A minor is eligible for a provisional patient card if:
147 (A) the minor has a qualifying condition;
148 (B) the minor's qualified medical provider recommends a medical cannabis treatment
149 to address the minor's qualifying condition;
150 (C) one of the minor's parents or legal guardians petitions the Compassionate Use
151 Board under Section 26-61a-105, and the Compassionate Use Board recommends department
152 approval of the petition; and
153 (D) the minor's parent or legal guardian is eligible for a medical cannabis guardian card
154 under Subsection (2)(b) or designates a caregiver under Subsection (2)(d) who is eligible for a
155 medical cannabis caregiver card under Section 26-61a-202.
156 (ii) The department shall automatically issue a provisional patient card to the minor
157 described in Subsection (2)(c)(i) at the same time the department issues a medical cannabis
158 guardian card to the minor's parent or legal guardian.
159 (d) Beginning on the earlier of September 1, 2021, or the date on which the electronic
160 verification system is functionally capable of servicing the designation, if the parent or legal
161 guardian of a minor described in Subsections (2)(c)(i)(A) through (C) does not qualify for a
162 medical cannabis guardian card under Subsection (2)(b), the parent or legal guardian may
163 designate up to two caregivers in accordance with Subsection 26-61a-202(1)(c) to ensure that
164 the minor has adequate and safe access to the recommended medical cannabis treatment.
165 (3) (a) An individual who is eligible for a medical cannabis card described in
166 Subsection (2)(a) or (b) shall submit an application for a medical cannabis card to the
167 department:
168 (i) through an electronic application connected to the state electronic verification
169 system;
170 (ii) with the recommending medical provider; and
171 (iii) with information including:
172 (A) the applicant's name, gender, age, and address;
173 (B) the number of the applicant's valid form of photo identification;
174 (C) for a medical cannabis guardian card, the name, gender, and age of the minor
175 receiving a medical cannabis treatment under the cardholder's medical cannabis guardian card;
176 and
177 (D) for a provisional patient card, the name of the minor's parent or legal guardian who
178 holds the associated medical cannabis guardian card.
179 (b) The department shall ensure that a medical cannabis card the department issues
180 under this section contains the information described in Subsection (3)(a)(iii).
181 (c) (i) If a recommending medical provider determines that, because of age, illness, or
182 disability, a medical cannabis patient cardholder requires assistance in administering the
183 medical cannabis treatment that the recommending medical provider recommends, the
184 recommending medical provider may indicate the cardholder's need in the state electronic
185 verification system, either directly or, for a limited medical provider, through the order
186 described in Subsections 26-61a-106(1)(c) and (d).
187 (ii) If a recommending medical provider makes the indication described in Subsection
188 (3)(c)(i):
189 (A) the department shall add a label to the relevant medical cannabis patient card
190 indicating the cardholder's need for assistance;
191 (B) any adult who is 18 years old or older and who is physically present with the
192 cardholder at the time the cardholder needs to use the recommended medical cannabis
193 treatment may handle the medical cannabis treatment and any associated medical cannabis
194 device as needed to assist the cardholder in administering the recommended medical cannabis
195 treatment; and
196 (C) an individual of any age who is physically present with the cardholder in the event
197 of an emergency medical condition, as that term is defined in Section [
198 31A-1-301, may handle the medical cannabis treatment and any associated medical cannabis
199 device as needed to assist the cardholder in administering the recommended medical cannabis
200 treatment.
201 (iii) A non-cardholding individual acting under Subsection (3)(c)(ii)(B) or (C) may not:
202 (A) ingest or inhale medical cannabis;
203 (B) possess, transport, or handle medical cannabis or a medical cannabis device outside
204 of the immediate area where the cardholder is present or with an intent other than to provide
205 assistance to the cardholder; or
206 (C) possess, transport, or handle medical cannabis or a medical cannabis device when
207 the cardholder is not in the process of being dosed with medical cannabis.
208 (4) To recommend a medical cannabis treatment to a patient or to renew a
209 recommendation, a recommending medical provider shall:
210 (a) before recommending or renewing a recommendation for medical cannabis in a
211 medicinal dosage form or a cannabis product in a medicinal dosage form:
212 (i) verify the patient's and, for a minor patient, the minor patient's parent or legal
213 guardian's valid form of identification described in Subsection (3)(a);
214 (ii) review any record related to the patient and, for a minor patient, the patient's parent
215 or legal guardian in:
216 (A) for a qualified medical provider, the state electronic verification system; and
217 (B) the controlled substance database created in Section 58-37f-201; and
218 (iii) consider the recommendation in light of the patient's qualifying condition and
219 history of medical cannabis and controlled substance use during an initial face-to-face visit
220 with the patient; and
221 (b) state in the recommending medical provider's recommendation that the patient:
222 (i) suffers from a qualifying condition, including the type of qualifying condition; and
223 (ii) may benefit from treatment with cannabis in a medicinal dosage form or a cannabis
224 product in a medicinal dosage form.
225 (5) (a) Except as provided in Subsection (5)(b), a medical cannabis card that the
226 department issues under this section is valid for the lesser of:
227 (i) an amount of time that the recommending medical provider determines; or
228 (ii) (A) six months for the first issuance, and, except as provided in Subsection
229 (5)(a)(ii)(B), for a renewal; or
230 (B) for a renewal, one year if, after at least one year following the issuance of the
231 original medical cannabis card, the recommending medical provider determines that the patient
232 has been stabilized on the medical cannabis treatment and a one-year renewal period is
233 justified.
234 (b) (i) A medical cannabis card that the department issues in relation to a terminal
235 illness described in Section 26-61a-104 does not expire.
236 (ii) The recommending medical provider may revoke a recommendation that the
237 provider made in relation to a terminal illness described in Section 26-61a-104 if the medical
238 cannabis cardholder no longer has the terminal illness.
239 (6) (a) A medical cannabis patient card or a medical cannabis guardian card is
240 renewable if:
241 (i) at the time of renewal, the cardholder meets the requirements of Subsection (2)(a) or
242 (b); or
243 (ii) the cardholder received the medical cannabis card through the recommendation of
244 the Compassionate Use Board under Section 26-61a-105.
245 (b) A cardholder described in Subsection (6)(a) may renew the cardholder's card:
246 (i) using the application process described in Subsection (3); or
247 (ii) through phone or video conference with the recommending medical provider who
248 made the recommendation underlying the card, at the qualifying medical provider's discretion.
249 (c) A cardholder under Subsection (2)(a) or (b) who renews the cardholder's card shall
250 pay to the department a renewal fee in an amount that:
251 (i) subject to Subsection 26-61a-109(5), the department sets in accordance with Section
252 63J-1-504; and
253 (ii) may not exceed the cost of the relatively lower administrative burden of renewal in
254 comparison to the original application process.
255 (d) If a minor meets the requirements of Subsection (2)(c), the minor's provisional
256 patient card renews automatically at the time the minor's parent or legal guardian renews the
257 parent or legal guardian's associated medical cannabis guardian card.
258 (7) (a) A cardholder under this section shall carry the cardholder's valid medical
259 cannabis card with the patient's name.
260 (b) (i) A medical cannabis patient cardholder or a provisional patient cardholder may
261 purchase, in accordance with this chapter and the recommendation underlying the card,
262 cannabis in a medicinal dosage form, a cannabis product in a medicinal dosage form, or a
263 medical cannabis device.
264 (ii) A cardholder under this section may possess or transport, in accordance with this
265 chapter and the recommendation underlying the card, cannabis in a medicinal dosage form, a
266 cannabis product in a medicinal dosage form, or a medical cannabis device.
267 (iii) To address the qualifying condition underlying the medical cannabis treatment
268 recommendation:
269 (A) a medical cannabis patient cardholder or a provisional patient cardholder may use
270 cannabis in a medicinal dosage form, a medical cannabis product in a medicinal dosage form,
271 or a medical cannabis device; and
272 (B) a medical cannabis guardian cardholder may assist the associated provisional
273 patient cardholder with the use of cannabis in a medicinal dosage form, a medical cannabis
274 product in a medicinal dosage form, or a medical cannabis device.
275 (c) If a licensed medical cannabis pharmacy is not operating within the state after
276 January 1, 2021, a cardholder under this section:
277 (i) may possess:
278 (A) up to the legal dosage limit of unprocessed cannabis in a medicinal dosage form;
279 (B) up to the legal dosage limit of a cannabis product in a medicinal dosage form; and
280 (C) marijuana drug paraphernalia; and
281 (ii) is not subject to prosecution for the possession described in Subsection (7)(c)(i).
282 (8) The department may revoke a medical cannabis card that the department issues
283 under this section if the cardholder:
284 (a) violates this chapter; or
285 (b) is convicted under state or federal law of:
286 (i) a felony; or
287 (ii) after March 17, 2021, a misdemeanor for drug distribution.
288 (9) The department shall establish by rule, in accordance with Title 63G, Chapter 3,
289 Utah Administrative Rulemaking Act, a process to provide information regarding the following
290 to an individual receiving a medical cannabis card:
291 (a) risks associated with medical cannabis treatment;
292 (b) the fact that a condition's listing as a qualifying condition does not suggest that
293 medical cannabis treatment is an effective treatment or cure for that condition, as described in
294 Subsection 26-61a-104(1); and
295 (c) other relevant warnings and safety information that the department determines.
296 (10) The department may establish procedures by rule, in accordance with Title 63G,
297 Chapter 3, Utah Administrative Rulemaking Act, to implement the application and issuance
298 provisions of this section.
299 (11) (a) On or before September 1, 2021, the department shall establish by rule, in
300 accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, a process to allow
301 an individual from another state to register with the department in order to purchase medical
302 cannabis or a medical cannabis device from a medical cannabis pharmacy while the individual
303 is visiting the state.
304 (b) The department may only provide the registration process described in Subsection
305 (11)(a):
306 (i) to a nonresident patient; and
307 (ii) for no more than two visitation periods per calendar year of up to 21 calendar days
308 per visitation period.
309 (12) (a) A person may submit to the department a request to conduct a research study
310 using medical cannabis cardholder data that the state electronic verification system contains.
311 (b) The department shall review a request described in Subsection (12)(a) to determine
312 whether an institutional review board, as that term is defined in Section 26-61-102, could
313 approve the research study.
314 (c) At the time an individual applies for a medical cannabis card, the department shall
315 notify the individual:
316 (i) of how the individual's information will be used as a cardholder;
317 (ii) that by applying for a medical cannabis card, unless the individual withdraws
318 consent under Subsection (12)(d), the individual consents to the use of the individual's
319 information for external research; and
320 (iii) that the individual may withdraw consent for the use of the individual's
321 information for external research at any time, including at the time of application.
322 (d) An applicant may, through the medical cannabis card application, and a medical
323 cannabis cardholder may, through the state central patient portal, withdraw the applicant's or
324 cardholder's consent to participate in external research at any time.
325 (e) The department may release, for the purposes of a study described in this
326 Subsection (12), information about a cardholder under this section who consents to participate
327 under Subsection (12)(c).
328 (f) If an individual withdraws consent under Subsection (12)(d), the withdrawal of
329 consent:
330 (i) applies to external research that is initiated after the withdrawal of consent; and
331 (ii) does not apply to research that was initiated before the withdrawal of consent.
332 (g) The department may establish standards for a medical research study's validity, by
333 rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
334 (13) The department shall record the issuance or revocation of a medical cannabis card
335 under this section in the controlled substance database.
336 Section 2. Section 26-61a-204 is amended to read:
337 26-61a-204. Medical cannabis card -- Patient and designated caregiver
338 requirements -- Rebuttable presumption.
339 (1) (a) A medical cannabis cardholder who possesses medical cannabis that the
340 cardholder purchased under this chapter:
341 (i) shall carry:
342 (A) at all times the cardholder's medical cannabis card; and
343 (B) after the earlier of January 1, 2021, or the day on which the individual purchases
344 any medical cannabis from a medical cannabis pharmacy, with the medical cannabis, a label
345 that identifies that the medical cannabis was sold from a licensed medical cannabis pharmacy
346 and includes an identification number that links the medical cannabis to the inventory control
347 system; [
348 (ii) may possess up to the legal dosage limit of:
349 (A) unprocessed cannabis in medicinal dosage form; and
350 (B) a cannabis product in medicinal dosage form;
351 (iii) may not possess more medical cannabis than described in Subsection (1)(a)(ii);
352 (iv) may only possess the medical cannabis in the container in which the cardholder
353 received the medical cannabis from the medical cannabis pharmacy; and
354 (v) may not alter or remove any label described in Section 4-41a-602 from the
355 container described in Subsection (1)(a)(iv).
356 (b) Except as provided in Subsection (1)(c) or (e), a medical cannabis cardholder who
357 possesses medical cannabis in violation of Subsection (1)(a) is:
358 (i) guilty of an infraction; and
359 (ii) subject to a $100 fine.
360 (c) A medical cannabis cardholder or a nonresident patient who possesses medical
361 cannabis in an amount that is greater than the legal dosage limit and equal to or less than twice
362 the legal dosage limit is:
363 (i) for a first offense:
364 (A) guilty of an infraction; and
365 (B) subject to a fine of up to $100; and
366 (ii) for a second or subsequent offense:
367 (A) guilty of a class B misdemeanor; and
368 (B) subject to a fine of $1,000.
369 (d) An individual who is guilty of a violation described in Subsection (1)(b) or (c) is
370 not guilty of a violation of Title 58, Chapter 37, Utah Controlled Substances Act, for the
371 conduct underlying the penalty described in Subsection (1)(b) or (c).
372 (e) A nonresident patient who possesses medical cannabis that is not in a medicinal
373 dosage form is:
374 (i) for a first offense:
375 (A) guilty of an infraction; and
376 (B) subject to a fine of up to $100; and
377 (ii) for a second or subsequent offense, is subject to the penalties described in Title 58,
378 Chapter 37, Utah Controlled Substances Act.
379 (f) A medical cannabis cardholder or a nonresident patient who possesses medical
380 cannabis in an amount that is greater than twice the legal dosage limit is subject to the penalties
381 described in Title 58, Chapter 37, Utah Controlled Substances Act.
382 (2) (a) As used in this Subsection (2), "emergency medical condition" means the same
383 as that term is defined in Section [
384 (b) Except as described in Subsection (2)(c), a medical cannabis patient cardholder, a
385 provisional patient cardholder, or a nonresident patient may not use, in public view, medical
386 cannabis or a cannabis product.
387 (c) In the event of an emergency medical condition, an individual described in
388 Subsection (2)(b) may use, and the holder of a medical cannabis guardian card or a medical
389 cannabis caregiver card may administer to the cardholder's charge, in public view, cannabis in a
390 medicinal dosage form or a cannabis product in a medicinal dosage form.
391 (d) An individual described in Subsection (2)(b) who violates Subsection (2)(b) is:
392 (i) for a first offense:
393 (A) guilty of an infraction; and
394 (B) subject to a fine of up to $100; and
395 (ii) for a second or subsequent offense:
396 (A) guilty of a class B misdemeanor; and
397 (B) subject to a fine of $1,000.
398 (3) If a medical cannabis cardholder carrying the cardholder's card possesses cannabis
399 in a medicinal dosage form or a cannabis product in compliance with Subsection (1), or a
400 medical cannabis device that corresponds with the cannabis or cannabis product:
401 (a) there is a rebuttable presumption that the cardholder possesses the cannabis,
402 cannabis product, or medical cannabis device legally; and
403 (b) there is no probable cause, based solely on the cardholder's possession of the
404 cannabis in medicinal dosage form, cannabis product in medicinal dosage form, or medical
405 cannabis device, to believe that the cardholder is engaging in illegal activity.
406 (4) (a) If a law enforcement officer stops an individual who possesses cannabis in a
407 medicinal dosage form, a cannabis product in a medicinal dosage form, or a medical cannabis
408 device, and the individual represents to the law enforcement officer that the individual holds a
409 valid medical cannabis card, but the individual does not have the medical cannabis card in the
410 individual's possession at the time of the stop by the law enforcement officer, the law
411 enforcement officer shall attempt to access the state electronic verification system to determine
412 whether the individual holds a valid medical cannabis card.
413 (b) If the law enforcement officer is able to verify that the individual described in
414 Subsection (4)(a) is a valid medical cannabis cardholder, the law enforcement officer:
415 (i) may not arrest or take the individual into custody for the sole reason that the
416 individual is in possession of cannabis in a medicinal dosage form, a cannabis product in a
417 medicinal dosage form, or a medical cannabis device; and
418 (ii) may not seize the cannabis, cannabis product, or medical cannabis device.
419 Section 3. Section 31A-1-301 is amended to read:
420 31A-1-301. Definitions.
421 As used in this title, unless otherwise specified:
422 (1) (a) "Accident and health insurance" means insurance to provide protection against
423 economic losses resulting from:
424 (i) a medical condition including:
425 (A) a medical care expense; or
426 (B) the risk of disability;
427 (ii) accident; or
428 (iii) sickness.
429 (b) "Accident and health insurance":
430 (i) includes a contract with disability contingencies including:
431 (A) an income replacement contract;
432 (B) a health care contract;
433 (C) [
434 (D) a credit accident and health contract;
435 (E) a continuing care contract; and
436 (F) a long-term care contract; and
437 (ii) may provide:
438 (A) hospital coverage;
439 (B) surgical coverage;
440 (C) medical coverage;
441 (D) loss of income coverage;
442 (E) prescription drug coverage;
443 (F) dental coverage; or
444 (G) vision coverage.
445 (c) "Accident and health insurance" does not include workers' compensation insurance.
446 (d) For purposes of a national licensing registry, "accident and health insurance" is the
447 same as "accident and health or sickness insurance."
448 (2) "Actuary" is as defined by the commissioner by rule, made in accordance with Title
449 63G, Chapter 3, Utah Administrative Rulemaking Act.
450 (3) "Administrator" means the same as that term is defined in Subsection [
451 (4) "Adult" means an individual who [
452 years old or older.
453 (5) "Affiliate" means a person who controls, is controlled by, or is under common
454 control with, another person. A corporation is an affiliate of another corporation, regardless of
455 ownership, if substantially the same group of individuals manage the corporations.
456 (6) "Agency" means:
457 (a) a person other than an individual, including a sole proprietorship by which an
458 individual does business under an assumed name; and
459 (b) an insurance organization licensed or required to be licensed under Section
460 31A-23a-301, 31A-25-207, or 31A-26-209.
461 (7) "Alien insurer" means an insurer domiciled outside the United States.
462 (8) "Amendment" means an endorsement to an insurance policy or certificate.
463 (9) "Annuity" means an agreement to make periodical payments for a period certain or
464 over the lifetime of one or more individuals if the making or continuance of all or some of the
465 series of the payments, or the amount of the payment, is dependent upon the continuance of
466 human life.
467 (10) "Application" means a document:
468 (a) (i) completed by an applicant to provide information about the risk to be insured;
469 and
470 (ii) that contains information that is used by the insurer to evaluate risk and decide
471 whether to:
472 (A) insure the risk under:
473 (I) the coverage as originally offered; or
474 (II) a modification of the coverage as originally offered; or
475 (B) decline to insure the risk; or
476 (b) used by the insurer to gather information from the applicant before issuance of an
477 annuity contract.
478 (11) "Articles" or "articles of incorporation" means:
479 (a) the original articles;
480 (b) a special law;
481 (c) a charter;
482 (d) an amendment;
483 (e) restated articles;
484 (f) articles of merger or consolidation;
485 (g) a trust instrument;
486 (h) another constitutive document for a trust or other entity that is not a corporation;
487 and
488 (i) an amendment to an item listed in Subsections (11)(a) through (h).
489 (12) "Bail bond insurance" means a guarantee that a person will attend court when
490 required, up to and including surrender of the person in execution of a sentence imposed under
491 Subsection 77-20-501(1), as a condition to the release of that person from confinement.
492 (13) "Binder" means the same as that term is defined in Section 31A-21-102.
493 (14) "Blanket insurance policy" or "blanket contract" means a group insurance policy
494 covering a defined class of persons:
495 (a) without individual underwriting or application; and
496 (b) that is determined by definition without designating each person covered.
497 (15) "Board," "board of trustees," or "board of directors" means the group of persons
498 with responsibility over, or management of, a corporation, however designated.
499 (16) "Bona fide office" means a physical office in this state:
500 (a) that is open to the public;
501 (b) that is staffed during regular business hours on regular business days; and
502 (c) at which the public may appear in person to obtain services.
503 (17) "Business entity" means:
504 (a) a corporation;
505 (b) an association;
506 (c) a partnership;
507 (d) a limited liability company;
508 (e) a limited liability partnership; or
509 (f) another legal entity.
510 (18) "Business of insurance" means the same as that term is defined in Subsection
511 [
512 (19) "Business plan" means the information required to be supplied to the
513 commissioner under Subsections 31A-5-204(2)(i) and (j), including the information required
514 when these subsections apply by reference under:
515 (a) Section 31A-8-205; or
516 (b) Subsection 31A-9-205(2).
517 (20) (a) "Bylaws" means the rules adopted for the regulation or management of a
518 corporation's affairs, however designated.
519 (b) "Bylaws" includes comparable rules for a trust or other entity that is not a
520 corporation.
521 (21) "Captive insurance company" means:
522 (a) an insurer:
523 (i) owned by a parent organization; and
524 (ii) whose purpose is to insure risks of the parent organization and other risks as
525 authorized under:
526 (A) Chapter 37, Captive Insurance Companies Act; and
527 (B) Chapter 37a, Special Purpose Financial Captive Insurance Company Act; or
528 (b) in the case of a group or association, an insurer:
529 (i) owned by the insureds; and
530 (ii) whose purpose is to insure risks of:
531 (A) a member organization;
532 (B) a group member; or
533 (C) an affiliate of:
534 (I) a member organization; or
535 (II) a group member.
536 (22) "Casualty insurance" means liability insurance.
537 (23) "Certificate" means evidence of insurance given to:
538 (a) an insured under a group insurance policy; or
539 (b) a third party.
540 (24) "Certificate of authority" is included within the term "license."
541 (25) "Claim," unless the context otherwise requires, means a request or demand on an
542 insurer for payment of a benefit according to the terms of an insurance policy.
543 (26) "Claims-made coverage" means an insurance contract or provision limiting
544 coverage under a policy insuring against legal liability to claims that are first made against the
545 insured while the policy is in force.
546 (27) (a) "Commissioner" or "commissioner of insurance" means Utah's insurance
547 commissioner.
548 (b) When appropriate, the terms listed in Subsection (27)(a) apply to the equivalent
549 supervisory official of another jurisdiction.
550 (28) (a) "Continuing care insurance" means insurance that:
551 (i) provides board and lodging;
552 (ii) provides one or more of the following:
553 (A) a personal service;
554 (B) a nursing service;
555 (C) a medical service; or
556 (D) any other health-related service; and
557 (iii) provides the coverage described in this Subsection (28)(a) under an agreement
558 effective:
559 (A) for the life of the insured; or
560 (B) for a period in excess of one year.
561 (b) Insurance is continuing care insurance regardless of whether or not the board and
562 lodging are provided at the same location as a service described in Subsection (28)(a)(ii).
563 (29) (a) "Control," "controlling," "controlled," or "under common control" means the
564 direct or indirect possession of the power to direct or cause the direction of the management
565 and policies of a person. This control may be:
566 (i) by contract;
567 (ii) by common management;
568 (iii) through the ownership of voting securities; or
569 (iv) by a means other than those described in Subsections (29)(a)(i) through (iii).
570 (b) There is no presumption that an individual holding an official position with another
571 person controls that person solely by reason of the position.
572 (c) A person having a contract or arrangement giving control is considered to have
573 control despite the illegality or invalidity of the contract or arrangement.
574 (d) There is a rebuttable presumption of control in a person who directly or indirectly
575 owns, controls, holds with the power to vote, or holds proxies to vote 10% or more of the
576 voting securities of another person.
577 (30) "Controlled insurer" means a licensed insurer that is either directly or indirectly
578 controlled by a producer.
579 (31) "Controlling person" means a person that directly or indirectly has the power to
580 direct or cause to be directed, the management, control, or activities of a reinsurance
581 intermediary.
582 (32) "Controlling producer" means a producer who directly or indirectly controls an
583 insurer.
584 (33) "Corporate governance annual disclosure" means a report an insurer or insurance
585 group files in accordance with the requirements of Chapter 16b, Corporate Governance Annual
586 Disclosure Act.
587 (34) (a) "Corporation" means an insurance corporation, except when referring to:
588 (i) a corporation doing business:
589 (A) as:
590 (I) an insurance producer;
591 (II) a surplus lines producer;
592 (III) a limited line producer;
593 (IV) a consultant;
594 (V) a managing general agent;
595 (VI) a reinsurance intermediary;
596 (VII) a third party administrator; or
597 (VIII) an adjuster; and
598 (B) under:
599 (I) Chapter 23a, Insurance Marketing - Licensing Producers, Consultants, and
600 Reinsurance Intermediaries;
601 (II) Chapter 25, Third Party Administrators; or
602 (III) Chapter 26, Insurance Adjusters; or
603 (ii) a noninsurer that is part of a holding company system under Chapter 16, Insurance
604 Holding Companies.
605 (b) "Mutual" or "mutual corporation" means a mutual insurance corporation.
606 (c) "Stock corporation" means a stock insurance corporation.
607 (35) (a) "Creditable coverage" has the same meaning as provided in federal regulations
608 adopted pursuant to the Health Insurance Portability and Accountability Act.
609 (b) "Creditable coverage" includes coverage that is offered through a public health plan
610 such as:
611 (i) the Primary Care Network Program under a Medicaid primary care network
612 demonstration waiver obtained subject to Section 26-18-3;
613 (ii) the Children's Health Insurance Program under Section 26-40-106; or
614 (iii) the Ryan White Program Comprehensive AIDS Resources Emergency Act, Pub. L.
615 No. 101-381, and Ryan White HIV/AIDS Treatment Modernization Act of 2006, Pub. L. No.
616 109-415.
617 (36) "Credit accident and health insurance" means insurance on a debtor to provide
618 indemnity for payments coming due on a specific loan or other credit transaction while the
619 debtor has a disability.
620 (37) (a) "Credit insurance" means insurance offered in connection with an extension of
621 credit that is limited to partially or wholly extinguishing that credit obligation.
622 (b) "Credit insurance" includes:
623 (i) credit accident and health insurance;
624 (ii) credit life insurance;
625 (iii) credit property insurance;
626 (iv) credit unemployment insurance;
627 (v) guaranteed automobile protection insurance;
628 (vi) involuntary unemployment insurance;
629 (vii) mortgage accident and health insurance;
630 (viii) mortgage guaranty insurance; and
631 (ix) mortgage life insurance.
632 (38) "Credit life insurance" means insurance on the life of a debtor in connection with
633 an extension of credit that pays a person if the debtor dies.
634 (39) "Creditor" means a person, including an insured, having a claim, whether:
635 (a) matured;
636 (b) unmatured;
637 (c) liquidated;
638 (d) unliquidated;
639 (e) secured;
640 (f) unsecured;
641 (g) absolute;
642 (h) fixed; or
643 (i) contingent.
644 (40) "Credit property insurance" means insurance:
645 (a) offered in connection with an extension of credit; and
646 (b) that protects the property until the debt is paid.
647 (41) "Credit unemployment insurance" means insurance:
648 (a) offered in connection with an extension of credit; and
649 (b) that provides indemnity if the debtor is unemployed for payments coming due on a:
650 (i) specific loan; or
651 (ii) credit transaction.
652 (42) (a) "Crop insurance" means insurance providing protection against damage to
653 crops from unfavorable weather conditions, fire or lightning, flood, hail, insect infestation,
654 disease, or other yield-reducing conditions or perils that is:
655 (i) provided by the private insurance market; or
656 (ii) subsidized by the Federal Crop Insurance Corporation.
657 (b) "Crop insurance" includes multiperil crop insurance.
658 (43) (a) "Customer service representative" means a person that provides an insurance
659 service and insurance product information:
660 (i) for the customer service representative's:
661 (A) producer;
662 (B) surplus lines producer; or
663 (C) consultant employer; and
664 (ii) to the customer service representative's employer's:
665 (A) customer;
666 (B) client; or
667 (C) organization.
668 (b) A customer service representative may only operate within the scope of authority of
669 the customer service representative's producer, surplus lines producer, or consultant employer.
670 (44) "Deadline" means a final date or time:
671 (a) imposed by:
672 (i) statute;
673 (ii) rule; or
674 (iii) order; and
675 (b) by which a required filing or payment must be received by the department.
676 (45) "Deemer clause" means a provision under this title under which upon the
677 occurrence of a condition precedent, the commissioner is considered to have taken a specific
678 action. If the statute so provides, a condition precedent may be the commissioner's failure to
679 take a specific action.
680 (46) "Degree of relationship" means the number of steps between two persons
681 determined by counting the generations separating one person from a common ancestor and
682 then counting the generations to the other person.
683 (47) "Department" means the Insurance Department.
684 (48) "Director" means a member of the board of directors of a corporation.
685 (49) "Disability" means a physiological or psychological condition that partially or
686 totally limits an individual's ability to:
687 (a) perform the duties of:
688 (i) that individual's occupation; or
689 (ii) an occupation for which the individual is reasonably suited by education, training,
690 or experience; or
691 (b) perform two or more of the following basic activities of daily living:
692 (i) eating;
693 (ii) toileting;
694 (iii) transferring;
695 (iv) bathing; or
696 (v) dressing.
697 (50) "Disability income insurance" means the same as that term is defined in
698 Subsection [
699 (51) "Domestic insurer" means an insurer organized under the laws of this state.
700 (52) "Domiciliary state" means the state in which an insurer:
701 (a) is incorporated;
702 (b) is organized; or
703 (c) in the case of an alien insurer, enters into the United States.
704 (53) (a) "Eligible employee" means:
705 (i) an employee who:
706 (A) works on a full-time basis; and
707 (B) has a normal work week of 30 or more hours; or
708 (ii) a person described in Subsection (53)(b).
709 (b) "Eligible employee" includes:
710 (i) an [
711 (A) works on a full-time basis; and
712 (B) has a normal work week of 30 or more hours; and
713 [
714 (ii) [
715 (A) an owner who employs at least one common employee;
716 [
717 [
718 [
719 (c) "Eligible employee" does not include[
720 (i) an individual who works on a temporary or substitute basis for a small employer;
721 (ii) an employer's spouse who does not meet the requirements of Subsection
722 (53)(a)[
723 (iii) a dependent of an employer who does not meet the requirements of Subsection
724 (53)(a)[
725 (54) "Emergency medical condition" means a medical condition that:
726 (a) manifests itself by acute symptoms, including severe pain; and
727 (b) would cause a prudent layperson possessing an average knowledge of medicine and
728 health to reasonably expect the absence of immediate medical attention through a hospital
729 emergency department to result in:
730 (i) placing the layperson's health or the layperson's unborn child's health in serious
731 jeopardy;
732 (ii) serious impairment to bodily functions; or
733 (iii) serious dysfunction of any bodily organ or part.
734 [
735 (a) an individual employed by an employer; [
736 (b) an [
737 [
738 (a) an employee; or
739 (b) a dependent of an employee.
740 [
741 (i) established or maintained, whether directly or through a trustee, by:
742 (A) one or more employers;
743 (B) one or more labor organizations; or
744 (C) a combination of employers and labor organizations; and
745 (ii) that provides employee benefits paid or contracted to be paid, other than income
746 from investments of the fund:
747 (A) by or on behalf of an employer doing business in this state; or
748 (B) for the benefit of a person employed in this state.
749 (b) "Employee welfare fund" includes a plan funded or subsidized by a user fee or tax
750 revenues.
751 [
752 to modify the policy or certificate coverage.
753 [
754 (i) a policyholder;
755 (ii) a certificate holder;
756 (iii) a subscriber; or
757 (iv) a covered individual:
758 (A) who has entered into a contract with an organization for health care; or
759 (B) on whose behalf an arrangement for health care has been made.
760 (b) "Enrollee" includes an insured.
761 [
762 (a) the first day of coverage; or
763 (b) if there is a waiting period, the first day of the waiting period.
764 [
765 involving one or more affiliates of an insurer that, if not remedied promptly, is likely to have a
766 material adverse effect upon the financial condition or liquidity of the insurer or its insurance
767 holding company system as a whole, including anything that would cause:
768 (a) the insurer's risk-based capital to fall into an action or control level as set forth in
769 Sections 31A-17-601 through 31A-17-613; or
770 (b) the insurer to be in hazardous financial condition set forth in Section 31A-27a-101.
771 [
772 (i) a transaction that effects the sale, transfer, encumbering, or leasing of real property,
773 when a person not a party to the transaction, and neither having nor acquiring an interest in the
774 title, performs, in accordance with the written instructions or terms of the written agreement
775 between the parties to the transaction, any of the following actions:
776 (A) the explanation, holding, or creation of a document; or
777 (B) the receipt, deposit, and disbursement of money;
778 (ii) a settlement or closing involving:
779 (A) a mobile home;
780 (B) a grazing right;
781 (C) a water right; or
782 (D) other personal property authorized by the commissioner.
783 (b) "Escrow" does not include:
784 (i) the following notarial acts performed by a notary within the state:
785 (A) an acknowledgment;
786 (B) a copy certification;
787 (C) jurat; and
788 (D) an oath or affirmation;
789 (ii) the receipt or delivery of a document; or
790 (iii) the receipt of money for delivery to the escrow agent.
791 [
792 requirements of Sections 31A-4-107, 31A-14-211, and 31A-23a-204, who is acting through an
793 individual title insurance producer licensed with an escrow subline of authority.
794 [
795 also excluded.
796 (b) The items listed in a list using the term "excludes" are representative examples for
797 use in interpretation of this title.
798 [
799 insurer does not provide insurance coverage, for whatever reason, for one of the following:
800 (a) a specific physical condition;
801 (b) a specific medical procedure;
802 (c) a specific disease or disorder; or
803 (d) a specific prescription drug or class of prescription drugs.
804 [
805 [
806
807 [
808 [
809 [
810 (66) "Fidelity insurance" means insurance guaranteeing the fidelity of a person holding
811 a position of public or private trust.
812 (67) (a) "Filed" means that a filing is:
813 (i) submitted to the department as required by and in accordance with applicable
814 statute, rule, or filing order;
815 (ii) received by the department within the time period provided in applicable statute,
816 rule, or filing order; and
817 (iii) accompanied by the appropriate fee in accordance with:
818 (A) Section 31A-3-103; or
819 (B) rule.
820 (b) "Filed" does not include a filing that is rejected by the department because it is not
821 submitted in accordance with Subsection (67)(a).
822 (68) "Filing," when used as a noun, means an item required to be filed with the
823 department including:
824 (a) a policy;
825 (b) a rate;
826 (c) a form;
827 (d) a document;
828 (e) a plan;
829 (f) a manual;
830 (g) an application;
831 (h) a report;
832 (i) a certificate;
833 (j) an endorsement;
834 (k) an actuarial certification;
835 (l) a licensee annual statement;
836 (m) a licensee renewal application;
837 (n) an advertisement;
838 (o) a binder; or
839 (p) an outline of coverage.
840 (69) "First party insurance" means an insurance policy or contract in which the insurer
841 agrees to pay a claim submitted to it by the insured for the insured's losses.
842 (70) (a) "Fixed indemnity insurance" means accident and health insurance written to
843 provide a fixed amount for a specified event relating to or resulting from an illness or injury.
844 (b) "Fixed indemnity insurance" includes hospital confinement indemnity insurance.
845 [
846 an alien insurer.
847 [
848 (i) a policy;
849 (ii) a certificate;
850 (iii) an application;
851 (iv) an outline of coverage; or
852 (v) an endorsement.
853 (b) "Form" does not include a document specially prepared for use in an individual
854 case.
855 [
856 through a mass marketing arrangement involving a defined class of persons related in some
857 way other than through the purchase of insurance.
858 [
859 (a) the general lines of insurance in Subsection [
860 (b) title insurance under one of the following sublines of authority:
861 (i) title examination, including authority to act as a title marketing representative;
862 (ii) escrow, including authority to act as a title marketing representative; and
863 (iii) title marketing representative only;
864 (c) surplus lines;
865 (d) workers' compensation; and
866 (e) another line of insurance that the commissioner considers necessary to recognize in
867 the public interest.
868 [
869 (a) accident and health;
870 (b) casualty;
871 (c) life;
872 (d) personal lines;
873 (e) property; and
874 (f) variable contracts, including variable life and annuity.
875 [
876 that the plan provides medical care:
877 (a) (i) to an employee; or
878 (ii) to a dependent of an employee; and
879 (b) (i) directly;
880 (ii) through insurance reimbursement; or
881 (iii) through another method.
882 [
883 that is issued:
884 (i) to a policyholder on behalf of the group; and
885 (ii) for the benefit of a member of the group who is selected under a procedure defined
886 in:
887 (A) the policy; or
888 (B) an agreement that is collateral to the policy.
889 (b) A group insurance policy may include a member of the policyholder's family or a
890 dependent.
891 [
892 official designated as the group-wide supervisor for an internationally active insurance group
893 under Section 31A-16-108.6.
894 [
895 connection with an extension of credit that pays the difference in amount between the
896 insurance settlement and the balance of the loan if the insured automobile is a total loss.
897 [
898 a policy, contract, certificate, or agreement offered or issued by [
899 provide, deliver, arrange for, pay for, or reimburse any of the costs of health care, including
900 major medical expense coverage.
901 (b) "Health benefit plan" does not include:
902 (i) coverage only for accident or disability income insurance, or any combination
903 thereof;
904 (ii) coverage issued as a supplement to liability insurance;
905 (iii) liability insurance, including general liability insurance and automobile liability
906 insurance;
907 (iv) workers' compensation or similar insurance;
908 (v) automobile medical payment insurance;
909 (vi) credit-only insurance;
910 (vii) coverage for on-site medical clinics;
911 (viii) other similar insurance coverage, specified in federal regulations issued pursuant
912 to Pub. L. No. 104-191, under which benefits for health care services are secondary or
913 incidental to other insurance benefits;
914 (ix) the following benefits if they are provided under a separate policy, certificate, or
915 contract of insurance or are otherwise not an integral part of the plan:
916 (A) limited scope dental or vision benefits;
917 (B) benefits for long-term care, nursing home care, home health care,
918 community-based care, or any combination thereof; or
919 (C) other similar limited benefits, specified in federal regulations issued pursuant to
920 Pub. L. No. 104-191;
921 (x) the following benefits if the benefits are provided under a separate policy,
922 certificate, or contract of insurance, there is no coordination between the provision of benefits
923 and any exclusion of benefits under any health plan, and the benefits are paid with respect to an
924 event without regard to whether benefits are provided under any health plan:
925 (A) coverage only for specified disease or illness; or
926 (B) [
927 (xi) the following if offered as a separate policy, certificate, or contract of insurance:
928 (A) Medicare supplemental health insurance as defined under the Social Security Act,
929 42 U.S.C. Sec. 1395ss(g)(1);
930 (B) coverage supplemental to the coverage provided under United States Code, Title
931 10, Chapter 55, Civilian Health and Medical Program of the Uniformed Services
932 (CHAMPUS); or
933 (C) similar supplemental coverage provided to coverage under a group health insurance
934 plan;
935 (xii) short-term limited duration health insurance; and
936 (xiii) student health insurance, except as required under 45 C.F.R. Sec. 147.145.
937 [
938 treatment, mitigation, or prevention of a human ailment or impairment:
939 (a) a professional service;
940 (b) a personal service;
941 (c) a facility;
942 (d) equipment;
943 (e) a device;
944 (f) supplies; or
945 (g) medicine.
946 [
947 providing:
948 (i) a health care benefit; or
949 (ii) payment of an incurred health care expense.
950 (b) "Health care insurance" or "health insurance" does not include accident and health
951 insurance providing a benefit for:
952 (i) replacement of income;
953 (ii) short-term accident;
954 (iii) fixed indemnity;
955 (iv) credit accident and health;
956 (v) supplements to liability;
957 (vi) workers' compensation;
958 (vii) automobile medical payment;
959 (viii) no-fault automobile;
960 (ix) equivalent self-insurance; or
961 (x) a type of accident and health insurance coverage that is a part of or attached to
962 another type of policy.
963 [
964 78B-3-403.
965 [
966 Sec. 155.20.
967 [
968 Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191, 110 Stat. 1936, as
969 amended.
970 [
971 insurance written to provide payments to replace income lost from accident or sickness.
972 [
973 insured loss.
974 [
975 under Section 31A-26-201 who engages in insurance adjusting as a representative of an insurer.
976 [
977 Section 31A-15-104.
978 [
979 [
980 (a) property in transit on or over land;
981 (b) property in transit over water by means other than boat or ship;
982 (c) bailee liability;
983 (d) fixed transportation property such as bridges, electric transmission systems, radio
984 and television transmission towers and tunnels; and
985 (e) personal and commercial property floaters.
986 [
987 (a) an insurer is unable to pay the insurer's obligations as the obligations are due;
988 (b) an insurer's total adjusted capital is less than the insurer's mandatory control level
989 RBC under Subsection 31A-17-601(8)(c); or
990 (c) an insurer's admitted assets are less than the insurer's liabilities.
991 [
992 (i) an arrangement, contract, or plan for the transfer of a risk or risks from one or more
993 persons to one or more other persons; or
994 (ii) an arrangement, contract, or plan for the distribution of a risk or risks among a
995 group of persons that includes the person seeking to distribute that person's risk.
996 (b) "Insurance" includes:
997 (i) a risk distributing arrangement providing for compensation or replacement for
998 damages or loss through the provision of a service or a benefit in kind;
999 (ii) a contract of guaranty or suretyship entered into by the guarantor or surety as a
1000 business and not as merely incidental to a business transaction; and
1001 (iii) a plan in which the risk does not rest upon the person who makes an arrangement,
1002 but with a class of persons who have agreed to share the risk.
1003 [
1004 investigation, negotiation, or settlement of a claim under an insurance policy other than life
1005 insurance or an annuity, on behalf of an insurer, policyholder, or a claimant under an insurance
1006 policy.
1007 [
1008 (a) providing health care insurance by an organization that is or is required to be
1009 licensed under this title;
1010 (b) providing a benefit to an employee in the event of a contingency not within the
1011 control of the employee, in which the employee is entitled to the benefit as a right, which
1012 benefit may be provided either:
1013 (i) by a single employer or by multiple employer groups; or
1014 (ii) through one or more trusts, associations, or other entities;
1015 (c) providing an annuity:
1016 (i) including an annuity issued in return for a gift; and
1017 (ii) except an annuity provided by a person specified in Subsections 31A-22-1305(2)
1018 and (3);
1019 (d) providing the characteristic services of a motor club [
1020
1021 (e) providing another person with insurance;
1022 (f) making as insurer, guarantor, or surety, or proposing to make as insurer, guarantor,
1023 or surety, a contract or policy offering title insurance;
1024 (g) transacting or proposing to transact any phase of title insurance, including:
1025 (i) solicitation;
1026 (ii) negotiation preliminary to execution;
1027 (iii) execution of a contract of title insurance;
1028 (iv) insuring; and
1029 (v) transacting matters subsequent to the execution of the contract and arising out of
1030 the contract, including reinsurance;
1031 (h) transacting or proposing a life settlement; and
1032 (i) doing, or proposing to do, any business in substance equivalent to Subsections
1033 [
1034 [
1035 (a) advises another person about insurance needs and coverages;
1036 (b) is compensated by the person advised on a basis not directly related to the insurance
1037 placed; and
1038 (c) except as provided in Section 31A-23a-501, is not compensated directly or
1039 indirectly by an insurer or producer for advice given.
1040 [
1041 company system.
1042 [
1043 affiliated persons, at least one of whom is an insurer.
1044 [
1045 to be licensed under the laws of this state to sell, solicit, or negotiate insurance.
1046 (b) (i) "Producer for the insurer" means a producer who is compensated directly or
1047 indirectly by an insurer for selling, soliciting, or negotiating an insurance product of that
1048 insurer.
1049 (ii) "Producer for the insurer" may be referred to as an "agent."
1050 (c) (i) "Producer for the insured" means a producer who:
1051 (A) is compensated directly and only by an insurance customer or an insured; and
1052 (B) receives no compensation directly or indirectly from an insurer for selling,
1053 soliciting, or negotiating an insurance product of that insurer to an insurance customer or
1054 insured.
1055 (ii) "Producer for the insured" may be referred to as a "broker."
1056 [
1057 makes a promise in an insurance policy and includes:
1058 (i) a policyholder;
1059 (ii) a subscriber;
1060 (iii) a member; and
1061 (iv) a beneficiary.
1062 (b) The definition in Subsection [
1063 (i) applies only to this title;
1064 (ii) does not define the meaning of "insured" as used in an insurance policy or
1065 certificate; and
1066 (iii) includes an enrollee.
1067 [
1068 means a person doing an insurance business as a principal including:
1069 (i) a fraternal benefit society;
1070 (ii) an issuer of a gift annuity other than an annuity specified in Subsections
1071 31A-22-1305(2) and (3);
1072 (iii) a motor club;
1073 (iv) an employee welfare plan;
1074 (v) a person purporting or intending to do an insurance business as a principal on that
1075 person's own account; and
1076 (vi) a health maintenance organization.
1077 (b) "Insurer," "carrier," "insurance carrier," or "insurance company" does not include a
1078 governmental entity.
1079 [
1080 Subsection [
1081 [
1082 company system:
1083 (a) that includes an insurer registered under Section 31A-16-105;
1084 (b) that has premiums written in at least three countries;
1085 (c) whose percentage of gross premiums written outside the United States is at least
1086 10% of its total gross written premiums; and
1087 (d) that, based on a three-year rolling average, has:
1088 (i) total assets of at least $50,000,000,000; or
1089 (ii) total gross written premiums of at least $10,000,000,000.
1090 [
1091 (a) offered in connection with an extension of credit; and
1092 (b) that provides indemnity if the debtor is involuntarily unemployed for payments
1093 coming due on a:
1094 (i) specific loan; or
1095 (ii) credit transaction.
1096 [
1097 employer who, with respect to a calendar year and to a plan year:
1098 (a) employed an average of at least 51 employees on business days during the
1099 preceding calendar year; and
1100 (b) employs at least one employee on the first day of the plan year.
1101 [
1102 an individual whose enrollment is a late enrollment.
1103 [
1104 enrollment of an individual other than:
1105 (a) on the earliest date on which coverage can become effective for the individual
1106 under the terms of the plan; or
1107 (b) through special enrollment.
1108 [
1109 31A-1-103, "legal expense insurance" means insurance written to indemnify or pay for a
1110 specified legal expense.
1111 (b) "Legal expense insurance" includes an arrangement that creates a reasonable
1112 expectation of an enforceable right.
1113 (c) "Legal expense insurance" does not include the provision of, or reimbursement for,
1114 legal services incidental to other insurance coverage.
1115 [
1116 (i) for death, injury, or disability of a human being, or for damage to property,
1117 exclusive of the coverages under:
1118 (A) medical malpractice insurance;
1119 (B) professional liability insurance; and
1120 (C) workers' compensation insurance;
1121 (ii) for a medical, hospital, surgical, and funeral benefit to a person other than the
1122 insured who is injured, irrespective of legal liability of the insured, when issued with or
1123 supplemental to insurance against legal liability for the death, injury, or disability of a human
1124 being, exclusive of the coverages under:
1125 (A) medical malpractice insurance;
1126 (B) professional liability insurance; and
1127 (C) workers' compensation insurance;
1128 (iii) for loss or damage to property resulting from an accident to or explosion of a
1129 boiler, pipe, pressure container, machinery, or apparatus;
1130 (iv) for loss or damage to property caused by:
1131 (A) the breakage or leakage of a sprinkler, water pipe, or water container; or
1132 (B) water entering through a leak or opening in a building; or
1133 (v) for other loss or damage properly the subject of insurance not within another kind
1134 of insurance as defined in this chapter, if the insurance is not contrary to law or public policy.
1135 (b) "Liability insurance" includes:
1136 (i) vehicle liability insurance;
1137 (ii) residential dwelling liability insurance; and
1138 (iii) making inspection of, and issuing a certificate of inspection upon, an elevator,
1139 boiler, machinery, or apparatus of any kind when done in connection with insurance on the
1140 elevator, boiler, machinery, or apparatus.
1141 [
1142 in an activity that is part of or related to the insurance business.
1143 (b) "License" includes a certificate of authority issued to an insurer.
1144 [
1145 (i) insurance on a human life; and
1146 (ii) insurance pertaining to or connected with human life.
1147 (b) The business of life insurance includes:
1148 (i) granting a death benefit;
1149 (ii) granting an annuity benefit;
1150 (iii) granting an endowment benefit;
1151 (iv) granting an additional benefit in the event of death by accident;
1152 (v) granting an additional benefit to safeguard the policy against lapse; and
1153 (vi) providing an optional method of settlement of proceeds.
1154 [
1155 (a) is issued for a specific product of insurance; and
1156 (b) limits an individual or agency to transact only for that product or insurance.
1157 [
1158 insurance:
1159 (a) credit life;
1160 (b) credit accident and health;
1161 (c) credit property;
1162 (d) credit unemployment;
1163 (e) involuntary unemployment;
1164 (f) mortgage life;
1165 (g) mortgage guaranty;
1166 (h) mortgage accident and health;
1167 (i) guaranteed automobile protection; and
1168 (j) another form of insurance offered in connection with an extension of credit that:
1169 (i) is limited to partially or wholly extinguishing the credit obligation; and
1170 (ii) the commissioner determines by rule should be designated as a form of limited line
1171 credit insurance.
1172 [
1173 solicits, or negotiates one or more forms of limited line credit insurance coverage to an
1174 individual through a master, corporate, group, or individual policy.
1175 [
1176 (a) bail bond;
1177 (b) limited line credit insurance;
1178 (c) legal expense insurance;
1179 (d) motor club insurance;
1180 (e) car rental related insurance;
1181 (f) travel insurance;
1182 (g) crop insurance;
1183 (h) self-service storage insurance;
1184 (i) guaranteed asset protection waiver;
1185 (j) portable electronics insurance; and
1186 (k) another form of limited insurance that the commissioner determines by rule should
1187 be designated a form of limited line insurance.
1188 [
1189 Subsection [
1190 [
1191 limited lines insurance.
1192 [
1193 advertised, marketed, offered, or designated to provide coverage:
1194 (i) in a setting other than an acute care unit of a hospital;
1195 (ii) for not less than 12 consecutive months for a covered person on the basis of:
1196 (A) expenses incurred;
1197 (B) indemnity;
1198 (C) prepayment; or
1199 (D) another method;
1200 (iii) for one or more necessary or medically necessary services that are:
1201 (A) diagnostic;
1202 (B) preventative;
1203 (C) therapeutic;
1204 (D) rehabilitative;
1205 (E) maintenance; or
1206 (F) personal care; and
1207 (iv) that may be issued by:
1208 (A) an insurer;
1209 (B) a fraternal benefit society;
1210 (C) (I) a nonprofit health hospital; and
1211 (II) a medical service corporation;
1212 (D) a prepaid health plan;
1213 (E) a health maintenance organization; or
1214 (F) an entity similar to the entities described in Subsections [
1215 through (E) to the extent that the entity is otherwise authorized to issue life or health care
1216 insurance.
1217 (b) "Long-term care insurance" includes:
1218 (i) any of the following that provide directly or supplement long-term care insurance:
1219 (A) a group or individual annuity or rider; or
1220 (B) a life insurance policy or rider;
1221 (ii) a policy or rider that provides for payment of benefits on the basis of:
1222 (A) cognitive impairment; or
1223 (B) functional capacity; or
1224 (iii) a qualified long-term care insurance contract.
1225 (c) "Long-term care insurance" does not include:
1226 (i) a policy that is offered primarily to provide basic Medicare supplement coverage;
1227 (ii) basic hospital expense coverage;
1228 (iii) basic medical/surgical expense coverage;
1229 (iv) hospital confinement indemnity coverage;
1230 (v) major medical expense coverage;
1231 (vi) income replacement or related asset-protection coverage;
1232 (vii) accident only coverage;
1233 (viii) coverage for a specified:
1234 (A) disease; or
1235 (B) accident;
1236 (ix) limited benefit health coverage; [
1237 (x) a life insurance policy that accelerates the death benefit to provide the option of a
1238 lump sum payment:
1239 (A) if the following are not conditioned on the receipt of long-term care:
1240 (I) benefits; or
1241 (II) eligibility; and
1242 (B) the coverage is for one or more the following qualifying events:
1243 (I) terminal illness;
1244 (II) medical conditions requiring extraordinary medical intervention; or
1245 (III) permanent institutional confinement[
1246 (xi) limited long-term care as defined in Section 31A-22-2002.
1247 [
1248 (a) licensed as a health maintenance organization under Chapter 8, Health Maintenance
1249 Organizations and Limited Health Plans; or
1250 (b) (i) licensed under:
1251 (A) Chapter 5, Domestic Stock and Mutual Insurance Corporations;
1252 (B) Chapter 7, Nonprofit Health Service Insurance Corporations; or
1253 (C) Chapter 14, Foreign Insurers; and
1254 (ii) that requires an enrollee to use, or offers incentives, including financial incentives,
1255 for an enrollee to use, network providers.
1256 [
1257 incident to the practice and provision of a medical service other than the practice and provision
1258 of a dental service.
1259 [
1260 corporation.
1261 [
1262 must be constantly maintained by a stock insurance corporation as required by statute.
1263 [
1264 connection with an extension of credit that provides indemnity for payments coming due on a
1265 mortgage while the debtor has a disability.
1266 [
1267 mortgagee or other creditor is indemnified against losses caused by the default of a debtor.
1268 [
1269 connection with an extension of credit that pays if the debtor dies.
1270 [
1271 (a) licensed under:
1272 (i) Chapter 5, Domestic Stock and Mutual Insurance Corporations;
1273 (ii) Chapter 11, Motor Clubs; or
1274 (iii) Chapter 14, Foreign Insurers; and
1275 (b) that promises for an advance consideration to provide for a stated period of time
1276 one or more:
1277 (i) legal services under Subsection 31A-11-102(1)(b);
1278 (ii) bail services under Subsection 31A-11-102(1)(c); or
1279 (iii) (A) trip reimbursement;
1280 (B) towing services;
1281 (C) emergency road services;
1282 (D) stolen automobile services;
1283 (E) a combination of the services listed in Subsections [
1284 (D); or
1285 (F) other services given in Subsections 31A-11-102(1)(b) through (f).
1286 [
1287 (128) "NAIC" means the National Association of Insurance Commissioners.
1288 (129) "NAIC liquidity stress test framework" means a NAIC publication that includes:
1289 (a) a history of the NAIC's development of regulatory liquidity stress testing;
1290 (b) the scope criteria applicable for a specific data year; and
1291 (c) the liquidity stress test instructions and reporting templates for a specific data year,
1292 as adopted by the NAIC and as amended by the NAIC in accordance with NAIC procedures.
1293 [
1294 (a) that is issued by an insurer; and
1295 (b) under which the financing and delivery of medical care is provided, in whole or in
1296 part, through a defined set of providers under contract with the insurer, including the financing
1297 and delivery of an item paid for as medical care.
1298 [
1299 with a managed care organization to provide health care services to an enrollee with an
1300 expectation of receiving payment, other than coinsurance, copayments, or deductibles, directly
1301 from the managed care organization.
1302 [
1303 not entitled to receive a dividend representing a share of the surplus of the insurer.
1304 [
1305 (a) ships or hulls of ships;
1306 (b) goods, freight, cargoes, merchandise, effects, disbursements, profits, money,
1307 securities, choses in action, evidences of debt, valuable papers, bottomry, respondentia
1308 interests, or other cargoes in or awaiting transit over the oceans or inland waterways;
1309 (c) earnings such as freight, passage money, commissions, or profits derived from
1310 transporting goods or people upon or across the oceans or inland waterways; or
1311 (d) a vessel owner or operator as a result of liability to employees, passengers, bailors,
1312 owners of other vessels, owners of fixed objects, customs or other authorities, or other persons
1313 in connection with maritime activity.
1314 [
1315 [
1316 and Solvency Assessment Guidance Manual developed and adopted by the National
1317 Association of Insurance Commissioners and as amended from time to time.
1318 [
1319 insurer or insurance group's own risk and solvency assessment.
1320 [
1321 health insurance policy.
1322 [
1323 group's confidential internal assessment:
1324 (a) (i) of each material and relevant risk associated with the insurer or insurance group;
1325 (ii) of the insurer or insurance group's current business plan to support each risk
1326 described in Subsection [
1327 (iii) of the sufficiency of capital resources to support each risk described in Subsection
1328 [
1329 (b) that is appropriate to the nature, scale, and complexity of an insurer or insurance
1330 group.
1331 [
1332 entitled to receive a dividend representing a share of the surplus of the insurer.
1333 [
1334 relating to the minimum percentage of eligible employees that must be enrolled in relation to
1335 the total number of eligible employees of an employer reduced by each eligible employee who
1336 voluntarily declines coverage under the plan because the employee:
1337 (a) has other group health care insurance coverage; or
1338 (b) receives:
1339 (i) Medicare, under the Health Insurance for the Aged Act, Title XVIII of the Social
1340 Security Amendments of 1965; or
1341 (ii) another government health benefit.
1342 [
1343 (a) an individual;
1344 (b) a partnership;
1345 (c) a corporation;
1346 (d) an incorporated or unincorporated association;
1347 (e) a joint stock company;
1348 (f) a trust;
1349 (g) a limited liability company;
1350 (h) a reciprocal;
1351 (i) a syndicate; or
1352 (j) another similar entity or combination of entities acting in concert.
1353 [
1354 coverage sold for primarily noncommercial purposes to:
1355 (a) an individual; or
1356 (b) a family.
1357 [
1358 1002(16)(B).
1359 [
1360 (a) the year that is designated as the plan year in:
1361 (i) the plan document of a group health plan; or
1362 (ii) a summary plan description of a group health plan;
1363 (b) if the plan document or summary plan description does not designate a plan year or
1364 there is no plan document or summary plan description:
1365 (i) the year used to determine deductibles or limits;
1366 (ii) the policy year, if the plan does not impose deductibles or limits on a yearly basis;
1367 or
1368 (iii) the employer's taxable year if:
1369 (A) the plan does not impose deductibles or limits on a yearly basis; and
1370 (B) (I) the plan is not insured; or
1371 (II) the insurance policy is not renewed on an annual basis; or
1372 (c) in a case not described in Subsection [
1373 [
1374 application that:
1375 (i) purports to be an enforceable contract; and
1376 (ii) memorializes in writing some or all of the terms of an insurance contract.
1377 (b) "Policy" includes a service contract issued by:
1378 (i) a motor club under Chapter 11, Motor Clubs;
1379 (ii) a service contract provided under Chapter 6a, Service Contracts; and
1380 (iii) a corporation licensed under:
1381 (A) Chapter 7, Nonprofit Health Service Insurance Corporations; or
1382 (B) Chapter 8, Health Maintenance Organizations and Limited Health Plans.
1383 (c) "Policy" does not include:
1384 (i) a certificate under a group insurance contract; or
1385 (ii) a document that does not purport to have legal effect.
1386 [
1387 contract by ownership, premium payment, or otherwise.
1388 [
1389 nonguaranteed elements of a policy offering life insurance over a period of years.
1390 [
1391 insurance policy.
1392 [
1393 No. 111-148 and the Health Care Education Reconciliation Act of 2010, Pub. L. No. 111-152,
1394 and related federal regulations and guidance.
1395 [
1396 (a) means a condition that was present before the effective date of coverage, whether or
1397 not medical advice, diagnosis, care, or treatment was recommended or received before that day;
1398 and
1399 (b) does not include a condition indicated by genetic information unless an actual
1400 diagnosis of the condition by a physician has been made.
1401 [
1402 (b) "Premium" includes, however designated:
1403 (i) an assessment;
1404 (ii) a membership fee;
1405 (iii) a required contribution; or
1406 (iv) monetary consideration.
1407 (c) (i) "Premium" does not include consideration paid to a third party administrator for
1408 the third party administrator's services.
1409 (ii) "Premium" includes an amount paid by a third party administrator to an insurer for
1410 insurance on the risks administered by the third party administrator.
1411 [
1412 Subsection 31A-5-203(3).
1413 [
1414 [
1415 incident to the practice of a profession and provision of a professional service.
1416 [
1417 insurance" means insurance against loss or damage to real or personal property of every kind
1418 and any interest in that property:
1419 (i) from all hazards or causes; and
1420 (ii) against loss consequential upon the loss or damage including vehicle
1421 comprehensive and vehicle physical damage coverages.
1422 (b) "Property insurance" does not include:
1423 (i) inland marine insurance; and
1424 (ii) ocean marine insurance.
1425 [
1426 long-term care insurance contract" means:
1427 (a) an individual or group insurance contract that meets the requirements of Section
1428 7702B(b), Internal Revenue Code; or
1429 (b) the portion of a life insurance contract that provides long-term care insurance:
1430 (i) (A) by rider; or
1431 (B) as a part of the contract; and
1432 (ii) that satisfies the requirements of Sections 7702B(b) and (e), Internal Revenue
1433 Code.
1434 [
1435 (a) is:
1436 (i) organized under the laws of the United States or any state; or
1437 (ii) in the case of a United States office of a foreign banking organization, licensed
1438 under the laws of the United States or any state;
1439 (b) is regulated, supervised, and examined by a United States federal or state authority
1440 having regulatory authority over a bank or trust company; and
1441 (c) meets the standards of financial condition and standing that are considered
1442 necessary and appropriate to regulate the quality of a financial institution whose letters of credit
1443 will be acceptable to the commissioner as determined by:
1444 (i) the commissioner by rule; or
1445 (ii) the Securities Valuation Office of the National Association of Insurance
1446 Commissioners.
1447 [
1448 (i) the cost of a given unit of insurance; or
1449 (ii) for property or casualty insurance, that cost of insurance per exposure unit either
1450 expressed as:
1451 (A) a single number; or
1452 (B) a pure premium rate, adjusted before the application of individual risk variations
1453 based on loss or expense considerations to account for the treatment of:
1454 (I) expenses;
1455 (II) profit; and
1456 (III) individual insurer variation in loss experience.
1457 (b) "Rate" does not include a minimum premium.
1458 [
1459 organization" means a person who assists an insurer in rate making or filing by:
1460 (i) collecting, compiling, and furnishing loss or expense statistics;
1461 (ii) recommending, making, or filing rates or supplementary rate information; or
1462 (iii) advising about rate questions, except as an attorney giving legal advice.
1463 (b) "Rate service organization" does not [
1464 (i) an employee of an insurer;
1465 (ii) a single insurer or group of insurers under common control;
1466 (iii) a joint underwriting group; or
1467 (iv) an individual serving as an actuarial or legal consultant.
1468 [
1469 renewal policy premiums:
1470 (a) a manual of rates;
1471 (b) a classification;
1472 (c) a rate-related underwriting rule; and
1473 (d) a rating formula that describes steps, policies, and procedures for determining
1474 initial and renewal policy premiums.
1475 [
1476 pay, allow, or give, directly or indirectly:
1477 (i) a refund of premium or portion of premium;
1478 (ii) a refund of commission or portion of commission;
1479 (iii) a refund of all or a portion of a consultant fee; or
1480 (iv) providing services or other benefits not specified in an insurance or annuity
1481 contract.
1482 (b) "Rebate" does not include:
1483 (i) a refund due to termination or changes in coverage;
1484 (ii) a refund due to overcharges made in error by the licensee; or
1485 (iii) savings or wellness benefits as provided in the contract by the licensee.
1486 [
1487 (a) the date delivered to and stamped received by the department, if delivered in
1488 person;
1489 (b) the post mark date, if delivered by mail;
1490 (c) the delivery service's post mark or pickup date, if delivered by a delivery service;
1491 (d) the received date recorded on an item delivered, if delivered by:
1492 (i) facsimile;
1493 (ii) email; or
1494 (iii) another electronic method; or
1495 (e) a date specified in:
1496 (i) a statute;
1497 (ii) a rule; or
1498 (iii) an order.
1499 [
1500 association of persons:
1501 (a) operating through an attorney-in-fact common to all of the persons; and
1502 (b) exchanging insurance contracts with one another that provide insurance coverage
1503 on each other.
1504 [
1505 consideration, transfers any portion of the risk it has assumed to another insurer. In referring to
1506 reinsurance transactions, this title sometimes refers to:
1507 (a) the insurer transferring the risk as the "ceding insurer"; and
1508 (b) the insurer assuming the risk as the:
1509 (i) "assuming insurer"; or
1510 (ii) "assuming reinsurer."
1511 [
1512 authority to assume reinsurance.
1513 [
1514 liability resulting from or incident to the ownership, maintenance, or use of a residential
1515 dwelling that is a detached single family residence or multifamily residence up to four units.
1516 [
1517 assumed under a reinsurance contract.
1518 (b) A reinsurer "retrocedes" when the reinsurer reinsures with another insurer part of a
1519 liability assumed under a reinsurance contract.
1520 [
1521 (a) an insurance policy; or
1522 (b) an insurance certificate.
1523 (169) "Scope criteria" means the designated exposure bases and minimum magnitudes
1524 for a specified data year that are used to establish a preliminary list of insurers considered
1525 scoped into the NAIC liquidity stress test framework for that data year.
1526 [
1527 exclusion from coverage in accident and health insurance.
1528 [
1529 (i) note;
1530 (ii) stock;
1531 (iii) bond;
1532 (iv) debenture;
1533 (v) evidence of indebtedness;
1534 (vi) certificate of interest or participation in a profit-sharing agreement;
1535 (vii) collateral-trust certificate;
1536 (viii) preorganization certificate or subscription;
1537 (ix) transferable share;
1538 (x) investment contract;
1539 (xi) voting trust certificate;
1540 (xii) certificate of deposit for a security;
1541 (xiii) certificate of interest of participation in an oil, gas, or mining title or lease or in
1542 payments out of production under such a title or lease;
1543 (xiv) commodity contract or commodity option;
1544 (xv) certificate of interest or participation in, temporary or interim certificate for,
1545 receipt for, guarantee of, or warrant or right to subscribe to or purchase any of the items listed
1546 in Subsections [
1547 (xvi) another interest or instrument commonly known as a security.
1548 (b) "Security" does not include:
1549 (i) any of the following under which an insurance company promises to pay money in a
1550 specific lump sum or periodically for life or some other specified period:
1551 (A) insurance;
1552 (B) an endowment policy; or
1553 (C) an annuity contract; or
1554 (ii) a burial certificate or burial contract.
1555 [
1556 person, including:
1557 (a) common stock;
1558 (b) preferred stock;
1559 (c) debt obligations; and
1560 (d) any other security convertible into or evidencing the right of any of the items listed
1561 in this Subsection [
1562 [
1563 provides for spreading [
1564 (b) "Self-insurance" includes:
1565 (i) an arrangement under which a governmental entity undertakes to indemnify an
1566 employee for liability arising out of the employee's employment; and
1567 (ii) an arrangement under which a person with a managed program of self-insurance
1568 and risk management undertakes to indemnify the person's affiliate, subsidiary, director,
1569 officer, or employee for liability or risk that arises out of the person's relationship with the
1570 affiliate, subsidiary, director, officer, or employee.
1571 [
1572 does not include:
1573 (i) an arrangement under which a number of persons spread their risks among
1574 themselves[
1575 (ii) an arrangement with an independent contractor.
1576 [
1577 [
1578
1579 [
1580
1581
1582 [
1583 [
1584 (a) by any means;
1585 (b) for money or its equivalent; and
1586 (c) on behalf of an insurance company.
1587 [
1588 product that:
1589 (a) after taking into account any renewals or extensions, has a total duration of no more
1590 than 36 months; and
1591 (b) has an expiration date specified in the contract that is less than 12 months after the
1592 original effective date of coverage under the health benefit product.
1593 [
1594 during each of which an individual does not have creditable coverage.
1595 [
1596 with respect to a calendar year and to a plan year, an employer who:
1597 (i) (A) employed at least one but not more than 50 eligible employees on business days
1598 during the preceding calendar year; or
1599 (B) if the employer did not exist for the entirety of the preceding calendar year,
1600 reasonably expects to employ an average of at least one but not more than 50 eligible
1601 employees on business days during the current calendar year;
1602 (ii) employs at least one employee on the first day of the plan year; and
1603 (iii) for an employer who has common ownership with one or more other employers, is
1604 treated as a single employer under 26 U.S.C. Sec. 414(b), (c), (m), or (o).
1605 (b) "Small employer" does not include an owner or a sole proprietor that does not
1606 employ at least one employee.
1607 [
1608 the same meaning as provided in federal regulations adopted pursuant to the Health Insurance
1609 Portability and Accountability Act.
1610 [
1611 either directly or indirectly through one or more affiliates or intermediaries.
1612 (b) "Wholly owned subsidiary" of a person is a subsidiary of which all of the voting
1613 shares are owned by that person either alone or with its affiliates, except for the minimum
1614 number of shares the law of the subsidiary's domicile requires to be owned by directors or
1615 others.
1616 [
1617 (a) a guarantee against loss or damage resulting from the failure of a principal to pay or
1618 perform the principal's obligations to a creditor or other obligee;
1619 (b) bail bond insurance; and
1620 (c) fidelity insurance.
1621 [
1622 and liabilities.
1623 (b) (i) "Permanent surplus" means the surplus of an insurer or organization that is
1624 designated by the insurer or organization as permanent.
1625 (ii) Sections 31A-5-211, 31A-7-201, 31A-8-209, 31A-9-209, and 31A-14-205 require
1626 that insurers or organizations doing business in this state maintain specified minimum levels of
1627 permanent surplus.
1628 (iii) Except for assessable mutuals, the minimum permanent surplus requirement is the
1629 same as the minimum required capital requirement that applies to stock insurers.
1630 (c) "Excess surplus" means:
1631 (i) for a life insurer, accident and health insurer, health organization, or property and
1632 casualty insurer as defined in Section 31A-17-601, the lesser of:
1633 (A) that amount of an insurer's or health organization's total adjusted capital that
1634 exceeds the product of:
1635 (I) 2.5; and
1636 (II) the sum of the insurer's or health organization's minimum capital or permanent
1637 surplus required under Section 31A-5-211, 31A-9-209, or 31A-14-205; or
1638 (B) that amount of an insurer's or health organization's total adjusted capital that
1639 exceeds the product of:
1640 (I) 3.0; and
1641 (II) the authorized control level RBC as defined in Subsection 31A-17-601(8)(a); and
1642 (ii) for a monoline mortgage guaranty insurer, financial guaranty insurer, or title insurer
1643 that amount of an insurer's paid-in-capital and surplus that exceeds the product of:
1644 (A) 1.5; and
1645 (B) the insurer's total adjusted capital required by Subsection 31A-17-609(1).
1646 [
1647 collects charges or premiums from, or who, for consideration, adjusts or settles claims of
1648 residents of the state in connection with insurance coverage, annuities, or service insurance
1649 coverage, except:
1650 (a) a union on behalf of its members;
1651 (b) a person administering a:
1652 (i) pension plan subject to the federal Employee Retirement Income Security Act of
1653 1974;
1654 (ii) governmental plan as defined in Section 414(d), Internal Revenue Code; or
1655 (iii) nonelecting church plan as described in Section 410(d), Internal Revenue Code;
1656 (c) an employer on behalf of the employer's employees or the employees of one or
1657 more of the subsidiary or affiliated corporations of the employer;
1658 (d) an insurer licensed under the following, but only for a line of insurance for which
1659 the insurer holds a license in this state:
1660 (i) Chapter 5, Domestic Stock and Mutual Insurance Corporations;
1661 (ii) Chapter 7, Nonprofit Health Service Insurance Corporations;
1662 (iii) Chapter 8, Health Maintenance Organizations and Limited Health Plans;
1663 (iv) Chapter 9, Insurance Fraternals; or
1664 (v) Chapter 14, Foreign Insurers;
1665 (e) a person:
1666 (i) licensed or exempt from licensing under:
1667 (A) Chapter 23a, Insurance Marketing - Licensing Producers, Consultants, and
1668 Reinsurance Intermediaries; or
1669 (B) Chapter 26, Insurance Adjusters; and
1670 (ii) whose activities are limited to those authorized under the license the person holds
1671 or for which the person is exempt; or
1672 (f) an institution, bank, or financial institution:
1673 (i) that is:
1674 (A) an institution whose deposits and accounts are to any extent insured by a federal
1675 deposit insurance agency, including the Federal Deposit Insurance Corporation or National
1676 Credit Union Administration; or
1677 (B) a bank or other financial institution that is subject to supervision or examination by
1678 a federal or state banking authority; and
1679 (ii) that does not adjust claims without a third party administrator license.
1680 [
1681 owner of real or personal property or the holder of liens or encumbrances on that property, or
1682 others interested in the property against loss or damage suffered by reason of liens or
1683 encumbrances upon, defects in, or the unmarketability of the title to the property, or invalidity
1684 or unenforceability of any liens or encumbrances on the property.
1685 [
1686 organization's statutory capital and surplus as determined in accordance with:
1687 (a) the statutory accounting applicable to the annual financial statements required to be
1688 filed under Section 31A-4-113; and
1689 (b) another item provided by the RBC instructions, as RBC instructions is defined in
1690 Section 31A-17-601.
1691 [
1692 a corporation.
1693 (b) "Trustee," when used in reference to an employee welfare fund, means an
1694 individual, firm, association, organization, joint stock company, or corporation, whether acting
1695 individually or jointly and whether designated by that name or any other, that is charged with
1696 or has the overall management of an employee welfare fund.
1697 [
1698 insurer" means an insurer:
1699 (i) not holding a valid certificate of authority to do an insurance business in this state;
1700 or
1701 (ii) transacting business not authorized by a valid certificate.
1702 (b) "Admitted insurer" or "authorized insurer" means an insurer:
1703 (i) holding a valid certificate of authority to do an insurance business in this state; and
1704 (ii) transacting business as authorized by a valid certificate.
1705 [
1706 insurer.
1707 [
1708 from or incident to ownership, maintenance, or use of a land vehicle or aircraft, exclusive of a
1709 vehicle comprehensive or vehicle physical damage coverage [
1710 [
1711 [
1712 security convertible into a security with a voting right associated with the security.
1713 [
1714 pass before coverage for an individual, who is otherwise eligible to enroll under the terms of
1715 the health benefit plan, can become effective.
1716 [
1717 (a) insurance for indemnification of an employer against liability for compensation
1718 based on:
1719 (i) a compensable accidental injury; and
1720 (ii) occupational disease disability;
1721 (b) employer's liability insurance incidental to workers' compensation insurance and
1722 written in connection with workers' compensation insurance; and
1723 (c) insurance assuring to a person entitled to workers' compensation benefits the
1724 compensation provided by law.
1725 Section 4. Section 31A-2-403 is amended to read:
1726 31A-2-403. Title and Escrow Commission created.
1727 (1) (a) Subject to Subsection (1)(b), there is created within the department the Title and
1728 Escrow Commission that is comprised of five members who shall be, in accordance with Title
1729 63G, Chapter 24, Part 2, Vacancies, appointed by the governor with the advice and consent of
1730 the Senate as follows:
1731 (i) except as provided in Subsection (1)(d), two members shall be employees of a title
1732 insurer;
1733 (ii) two members shall:
1734 (A) be employees of a Utah agency title insurance producer;
1735 (B) be or have been licensed under the title insurance line of authority;
1736 (C) as of the day on which the member is appointed, be or have been licensed with the
1737 title examination or escrow subline of authority for at least five years; and
1738 (D) as of the day on which the member is appointed, not be from the same county as
1739 another member appointed under this Subsection (1)(a)(ii); and
1740 (iii) one member shall be a member of the general public from any county in the state.
1741 (b) No more than one commission member may be appointed from a single company
1742 or an affiliate or subsidiary of the company.
1743 (c) No more than two commission members may be employees of an entity operating
1744 under an affiliated business arrangement, as defined in Section 31A-23a-1001.
1745 (d) If the governor is unable to identify more than one individual who is an employee
1746 of a title insurer and willing to serve as a member of the commission, the commission shall
1747 include the following members in lieu of the members described in Subsection (1)(a)(i):
1748 (i) one member who is an employee of a title insurer; and
1749 (ii) one member who is an employee of a Utah agency title insurance producer.
1750 (2) (a) Subject to Subsection (2)(c), a commission member shall comply with the
1751 conflict of interest provisions described in Title 63G, Chapter 24, Part 3, Conflicts of Interest,
1752 and file with the commissioner a disclosure of any position of employment or ownership
1753 interest that the commission member has with respect to a person that is subject to the
1754 jurisdiction of the commissioner.
1755 (b) The disclosure statement required by this Subsection (2) shall be:
1756 (i) filed by no later than the day on which the person begins that person's appointment;
1757 and
1758 (ii) amended when a significant change occurs in any matter required to be disclosed
1759 under this Subsection (2).
1760 (c) A commission member is not required to disclose an ownership interest that the
1761 commission member has if the ownership interest is in a publicly traded company or held as
1762 part of a mutual fund, trust, or similar investment.
1763 (3) (a) Except as required by Subsection (3)(b), as terms of current commission
1764 members expire, the governor shall appoint each new commission member to a four-year term
1765 ending on June 30.
1766 (b) Notwithstanding the requirements of Subsection (3)(a), the governor shall, at the
1767 time of appointment, adjust the length of terms to ensure that the terms of the commission
1768 members are staggered so that approximately half of the members appointed under Subsection
1769 (1)(a)(i) and half of the members appointed under Subsection (1)(a)(ii) are appointed every two
1770 years.
1771 (c) A commission member may not serve more than one consecutive term.
1772 (d) When a vacancy occurs in the membership for any reason, the governor, with the
1773 advice and consent of the Senate, shall appoint a replacement for the unexpired term.
1774 (e) Notwithstanding the other provisions of this Subsection (3), a commission member
1775 serves until a successor is appointed by the governor with the advice and consent of the Senate.
1776 (4) A commission member may not receive compensation or benefits for the
1777 commission member's service, but may receive per diem and travel expenses in accordance
1778 with:
1779 (a) Section 63A-3-106;
1780 (b) Section 63A-3-107; and
1781 (c) rules made by the Division of Finance pursuant to Sections 63A-3-106 and
1782 63A-3-107.
1783 (5) Members of the commission shall annually select one commission member to serve
1784 as chair.
1785 (6) (a) (i) Except as provided in Subsection (6)(b), the commission shall meet at least
1786 monthly.
1787 (ii) (A) The commissioner shall, with the concurrence of the chair of the commission,
1788 designate [
1789 [
1790
1791
1792
1793
1794 (B) A commission member may, after providing advance notice to the commissioner,
1795 attend an in-person meeting through electronic means.
1796 (b) (i) Except as provided in Subsection (6)(b)(ii), the commissioner may, with the
1797 concurrence of the chair of the commission, cancel a monthly meeting of the commission if,
1798 due to the number or nature of pending title insurance matters, the monthly meeting is not
1799 necessary.
1800 (ii) The commissioner may not cancel a monthly meeting designated as an in-person
1801 meeting under Subsection (6)(a)(ii)(A).
1802 (c) The commissioner may call additional meetings:
1803 (i) at the commissioner's discretion;
1804 (ii) upon the request of the chair of the commission; or
1805 (iii) upon the written request of three or more commission members.
1806 (d) (i) Three commission members constitute a quorum for the transaction of business.
1807 (ii) The action of a majority of the commission members when a quorum is present is
1808 the action of the commission.
1809 (7) The commissioner shall staff the commission.
1810 Section 5. Section 31A-6a-104 is amended to read:
1811 31A-6a-104. Required disclosures.
1812 (1) A reimbursement insurance policy insuring a service contract or a vehicle
1813 protection product warranty that is issued, sold, or offered for sale in this state shall
1814 conspicuously state that, upon failure of the service contract provider or warrantor to perform
1815 under the contract, the issuer of the policy shall:
1816 (a) pay on behalf of the service contract provider or warrantor any sums the service
1817 contract provider or warrantor is legally obligated to pay according to the service contract
1818 provider's or warrantor's contractual obligations under the service contract or a vehicle
1819 protection product warranty issued or sold by the service contract provider or warrantor; or
1820 (b) provide the service which the service contract provider is legally obligated to
1821 perform, according to the service contract provider's contractual obligations under the service
1822 contract issued or sold by the service contract provider.
1823 (2) (a) A service contract may not be issued, sold, or offered for sale in this state unless
1824 the service contract contains the following statements in substantially the following form:
1825 (i) "Obligations of the provider under this service contract are guaranteed under a
1826 service contract reimbursement insurance policy. Should the provider fail to pay or provide
1827 service on any claim within 60 days after proof of loss has been filed, the contract holder is
1828 entitled to make a claim directly against the Insurance Company.";
1829 (ii) "This service contract or warranty is subject to limited regulation by the Utah
1830 Insurance Department. To file a complaint, contact the Utah Insurance Department."; and
1831 (iii) A service contract or reimbursement insurance policy may not be issued, sold, or
1832 offered for sale in this state unless the contract contains a statement in substantially the
1833 following form, "Coverage afforded under this contract is not guaranteed by the Property and
1834 Casualty Guaranty Association."
1835 (b) A vehicle protection product warranty may not be issued, sold, or offered for sale in
1836 this state unless the vehicle protection product warranty contains the following statements in
1837 substantially the following form:
1838 (i) "Obligations of the warrantor under this vehicle protection product warranty are
1839 guaranteed under a reimbursement insurance policy. Should the warrantor fail to pay on any
1840 claim within 60 days after proof of loss has been filed, the warranty holder is entitled to make a
1841 claim directly against the Insurance Company.";
1842 (ii) "This vehicle protection product warranty is subject to limited regulation by the
1843 Utah Insurance Department. To file a complaint, contact the Utah Insurance Department."; and
1844 (iii) as applicable:
1845 (A) "The warrantor under this vehicle protection product warranty will reimburse the
1846 warranty holder as specified in the warranty upon the theft of the vehicle."; or
1847 (B) "The warrantor under this vehicle protection product warranty will reimburse the
1848 warranty holder as specified in the warranty and at the end of the time period specified in the
1849 warranty if, following the theft of the vehicle, the stolen vehicle is not recovered within a time
1850 period specified in the warranty, not to exceed 30 days after the day on which the vehicle is
1851 reported stolen."
1852 (c) A vehicle protection product warranty, or reimbursement insurance policy, may not
1853 be issued, sold, or offered for sale in this state unless the warranty contains a statement in
1854 substantially the following form, "Coverage afforded under this warranty is not guaranteed by
1855 the Property and Casualty Guaranty Association."
1856 (3) (a) A service contract and a vehicle protection product warranty shall:
1857 (i) conspicuously state the name, address, and a toll free claims service telephone
1858 number of the reimbursement insurer;
1859 (ii) (A) identify the service contract provider, the seller, and the service contract holder;
1860 or
1861 (B) identify the warrantor, the seller, and the warranty holder;
1862 (iii) conspicuously state the total purchase price and the terms under which the service
1863 contract or warranty is to be paid;
1864 (iv) conspicuously state the existence of any deductible amount or service fee;
1865 (v) specify the merchandise, service to be provided, and any limitation, exception, or
1866 exclusion;
1867 (vi) state a term, restriction, or condition governing the transferability of the service
1868 contract or warranty; and
1869 (vii) state a term, restriction, or condition that governs cancellation of the service
1870 contract as provided in Sections 31A-21-303 through 31A-21-305 by either the contract holder
1871 or service contract provider.
1872 (b) Beginning January 1, 2021, a service contract shall contain a conspicuous statement
1873 in substantially the following form: "Purchase of this product is optional and is not required in
1874 order to finance, lease, or purchase a motor vehicle."
1875 (4) If prior approval of repair work is required under a home protection service contract
1876 or a vehicle service contract, the contract shall conspicuously state the procedure for obtaining
1877 prior approval and for making a claim, including:
1878 (a) a toll free telephone number for claim service; and
1879 (b) a procedure for obtaining reimbursement for emergency repairs performed outside
1880 of normal business hours.
1881 (5) A preexisting condition clause in a service contract shall specifically state which
1882 preexisting condition is excluded from coverage.
1883 (6) (a) Except as provided in Subsection (6)(c), a service contract shall state the
1884 conditions upon which the use of a nonmanufacturers' part is allowed.
1885 (b) A condition described in Subsection (6)(a) shall comply with applicable state and
1886 federal laws.
1887 (c) This Subsection (6) does not apply to:
1888 (i) a home warranty service contract; or
1889 (ii) a service contract that does not impose an obligation to provide parts.
1890 (7) This section applies to a vehicle protection product warranty, except for the
1891 requirements of Subsections (3)(a)(iv) and (vii), (4), (5), and (6). The department may make
1892 rules in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, to
1893 implement the application of this section to a vehicle protection product warranty.
1894 (8) (a) As used in this Subsection (8), "conspicuous statement" means a disclosure that:
1895 (i) appears in all-caps, bold, and 14-point font; and
1896 (ii) provides a space to be initialed by the consumer:
1897 (A) immediately below the printed disclosure; and
1898 (B) at or before the time the consumer purchases the vehicle protection product.
1899 (b) A vehicle protection product warranty shall contain a conspicuous statement in
1900 substantially the following form: "Purchase of this product is optional and is not required in
1901 order to finance, lease, or purchase a motor vehicle."
1902 (9) If a vehicle protection product warranty states that the warrantor will reimburse the
1903 warranty holder for incidental costs, the vehicle protection product warranty shall state how
1904 incidental costs paid under the warranty are calculated.
1905 (10) If a vehicle protection product warranty states that the warrantor will reimburse
1906 the warranty holder in a fixed amount, the vehicle protection product warranty shall state the
1907 fixed amount.
1908 Section 6. Section 31A-16-105 is amended to read:
1909 31A-16-105. Registration of insurers.
1910 (1) (a) An insurer that is authorized to do business in this state and that is a member of
1911 an insurance holding company system shall register with the commissioner, except a foreign
1912 insurer subject to registration requirements and standards adopted by statute or regulation in the
1913 jurisdiction of its domicile, if the requirements and standards are substantially similar to those
1914 contained in this section, Subsections 31A-16-106(1)(a) and (2) and either Subsection
1915 31A-16-106(1)(b) or a statutory provision similar to the following: "Each registered insurer
1916 shall keep current the information required to be disclosed in its registration statement by
1917 reporting all material changes or additions within 15 days after the end of the month in which it
1918 learns of each change or addition."
1919 (b) An insurer that is subject to registration under this section shall register within 15
1920 days after it becomes subject to registration, and annually thereafter by June 30 of each year for
1921 the previous calendar year, unless the commissioner for good cause extends the time for
1922 registration and then at the end of the extended time period. The commissioner may require
1923 any insurer authorized to do business in the state, which is a member of a holding company
1924 system, and which is not subject to registration under this section, to furnish a copy of the
1925 registration statement, the summary specified in Subsection (3), or any other information filed
1926 by the insurer with the insurance regulatory authority of domiciliary jurisdiction.
1927 (2) An insurer subject to registration shall file the registration statement with the
1928 commissioner on a form and in a format prescribed by the [
1929
1930 (a) the capital structure, general financial condition, and ownership and management of
1931 the insurer and any person controlling the insurer;
1932 (b) the identity and relationship of every member of the insurance holding company
1933 system;
1934 (c) any of the following agreements in force, and transactions currently outstanding or
1935 which have occurred during the last calendar year between the insurer and its affiliates:
1936 (i) loans, other investments, or purchases, sales or exchanges of securities of the
1937 affiliates by the insurer or of securities of the insurer by its affiliates;
1938 (ii) purchases, sales, or exchanges of assets;
1939 (iii) transactions not in the ordinary course of business;
1940 (iv) guarantees or undertakings for the benefit of an affiliate which result in an actual
1941 contingent exposure of the insurer's assets to liability, other than insurance contracts entered
1942 into in the ordinary course of the insurer's business;
1943 (v) all management agreements, service contracts, and all cost-sharing arrangements;
1944 (vi) reinsurance agreements;
1945 (vii) dividends and other distributions to shareholders; and
1946 (viii) consolidated tax allocation agreements;
1947 (d) any pledge of the insurer's stock, including stock of any subsidiary or controlling
1948 affiliate, for a loan made to any member of the insurance holding company system;
1949 (e) if requested by the commissioner, financial statements of or within an insurance
1950 holding company system, including all affiliates:
1951 (i) which may include annual audited financial statements filed with the United States
1952 Securities and Exchange Commission pursuant to the Securities Act of 1933, as amended, or
1953 the Securities Exchange Act of 1934, as amended; and
1954 (ii) which request is satisfied by providing the commissioner with the most recently
1955 filed parent corporation financial statements that have been filed with the United States
1956 Securities and Exchange Commission;
1957 (f) any other matters concerning transactions between registered insurers and any
1958 affiliates as may be included in any subsequent registration forms adopted or approved by the
1959 commissioner;
1960 (g) statements that the insurer's board of directors oversees corporate governance and
1961 internal controls and that the insurer's officers or senior management have approved,
1962 implemented, and continue to maintain and monitor corporate governance and internal control
1963 procedures; and
1964 (h) any other information required by rule made by the commissioner in accordance
1965 with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
1966 (3) All registration statements shall contain a summary outlining all items in the
1967 current registration statement representing changes from the prior registration statement.
1968 (4) (a) No information need be disclosed on the registration statement filed pursuant to
1969 Subsection (2) if the information is not material for the purposes of this section.
1970 (b) Unless the commissioner by rule or order provides otherwise, sales, purchases,
1971 exchanges, loans or extensions of credit, investments, or guarantees involving one-half of 1%,
1972 or less, of an insurer's admitted assets as of the next preceding December 31 may not be
1973 considered material for purposes of [
1974 (5) Subject to Section 31A-16-106, each registered insurer shall report to the
1975 commissioner a dividend or other distribution to shareholders within 15 business days
1976 following the declaration of the dividend or distribution.
1977 (6) Any person within an insurance holding company system subject to registration
1978 shall provide complete and accurate information to an insurer if the information is reasonably
1979 necessary to enable the insurer to comply with the provisions of this chapter.
1980 (7) The commissioner shall terminate the registration of any insurer which
1981 demonstrates that it no longer is a member of an insurance holding company system.
1982 (8) The commissioner may require or allow two or more affiliated insurers subject to
1983 registration under this section to file a consolidated registration statement.
1984 (9) The commissioner may allow an insurer which is authorized to do business in this
1985 state, and which is part of an insurance holding company system, to register on behalf of any
1986 affiliated insurer which is required to register under Subsection (1) and to file all information
1987 and material required to be filed under this section.
1988 (10) This section does not apply to any insurer, information, or transaction if, and to
1989 the extent that, the commissioner by rule or order exempts the insurer from this section.
1990 (11) Any person may file with the commissioner a disclaimer of affiliation with any
1991 authorized insurer, or a disclaimer of affiliation may be filed by any insurer or any member of
1992 an insurance holding company system. The disclaimer shall fully disclose all material
1993 relationships and bases for affiliation between the person and the insurer as well as the basis for
1994 disclaiming the affiliation. A disclaimer of affiliation is considered to have been granted
1995 unless the commissioner, within 30 days following receipt of a complete disclaimer, notifies
1996 the filing party the disclaimer is disallowed. If disallowed, the disclaiming party may request
1997 an administrative hearing, which shall be granted. The disclaiming party shall be relieved of its
1998 duty to register under this section if approval of the disclaimer is granted by the commissioner,
1999 or if the disclaimer is considered to have been approved.
2000 (12) The ultimate controlling person of an insurer subject to registration shall also file
2001 an annual enterprise risk report. The annual enterprise risk report shall, to the best of the
2002 ultimate controlling person's knowledge and belief, identify the material risks within the
2003 insurance holding company that could pose enterprise risk to the insurer. The annual enterprise
2004 risk report shall be filed with the lead state commissioner of the insurance holding company
2005 system as determined by the procedures within the Financial Analysis Handbook adopted by
2006 the [
2007 (13) (a) The ultimate controlling person of an insurer subject to registration shall
2008 concurrently file with the registration an annual group capital calculation report as directed by
2009 the lead state commissioner.
2010 (b) The annual group capital calculation report described in Subsection (13)(a) shall be
2011 filed with the lead state commissioner of the insurance holding company system as determined
2012 by the commissioner in accordance with the procedures within the Financial Analysis
2013 Handbook adopted by the NAIC.
2014 (c) Subject to Subsections (13)(d) and (e), the following insurance holding company
2015 systems are exempt from filing the annual group capital calculation report described in
2016 Subsection (13)(a):
2017 (i) an insurance holding company system that:
2018 (A) has only one insurer within the insurance holding company's structure;
2019 (B) writes business and is licensed only in the insurance holding company system's
2020 domestic state; and
2021 (C) assumes no business from any other insurer;
2022 (ii) an insurance holding company system that is required to perform a group capital
2023 calculation specified by the United States Federal Reserve Board unless:
2024 (A) the lead state commissioner requests the calculation from the Federal Reserve
2025 Board under the terms of information sharing agreements in effect; and
2026 (B) the Federal Reserve Board cannot share the calculation with the lead state
2027 commissioner;
2028 (iii) an insurance holding company system whose non-United States group-wide
2029 supervisor is located within a reciprocal jurisdiction as described in Subsection 31A-17-404(8)
2030 that recognizes the United States' state regulatory approach to group supervision and group
2031 capital; and
2032 (iv) an insurance holding company system:
2033 (A) that provides information to the lead state that meets the requirements for
2034 accreditation under the NAIC financial standards and accreditation program, either directly or
2035 indirectly through the group-wide supervisor, who has determined the information is
2036 satisfactory to allow the lead state to comply with the NAIC group supervision approach, as
2037 detailed in the NAIC Financial Analysis Handbook; and
2038 (B) whose non-United States group-wide supervisor that is not located in a reciprocal
2039 jurisdiction recognizes and accepts, as specified by the lead state commissioner in regulation,
2040 the group capital calculation as the world-wide group capital assessment for United States
2041 insurance groups that operate in that jurisdiction.
2042 (d) If, after consultation with other supervisors or officials, the lead state commissioner
2043 determines appropriate for prudential oversight and solvency monitoring purposes or for
2044 ensuring the competitiveness of the insurance marketplace, the lead state commissioner shall
2045 require the group capital calculation for United States operations of any non-United States
2046 based insurance holding company system.
2047 (e) The lead state commissioner may:
2048 (i) exempt the ultimate controlling person from filing the annual group capital
2049 calculation; or
2050 (ii) accept a limited group capital filing or report in accordance with criteria as
2051 specified by the lead state commissioner in regulation.
2052 (f) If the lead state commissioner determines that an insurance holding company
2053 system no longer meets one or more of the requirements for an exemption from filing the group
2054 capital calculation under this section, the insurance holding company system shall file the
2055 group capital calculation at the next annual filing date unless the lead state commissioner gives
2056 an extension based on reasonable grounds.
2057 (14) (a) The ultimate controlling person of every insurer subject to registration and also
2058 scoped into the NAIC liquidity stress test framework shall file the results of a specific year's
2059 liquidity stress test.
2060 (b) The filing described in Subsection (14)(a) shall be made to the lead state insurance
2061 commissioner of the insurance holding company system as determined by the procedures
2062 within the Financial Analysis Handbook adopted by the NAIC.
2063 (c) Any change to the NAIC liquidity stress test framework or to the data year for
2064 which the scope criteria are to be measured shall be effective on January 1 of the year
2065 following the calendar year in which the change is adopted.
2066 (d) Insurers meeting at least one threshold of the NAIC liquidity stress test framework's
2067 scope criteria are scoped into the NAIC liquidity stress test framework for the specified data
2068 year unless the lead state insurance commissioner, in consultation with the NAIC Financial
2069 Stability Task Force or the NAIC Financial Stability Task Force's successor, determines the
2070 insurer should not be scoped into the NAIC liquidity stress test framework for that data year.
2071 (e) Insurers that do not meet at least one threshold of the NAIC liquidity stress test
2072 framework's scope criteria are scoped out of the NAIC liquidity stress test framework for the
2073 specified data year, unless the lead state insurance commissioner, in consultation with the
2074 NAIC Financial Stability Task Force or the NAIC Financial Stability Task Force's successor,
2075 determines the insurer should be scoped into the NAIC liquidity stress test framework for that
2076 data year.
2077 (f) To avoid having insurers scoped in and out of the NAIC liquidity stress test
2078 framework on a frequent basis, the lead state insurance commissioner, in consultation with the
2079 Financial Stability Task Force or the NAIC Financial Stability Task Force's successor, shall
2080 assess this concern as part of the lead state insurance commissioner's determination of whether
2081 an insurer is scoped into the NAIC liquidity stress test framework for a specified data year.
2082 (g) The performance of, and filing of the results from, a specific year's liquidity stress
2083 test shall comply with:
2084 (i) the NAIC liquidity stress test framework instructions and reporting templates for
2085 that year; and
2086 (ii) lead state insurance commissioner determinations made in conjunction with the
2087 NAIC Financial Stability Task Force or the NAIC Financial Stability Task Force's successor,
2088 provided within the NAIC liquidity stress test framework.
2089 [
2090 registration statement or enterprise risk filing required by this section within the time specified
2091 for the filing is a violation of this section.
2092 Section 7. Section 31A-16-106 is amended to read:
2093 31A-16-106. Standards and management of an insurer within a holding company
2094 system.
2095 (1) (a) Transactions within an insurance holding company system to which an insurer
2096 subject to registration is a party are subject to the following standards:
2097 (i) the terms shall be fair and reasonable;
2098 (ii) agreements for cost sharing services and management shall include the provisions
2099 required by rule made by the commissioner in accordance with Title 63G, Chapter 3, Utah
2100 Administrative Rulemaking Act;
2101 (iii) charges or fees for services performed shall be reasonable;
2102 (iv) expenses incurred and payment received shall be allocated to the insurer in
2103 conformity with customary insurance accounting practices consistently applied;
2104 (v) the books, accounts, and records of each party to all transactions shall be so
2105 maintained as to clearly and accurately disclose the nature and details of the transactions,
2106 including the accounting information necessary to support the reasonableness of the charges or
2107 fees to the respective parties; [
2108 (vi) the insurer's surplus held for policyholders, following any dividends or
2109 distributions to shareholder affiliates, shall be reasonable in relation to the insurer's outstanding
2110 liabilities and shall be adequate to its financial needs[
2111 (vii) the commissioner may require the insurer to secure and maintain a deposit held by
2112 the commissioner or a bond, as determined by the insurer at the insurer's discretion, in an
2113 amount determined by the commissioner not to exceed the value of the agreement in any one
2114 year, if the commissioner:
2115 (A) determines that the insurer is in a hazardous financial condition under Title 31A,
2116 Chapter 27a, Insurer Receivership Act, or a condition that would warrant a delinquency
2117 proceeding under Title 31A, Chapter 27a, Insurer Receivership Act; and
2118 (B) believes that the insurers' affiliate may be unable to fulfill an agreement with the
2119 insurer if the insurer were put into liquidation;
2120 (viii) all insurer records and data held by an affiliate:
2121 (A) are the insurer's property;
2122 (B) are subject to the insurer's control;
2123 (C) are identifiable;
2124 (D) are segregated or readily capable of segregation, at no additional cost to the insurer,
2125 from all other records and data;
2126 (E) shall be provided to a receiver, at the insurer's request, including any information,
2127 software, licensing agreement, release, waiver, or any other thing required to access the records
2128 and data; and
2129 (F) may be restricted in use by the affiliate if the affiliate is not operating the insurer's
2130 business; and
2131 (ix) (A) all funds belonging to the insurer that an affiliate collects or holds are the
2132 exclusive property of the insurer and subject to the control of the insurer; and
2133 (B) if the insurer is placed into receivership, any right of offset against the funds is
2134 subject to Title 31A, Chapter 27a, Insurance Receivership Act.
2135 (b) The following transactions involving a domestic insurer and any person in its
2136 insurance holding company system, including amendments or modifications of affiliate
2137 agreements previously filed pursuant to this section, which are subject to any materiality
2138 standards contained in Subsections (1)(a)(i) through (vi), may not be entered into unless the
2139 insurer has notified the commissioner in writing of its intention to enter into the transaction at
2140 least 30 days before entering into the transaction, or within any shorter period the
2141 commissioner may permit, if the commissioner has not disapproved the transaction within the
2142 period. The notice for an amendment or modification shall include the reasons for the change
2143 and financial impact on the domestic insurer. Informal notice shall be reported, within 30 days
2144 after a termination of a previously filed agreement, to the commissioner for determination of
2145 the type of filing required, if any:
2146 (i) sales, purchases, exchanges, loans or extensions of credit, guarantees, or
2147 investments if the transactions are equal to, or exceed as of the next preceding December 31:
2148 (A) for nonlife insurers, the lesser of 3% of the insurer's admitted assets or 25% of
2149 surplus held for policyholders;
2150 (B) for life insurers, 3% of the insurer's admitted assets;
2151 (ii) loans or extensions of credit made to any person who is not an affiliate, if the
2152 insurer makes the loans or extensions of credit with the agreement or understanding that the
2153 proceeds of the transactions, in whole or in substantial part, are to be used to make loans or
2154 extensions of credit to, to purchase assets of, or to make investments in, any affiliate of the
2155 insurer making the loans or extensions of credit if the transactions are equal to, or exceed as of
2156 the next preceding December 31:
2157 (A) for nonlife insurers, the lesser of 3% of the insurer's admitted assets or 25% of
2158 surplus held for policyholders;
2159 (B) for life insurers, 3% of the insurer's admitted assets;
2160 (iii) reinsurance agreements or modifications to reinsurance agreements, including an
2161 agreement in which the reinsurance premium, a change in the insurer's liabilities, or the
2162 projected reinsurance premium or a change in the insurer's liabilities in any of the current and
2163 succeeding three years, equals or exceeds 5% of the insurer's surplus held for policyholders, as
2164 of the next preceding December 31, including those agreements that may require as
2165 consideration the transfer of assets from an insurer to a non-affiliate, if an agreement or
2166 understanding exists between the insurer and the non-affiliate that any portion of the assets will
2167 be transferred to one or more affiliates of the reinsurer;
2168 (iv) all management agreements, service contracts, tax allocation agreements, and all
2169 cost-sharing arrangements;
2170 (v) guarantees when made by a domestic insurer, except that:
2171 (A) a guarantee that is quantifiable as to amount is not subject to the notice
2172 requirements of this Subsection (1) unless it exceeds the lesser of .5% of the insurer's admitted
2173 assets or 10% of surplus held for policyholders, as of the next preceding December 31; and
2174 (B) a guarantee that is not quantifiable as to amount is subject to the notice
2175 requirements of this Subsection (1);
2176 (vi) direct or indirect acquisitions or investments in a person that controls the insurer or
2177 in an affiliate of the insurer in an amount that, together with its present holdings in the
2178 investments, exceeds 2.5% of the insurer's surplus to policyholders, except that a direct or
2179 indirect acquisition or investment in a subsidiary acquired pursuant to Section 31A-16-102.5,
2180 or in a non-subsidiary insurance affiliate that is subject to this chapter, is exempt from this
2181 Subsection (1)(b)(vi);
2182 (vii) any material transactions, specified by rule, which the commissioner determines
2183 may adversely affect the interests of the insurer's policyholders; and
2184 (viii) this Subsection (1) may not be interpreted to authorize or permit any transactions
2185 which would be otherwise contrary to law in the case of an insurer not a member of the same
2186 holding company system.
2187 (c) A domestic insurer may not enter into transactions which are part of a plan or series
2188 of like transactions with persons within the holding company system if the purpose of the
2189 separate transactions is to avoid the statutory threshold amount and thus to avoid the review by
2190 the commissioner that would occur otherwise. If the commissioner determines that the
2191 separate transactions were entered into over any 12 month period for such a purpose, the
2192 commissioner may exercise the commissioner's authority under Section 31A-16-110.
2193 (d) The commissioner, in reviewing transactions pursuant to Subsection (1)(b), shall
2194 consider whether the transactions comply with the standards set forth in Subsection (1)(a) and
2195 whether they may adversely affect the interests of policyholders.
2196 (e) The commissioner shall be notified within 30 days of any investment of the
2197 domestic insurer in any one corporation, if the total investment in the corporation by the
2198 insurance holding company system exceeds 10% of the corporation's voting securities.
2199 (2) (a) A domestic insurer may not pay any extraordinary dividend or make any other
2200 extraordinary distribution to its shareholders until:
2201 (i) 30 days after the commissioner has received notice of the declaration of the
2202 dividend and has not within the 30-day period disapproved the payment; or
2203 (ii) the commissioner has approved the payment within the 30-day period.
2204 (b) For purposes of this Subsection (2), an extraordinary dividend or distribution
2205 includes any dividend or distribution of cash or other property, fair market value of which,
2206 together with that of other dividends or distributions made within the preceding 12 months,
2207 exceeds the lesser of:
2208 (i) 10% of the insurer's surplus held for policyholders as of the next preceding
2209 December 31;
2210 (ii) the net gain from operations of the insurer, if the insurer is a life insurer, or the net
2211 income, if the insurer is not a life insurer, not including realized capital gains, for the 12-month
2212 period ending the next preceding December 31; or
2213 (iii) an extraordinary dividend does not include pro rata distributions of any class of the
2214 insurer's own securities.
2215 (c) In determining whether a dividend or distribution is extraordinary, an insurer other
2216 than a life insurer may carry forward net income from the previous two calendar years that has
2217 not already been paid out as dividends. This carry-forward shall be computed by taking the net
2218 income from the second and third preceding calendar years, not including realized capital
2219 gains, less dividends paid in the second and immediate preceding calendar years.
2220 (d) Notwithstanding any other provision of law, an insurer may declare an
2221 extraordinary dividend or distribution, which is conditioned upon the commissioner's approval
2222 of the dividend or distribution, and the declaration shall confer no rights upon shareholders
2223 until:
2224 (i) the commissioner has approved the payment of the dividend or distribution; or
2225 (ii) the commissioner has not disapproved the payment within the 30-day period
2226 referred to in Subsection (2)(a).
2227 (3) (a) Notwithstanding the control of a domestic insurer by any person, the officers
2228 and directors of the insurer may not be relieved of any obligation or liability to which they
2229 would otherwise be subject by law, and the insurer shall be managed so as to assure its separate
2230 operating identity consistent with this chapter.
2231 (b) Nothing in this section precludes a domestic insurer from having or sharing a
2232 common management or cooperative or joint use of personnel, property, or services with one or
2233 more other persons under arrangements meeting the standards of Subsection (1)(a).
2234 (c) (i) Not less than one-third of the directors of a domestic insurer, and not less than
2235 one-third of the members of each committee of the board of directors of a domestic insurer,
2236 shall be persons who are not officers or employees of the insurer or of any entity controlling,
2237 controlled by, or under common control with the insurer and who are not beneficial owners of a
2238 controlling interest in the voting stock of the insurer or entity.
2239 (ii) At least one person described in Subsection (3)(c)(i) shall be included in a quorum
2240 for the transaction of business at a meeting of the board of directors or a committee of the
2241 board of directors.
2242 (d) Subsection (3)(c) does not apply to a domestic insurer if the person controlling the
2243 insurer, such as an insurer, a mutual insurance holding company, or a publicly held corporation,
2244 has a board of directors and committees of the board of directors that meet the requirements of
2245 Subsection (3)(c) with respect to the controlling entity.
2246 (e) An insurer may make application to the commissioner for a waiver from the
2247 requirements of this Subsection (3) if the insurer's annual direct written and assumed premium,
2248 excluding premiums reinsured with the Federal Crop Insurance Corporation and Federal Flood
2249 Program, is less than $300,000,000. An insurer may also make application to the
2250 commissioner for a waiver from the requirements of this Subsection (3) based upon unique
2251 circumstances. The commissioner may consider various factors, including:
2252 (i) the type of business entity;
2253 (ii) the volume of business written;
2254 (iii) the availability of qualified board members; or
2255 (iv) the ownership or organizational structure of the entity.
2256 (4) (a) For purposes of this chapter, in determining whether an insurer's surplus as
2257 regards policyholders is reasonable in relation to the insurer's outstanding liabilities and
2258 adequate to meet its financial needs, the following factors, among others, shall be considered:
2259 (i) the size of the insurer as measured by its assets, capital and surplus, reserves,
2260 premium writings, insurance in force, and other appropriate criteria;
2261 (ii) the extent to which the insurer's business is diversified among several lines of
2262 insurance;
2263 (iii) the number and size of risks insured in each line of business;
2264 (iv) the extent of the geographical dispersion of the insurer's insured risks;
2265 (v) the nature and extent of the insurer's reinsurance program;
2266 (vi) the quality, diversification, and liquidity of the insurer's investment portfolio;
2267 (vii) the recent past and projected future trend in the size of the insurer's investment
2268 portfolio;
2269 (viii) the surplus as regards policyholders maintained by other comparable insurers;
2270 (ix) the adequacy of the insurer's reserves; and
2271 (x) the quality and liquidity of investments in affiliates.
2272 (b) The commissioner may treat an investment described in Subsection (4)(a)(x) as a
2273 disallowed asset for purposes of determining the adequacy of surplus as regards policyholders
2274 whenever in the judgment of the commissioner the investment so warrants.
2275 Section 8. Section 31A-16-109 is amended to read:
2276 31A-16-109. Confidentiality of information obtained by commissioner.
2277 (1) (a) Documents, materials, or information obtained by or disclosed to the
2278 commissioner or any other person in the course of an examination or investigation made under
2279 Section 31A-16-107.5, and all information reported or provided to the department under
2280 Section 31A-16-105 or 31A-16-108.6, is confidential.
2281 (b) Any confidential document, material, or information described in Subsection (1)(a)
2282 is not subject to subpoena and may not be made public by the commissioner or any other
2283 person without the permission of the insurer, except the confidential document, material, or
2284 information may be provided to the insurance departments of other states, without the prior
2285 written consent of the insurer to which the confidential document, material, or information
2286 pertains.
2287 (c) The commissioner shall maintain the confidentiality of the following received in
2288 accordance with Section 31A-16-105 from an insurance holding company supervised by the
2289 Federal Reserve Board or any United States group-wide supervisor:
2290 (i) a group capital calculation;
2291 (ii) a group capital ratio produced within the group capital calculation; or
2292 (iii) group capital information.
2293 (d) The commissioner shall maintain the confidentiality of the liquidity stress test
2294 results, supporting disclosures, and any liquidity stress test information received in accordance
2295 with Section 31A-16-105 from an insurance holding company supervised by the Federal
2296 Reserve Board and non-United States group-wide supervisors.
2297 (2) The commissioner and any person who receives documents, materials, or other
2298 information while acting under the authority of the commissioner or with whom the
2299 documents, materials, or other information are shared pursuant to this chapter shall keep
2300 confidential any confidential documents, materials, or information subject to Subsection (1).
2301 (3) [
2302 [
2303 other information, including the confidential documents, materials, or information subject to
2304 Subsection (1), with the following if the recipient agrees in writing to maintain the
2305 confidentiality status of the document, material, or other information, and has verified in
2306 writing the legal authority to maintain confidentiality:
2307 [
2308 [
2309
2310 (iii) a third-party consultant designated by the commissioner; or
2311 [
2312 member of a supervisory college described in Section 31A-16-108.5;
2313 [
2314 material, or information reported pursuant to Section 31A-16-105 or 31A-16-108.6 with a
2315 commissioner of a state having statutes or regulations substantially similar to Subsection (1)
2316 and who has agreed in writing not to disclose the documents, material, or information;
2317 [
2318 or other information, including otherwise confidential documents, materials, or information
2319 from:
2320 [
2321 affiliate or subsidiary; or
2322 [
2323 [
2324 received under this section with notice or the understanding that it is confidential under the
2325 laws of the jurisdiction that is the source of the document, material, or information; and
2326 [
2327
2328 sharing and use of information provided pursuant to this chapter consistent with this
2329 Subsection (3) that shall:
2330 [
2331 information shared with the [
2332 NAIC affiliates and subsidiaries pursuant to this chapter, including procedures and protocols
2333 for sharing by the [
2334 federal, or international regulators;
2335 [
2336
2337 chapter remains with the commissioner and the [
2338
2339 [
2340 information in the possession of the [
2341 pursuant to this chapter is subject to a request or subpoena to the [
2342
2343 [
2344 NAIC affiliates and subsidiaries to consent to intervention by an insurer in any judicial or
2345 administrative action in which the [
2346 and NAIC affiliates and subsidiaries may be required to disclose confidential information about
2347 the insurer shared with the [
2348 NAIC affiliates and subsidiaries pursuant to this chapter.
2349 (4) The sharing of information by the commissioner pursuant to this chapter does not
2350 constitute a delegation of regulatory authority or rulemaking, and the commissioner is solely
2351 responsible for the administration, execution, and enforcement of this chapter.
2352 (5) A waiver of any applicable claim of confidentiality in the documents, materials, or
2353 information does not occur as a result of disclosure to the commissioner under this section or
2354 as a result of sharing as authorized in Subsection (3).
2355 (6) Documents, materials, or other information in the possession or control of the
2356 [
2357 (a) confidential, not public records, and not open to public inspection; and
2358 (b) not subject to Title 63G, Chapter 2, Government Records Access and Management
2359 Act.
2360 Section 9. Section 31A-17-408 is amended to read:
2361 31A-17-408. Title insurance reserves.
2362 (1) In addition to an adequate reserve for outstanding losses, a title insurance company
2363 shall either:
2364 (a) maintain and segregate an unearned premium reserve fund of not less than 10 cents
2365 for each $1,000 face amount of retained liability under each title insurance contract or policy
2366 on a single insurance risk issued; or
2367 (b) have the commissioner review and approve a contract of reinsurance applicable to
2368 the title insurance company's policies, which contract adequately covers the exposure or risk
2369 which the unearned premium reserve would serve.
2370 (2) The fund shall be maintained for the protection of policyholders and is not subject
2371 to the claims of stockholders or creditors other than policyholders.
2372 (3) The title insurance company may release the fund in accordance with the standards
2373 of the NAIC Accounting Practices and Procedures Manual.
2374 Section 10. Section 31A-17-601 is amended to read:
2375 31A-17-601. Definitions.
2376 As used in this part:
2377 (1) "Adjusted RBC report" means an RBC report that has been adjusted by the
2378 commissioner in accordance with Subsection 31A-17-602(5).
2379 (2) "Corrective order" means an order issued by the commissioner specifying
2380 corrective action that the commissioner determines is required.
2381 (3) "Health organization" means:
2382 (a) an entity that is authorized under Chapter 7, Nonprofit Health Service Insurance
2383 Corporations, or Chapter 8, Health Maintenance Organizations and Limited Health Plans; and
2384 (b) that is:
2385 (i) a health maintenance organization;
2386 (ii) a limited health service organization;
2387 (iii) a dental or vision plan;
2388 (iv) a hospital, medical, and dental indemnity or service corporation; or
2389 (v) other managed care organization.
2390 (4) "Life or accident and health insurer" means:
2391 (a) an insurance company licensed to write life insurance, [
2392 health insurance, or both; or
2393 (b) a licensed property casualty insurer writing only disability insurance.
2394 (5) "Property and casualty insurer" means any insurance company licensed to write
2395 lines of insurance other than life but does not include a monoline mortgage guaranty insurer,
2396 financial guaranty insurer, or title insurer.
2397 (6) "RBC" means risk-based capital.
2398 (7) "RBC instructions" means the RBC report including the National Association of
2399 Insurance Commissioner's risk-based capital instructions that govern the year for which an
2400 RBC report is prepared.
2401 (8) "RBC level" means an insurer's or health organization's authorized control level
2402 RBC, company action level RBC, mandatory control level RBC, or regulatory action level
2403 RBC.
2404 (a) "Authorized control level RBC" means the number determined under the risk-based
2405 capital formula in accordance with the RBC instructions;
2406 (b) "Company action level RBC" means the product of 2.0 and its authorized control
2407 level RBC;
2408 (c) "Mandatory control level RBC" means the product of .70 and the authorized control
2409 level RBC; and
2410 (d) "Regulatory action level RBC" means the product of 1.5 and its authorized control
2411 level RBC.
2412 (9) (a) "RBC plan" means a comprehensive financial plan containing the elements
2413 specified in Subsection 31A-17-603(2).
2414 (b) Notwithstanding Subsection (9)(a), the plan is a "revised RBC plan" if:
2415 (i) the commissioner rejects the RBC plan; and
2416 (ii) the plan is revised by the insurer or health organization, with or without the
2417 commissioner's recommendation.
2418 (10) "RBC report" means the report required in Section 31A-17-602.
2419 Section 11. Section 31A-19a-209 is amended to read:
2420 31A-19a-209. Special provisions for title insurance.
2421 (1) (a) (i) The Title and Escrow Commission [
2422 31A-2-404, establishing rate standards and rating methods [
2423
2424 (ii) The commissioner shall determine compliance with rate standards and rating
2425 methods [
2426
2427 (b) In addition to the considerations in determining compliance with rate standards and
2428 rating methods as set forth in Sections 31A-19a-201 and 31A-19a-202, including for title
2429 insurers, the commissioner and the Title and Escrow Commission shall consider the costs and
2430 expenses incurred by title insurers, individual title insurance producers, and agency title
2431 insurance producers peculiar to the business of title insurance including:
2432 (i) the maintenance of title plants; and
2433 (ii) the examining of public records to determine insurability of title to real
2434 redevelopment property.
2435 (2) (a) [
2436 an agency title insurance producer, or an individual title insurance producer who is not an
2437 employee of a title insurer or who is not designated by an agency title insurance producer shall
2438 annually file with the[
2439 certified statement of the following for residential transactions involving a dwelling, as defined
2440 in Section 57-21-2, for the prior calendar year:
2441 (i) the average escrow fee the filer charged on the buyer's side; and
2442 (ii) the average escrow fee the filer charged on the seller's side.
2443 (b) In 2022, a filer shall file the certified statement described in Subsection (2)(a) on or
2444 before July 1.
2445 (c) In calculating the average residential escrow fees under Subsection (2)(a), the filer
2446 shall:
2447 (i) include the sum of the fees charged for conducting escrow services; and
2448 (ii) exclude any pass-through cost incurred incident to the escrow services or the
2449 issuance of the title insurance and separately charged to the consumer.
2450 (d) Each year the commissioner shall:
2451 (i) calculate:
2452 (A) the average escrow fee reported under Subsection (2)(a)(i); and
2453 (B) the average escrow fee reported under Subsection (2)(a)(ii); and
2454 (ii) establish by rule made in accordance with Title 63G, Chapter 3, Utah
2455 Administrative Rulemaking Act:
2456 (A) the industry average buyer's side escrow fee as equal to the amount calculated
2457 under Subsection (2)(d)(i)(A); and
2458 (B) the industry average seller's side escrow fee as equal to the amount calculated
2459 under Subsection (2)(d)(i)(B).
2460 (e) The rule described in Subsection (2)(d) shall take effect on January 1 of the
2461 following calendar year.
2462 (3) A title insurer, an agency title insurance producer, or an individual title insurance
2463 producer may not charge for escrow services an amount less than 50% of the applicable
2464 industry average escrow fee described in Subsection (2)(d).
2465 [
2466
2467
2468 [
2469
2470 [
2471
2472 [
2473
2474 [
2475
2476
2477
2478 [
2479
2480
2481
2482 [
2483 [
2484 [
2485 [
2486 [
2487
2488
2489 [
2490 [
2491
2492 [
2493
2494 [
2495
2496 [
2497
2498 [
2499 [
2500 [
2501
2502 [
2503 [
2504
2505
2506 [
2507 [
2508
2509 Section 12. Section 31A-21-201 is amended to read:
2510 31A-21-201. Filing of forms.
2511 (1) (a) Except as exempted under Subsections 31A-21-101(2) through (6), a form may
2512 not be used, sold, or offered for sale until the form is filed with the commissioner.
2513 (b) A form is considered filed with the commissioner when the commissioner receives:
2514 (i) the form;
2515 (ii) the applicable filing fee as prescribed under Section 31A-3-103; and
2516 (iii) the applicable transmittal forms as required by the commissioner.
2517 (2) In filing a form for use in this state the insurer is responsible for assuring that the
2518 form is in compliance with this title and rules adopted by the commissioner.
2519 (3) (a) The commissioner may prohibit the use of a form at any time upon a finding
2520 that:
2521 (i) the form:
2522 (A) is inequitable;
2523 (B) is unfairly discriminatory;
2524 (C) is misleading;
2525 (D) is deceptive;
2526 (E) is obscure;
2527 (F) is unfair;
2528 (G) encourages misrepresentation; or
2529 (H) is not in the public interest;
2530 (ii) the form provides benefits or contains another provision that endangers the solidity
2531 of the insurer;
2532 (iii) except for a life or accident and health insurance policy form, the form is an
2533 insurance policy or application for an insurance policy, that fails to conspicuously provide:
2534 (A) the exact name of the insurer; and
2535 (B) the state of domicile of the insurer filing the insurance policy or application for the
2536 insurance policy;
2537 (iv) except an application required by Section 31A-22-635, the form is a life or
2538 accident and health insurance [
2539 (A) the exact name of the insurer;
2540 (B) the state of domicile of the insurer [
2541
2542 (C) for a life insurance policy only, the address of the administrative office of the
2543 insurer filing the form;
2544 (v) the form violates a statute or a rule adopted by the commissioner; or
2545 (vi) the form is otherwise contrary to law.
2546 (b) (i) When the commissioner prohibits the use of a form under Subsection (3)(a), the
2547 commissioner may order that, on or before a date not less than 15 days after the day on which
2548 the commissioner issues the order, the use of the form be discontinued.
2549 (ii) Once use of a form is prohibited, the form may not be used until appropriate
2550 changes are filed with and reviewed by the commissioner.
2551 (iii) When the commissioner prohibits the use of a form under Subsection (3)(a), the
2552 commissioner may require the insurer to disclose contract deficiencies to the existing
2553 policyholders.
2554 (c) If the commissioner prohibits use of a form under this Subsection (3), the
2555 prohibition shall:
2556 (i) be in writing;
2557 (ii) constitute an order; and
2558 (iii) state the reasons for the prohibition.
2559 (4) (a) If, after a hearing, the commissioner determines that it is in the public interest,
2560 the commissioner may require by rule or order that a form be subject to the commissioner's
2561 approval before an insurer uses the form.
2562 (b) The rule or order described in Subsection (4)(a) shall prescribe the filing
2563 procedures for a form if the procedures are different from the procedures stated in this section.
2564 (c) The type of form that under Subsection (4)(a) the commissioner may require
2565 approval of before use includes:
2566 (i) a form for a particular class of insurance;
2567 (ii) a form for a specific line of insurance;
2568 (iii) a specific type of form; or
2569 (iv) a form for a specific market segment.
2570 (5) (a) An insurer shall maintain a complete and accurate record of the following for
2571 the time period described in Subsection (5)(b):
2572 (i) a form:
2573 (A) filed under this section for use; or
2574 (B) that is in use; and
2575 (ii) a document filed under this section with a form described in Subsection (5)(a)(i).
2576 (b) The insurer shall maintain a record required under Subsection (5)(a) for the balance
2577 of the current year, plus five years from:
2578 (i) the last day on which the form is used; or
2579 (ii) the last day an insurance policy that is issued using the form is in effect.
2580 Section 13. Section 31A-21-303 is amended to read:
2581 31A-21-303. Cancellation, issuance, renewal.
2582 (1) (a) Except as otherwise provided in this section, other statutes, or by rule under
2583 Subsection (1)(c), this section applies to all policies of insurance:
2584 (i) except for:
2585 (A) life insurance;
2586 (B) accident and health insurance; and
2587 (C) annuities; and
2588 (ii) if the policies of insurance are issued on forms that are subject to filing under
2589 Subsection 31A-21-201(1).
2590 (b) A policy may provide terms more favorable to insureds than this section requires.
2591 (c) The commissioner may by rule totally or partially exempt from this section classes
2592 of insurance policies in which the insureds do not need protection against arbitrary or
2593 unannounced termination.
2594 (d) The rights provided by this section are in addition to and do not prejudice any other
2595 rights the insureds may have at common law or under other statutes.
2596 (2) (a) As used in this Subsection (2), "grounds" means:
2597 (i) material misrepresentation;
2598 (ii) substantial change in the risk assumed, unless the insurer should reasonably have
2599 foreseen the change or contemplated the risk when entering into the contract;
2600 (iii) substantial breaches of contractual duties, conditions, or warranties;
2601 (iv) attainment of the age specified as the terminal age for coverage, in which case the
2602 insurer may cancel by notice under Subsection (2)(c), accompanied by a tender of proportional
2603 return of premium; or
2604 (v) in the case of motor vehicle insurance, revocation or suspension of the driver's
2605 license of:
2606 (A) the named insured; or
2607 (B) any other person who customarily drives the motor vehicle.
2608 (b) (i) Except as provided in Subsection (2)(e) or unless the conditions of Subsection
2609 (2)(b)(ii) are met, an insurance policy may not be canceled by the insurer before the earlier of:
2610 (A) the expiration of the agreed term; or
2611 (B) one year from the effective date of the policy or renewal.
2612 (ii) Notwithstanding Subsection (2)(b)(i), an insurance policy may be canceled by the
2613 insurer for:
2614 (A) nonpayment of a premium when due; or
2615 (B) on grounds defined in Subsection (2)(a).
2616 (c) (i) The cancellation provided by Subsection (2)(b), except cancellation for
2617 nonpayment of premium, is effective no sooner than 30 days after the delivery or first-class
2618 mailing of a written notice to the policyholder.
2619 (ii) Cancellation for nonpayment of premium of a personal lines policy is effective no
2620 sooner than 10 days after delivery or first-class mailing of a written notice to the policyholder.
2621 (iii) Cancellation for nonpayment of premium of a commercial lines policy is effective
2622 no sooner than 10 days after delivery or first-class mailing of a written notice to:
2623 (A) the policyholder;
2624 (B) each assignee of the policyholder, if the assignee is named in the policy; and
2625 (C) each loss payee or mortgagee or lienholder under property insurance of the
2626 policyholder, if the loss payee, mortgagee, or lienholder is named in the policy.
2627 (iv) An insurer shall deliver or send by first-class mail a copy of the notice of
2628 cancellation for nonpayment of premium described in Subsection (2)(c)(iii) to an agent of
2629 record of the policyholder on or before the day on which the insurer provides the notice to the
2630 policyholder.
2631 (d) (i) Notice of cancellation for nonpayment of premium shall include a statement of
2632 the reason for cancellation.
2633 (ii) Subsection (7) applies to the notice required for grounds of cancellation other than
2634 nonpayment of premium.
2635 (e) (i) Subsections (2)(a) through (d) do not apply to any insurance contract that has not
2636 been previously renewed if the contract has been in effect less than 60 days on the day on
2637 which the written notice of cancellation is mailed or delivered.
2638 (ii) A cancellation under this Subsection (2)(e) may not be effective until at least 10
2639 days after the day on which a written notice of cancellation is delivered to the insured.
2640 (iii) If the notice required by this Subsection (2)(e) is sent by first-class mail, postage
2641 prepaid, to the insured at the insured's last-known address, delivery is considered accomplished
2642 after the passing, since the mailing date, of the mailing time specified in the Utah Rules of
2643 Civil Procedure.
2644 (iv) A policy cancellation subject to this Subsection (2)(e) is not subject to the
2645 procedures described in Subsection (7).
2646 (3) A policy may be issued for a term longer than one year or for an indefinite term if
2647 the policy includes a clause providing for cancellation by the insurer by giving notice as
2648 provided in Subsection (4)(b)(i) 30 days before an anniversary date.
2649 (4) (a) Subject to Subsections (2), (3), and (4)(b), a policyholder has a right to have the
2650 policy renewed:
2651 (i) on the terms then being applied by the insurer to similar risks; and
2652 (ii) (A) for an additional period of time equivalent to the expiring term if the agreed
2653 term is one year or less; or
2654 (B) for one year if the agreed term is longer than one year.
2655 (b) Except as provided in Subsections (4)(c) and (5), the right to renewal under
2656 Subsection (4)(a) is extinguished if:
2657 (i) at least 30 days before the day on which the policy expires or completes an
2658 anniversary, the insurer delivers or sends by first-class mail a notice of intention not to renew
2659 the policy beyond the agreed expiration or anniversary date to the policyholder at the
2660 policyholder's last-known address;
2661 (ii) not more than 45 nor less than 14 days before the day on which the renewal
2662 premium is due, the insurer delivers or sends by first-class mail a notice to the policyholder at
2663 the policyholder's last-known address, clearly stating:
2664 (A) the renewal premium;
2665 (B) how the renewal premium may be paid, including the due date for payment of the
2666 renewal premium;
2667 (C) that failure to pay the renewal premium extinguishes the policyholder's right to
2668 renewal; and
2669 (D) subject to Subsection (4)(e), that the extinguishment of the right to renew for
2670 nonpayment of premium is effective no sooner than at least 10 days after delivery or first-class
2671 mailing of a written notice to the policyholder that the policyholder has failed to pay the
2672 premium when due;
2673 (iii) the policyholder has:
2674 (A) accepted replacement coverage; or
2675 (B) requested or agreed to nonrenewal; or
2676 (iv) the policy is expressly designated as nonrenewable.
2677 (c) Unless the conditions of Subsection (4)(b)(iii) or (iv) apply, an insurer may not fail
2678 to renew an insurance policy as a result of a telephone call or other inquiry that:
2679 (i) references a policy coverage; and
2680 (ii) does not result in the insured requesting payment of a claim.
2681 (d) Failure to renew under this Subsection (4) is subject to Subsection (5).
2682 (e) (i) (A) If the policy is a personal lines policy, during the period that begins when an
2683 insurer delivers or sends by first-class mail the notice described in Subsection (4)(b)(ii)(D) and
2684 ends when the premium is paid, coverage exists and premiums are due.
2685 (B) If the policy is a commercial lines policy, during the period that begins when an
2686 insurer delivers or sends by first-class mail the notice described in Subsection (2)(c)(iii) and
2687 ends when the premium is paid, coverage exists and premiums are due.
2688 (ii) (A) If after receiving the notice required by Subsection (4)(b)(ii)(D) a personal
2689 lines policyholder fails to pay the renewal premium, the coverage is extinguished as of the date
2690 the renewal premium is originally due.
2691 (B) If after receiving the notice required under Subsection (2)(c)(iii), a commercial
2692 lines policyholder fails to pay the renewal premium within the 10 days before the day on which
2693 cancellation for nonpayment is effective, the coverage is extinguished as of the day on which
2694 the renewal premium is originally due.
2695 (iii) Delivery of the notice required by Subsection (2)(c)(iii), (2)(c)(iv), or (4)(b)(ii)(D)
2696 includes electronic delivery in accordance with Section 31A-21-316.
2697 (iv) An insurer is not subject to Subsection (4)(b)(ii)(D) if:
2698 (A) the insurer provides notice of the extinguishment of the right to renew for failure to
2699 pay premium at least 15 days, but no longer than 45 days, before the day on which the renewal
2700 payment is due; and
2701 (B) the policy is a personal lines policy.
2702 (v) Subsection (4)(b)(ii)(D) does not apply to a policy that provides coverage for 30
2703 days or less.
2704 (5) Notwithstanding Subsection (4), an insurer may not fail to renew the following
2705 personal lines insurance policies solely on the basis of:
2706 (a) in the case of a motor vehicle insurance policy:
2707 (i) a claim from the insured that:
2708 (A) results from an accident in which:
2709 (I) the insured is not at fault; and
2710 (II) the driver of the motor vehicle that is covered by the motor vehicle insurance
2711 policy is 21 years of age or older; and
2712 (B) is the only claim meeting the condition of Subsection (5)(a)(i)(A) within a
2713 36-month period;
2714 (ii) a single traffic violation by an insured that:
2715 (A) is a violation of a speed limit under Title 41, Chapter 6a, Traffic Code;
2716 (B) is not in excess of 10 miles per hour over the speed limit;
2717 (C) is not a traffic violation under:
2718 (I) Section 41-6a-601;
2719 (II) Section 41-6a-604; or
2720 (III) Section 41-6a-605;
2721 (D) is not a violation by an insured driver who is younger than 21 years of age; and
2722 (E) is the only violation meeting the conditions of Subsections (5)(a)(ii)(A) through
2723 (D) within a 36-month period; or
2724 (iii) a claim for damage that:
2725 (A) results solely from:
2726 (I) wind;
2727 (II) hail;
2728 (III) lightning; or
2729 (IV) an earthquake;
2730 (B) is not preventable by the exercise of reasonable care; and
2731 (C) is the only claim meeting the conditions of Subsections (5)(a)(iii)(A) and (B)
2732 within a 36-month period; and
2733 (b) in the case of a homeowner's insurance policy, a claim by the insured that is for
2734 damage that:
2735 (i) results solely from:
2736 (A) wind;
2737 (B) hail; or
2738 (C) lightning;
2739 (ii) is not preventable by the exercise of reasonable care; and
2740 (iii) is the only claim meeting the conditions of Subsections (5)(b)(i) and (ii) within a
2741 36-month period.
2742 (6) (a) (i) Subject to Subsection (6)(b), if the insurer offers or purports to renew the
2743 policy, but on less favorable terms or at higher rates, the new terms or rates take effect on the
2744 renewal date if the insurer delivered or sent by first-class mail to the policyholder notice of the
2745 new terms or rates at least 30 days before the day on which the previous policy expires.
2746 (ii) If the insurer did not give the prior notification described in Subsection (6)(a)(i) to
2747 the policyholder, the new terms or rates do not take effect until 30 days after the day on which
2748 the insurer delivers or sends by first-class mail the notice, in which case the policyholder may
2749 elect to cancel the renewal policy at any time during the 30-day period.
2750 (iii) Return premiums or additional premium charges shall be calculated
2751 proportionately on the basis that the old rates apply.
2752 (b) Except as provided in Subsection (6)(c), Subsection (6)(a) does not apply if the
2753 only change in terms that is adverse to the policyholder is:
2754 (i) a rate increase generally applicable to the class of business to which the policy
2755 belongs;
2756 (ii) a rate increase resulting from a classification change based on the altered nature or
2757 extent of the risk insured against; or
2758 (iii) a policy form change made to make the form consistent with Utah law.
2759 (c) Subsections (6)(b)(i) and (ii) do not apply to a rate increase of 25% or more on a
2760 commercial policy.
2761 (7) (a) If a notice of cancellation or nonrenewal under Subsection (2)(c) does not state
2762 with reasonable precision the facts on which the insurer's decision is based, the insurer shall
2763 send by first-class mail or deliver that information within 10 working days after receipt of a
2764 written request by the policyholder.
2765 (b) A notice under Subsection (2)(c) is not effective unless it contains information
2766 about the policyholder's right to make the request.
2767 (8) (a) An insurer that gives a notice of nonrenewal or cancellation of insurance on a
2768 motor vehicle insurance policy issued in accordance with the requirements of Chapter 22, Part
2769 3, Motor Vehicle Insurance, for nonpayment of a premium shall provide notice of nonrenewal
2770 or cancellation to a lienholder if the insurer has been provided the name and mailing address of
2771 the lienholder.
2772 (b) An insurer shall provide the notice described in Subsection (8)(a) to the lienholder
2773 by first-class mail or, if agreed by the parties, any electronic means of communication.
2774 (c) A lienholder shall provide a current physical address of notification or an electronic
2775 address of notification to an insurer that is required to make a notification under Subsection
2776 (8)(a).
2777 (9) If a risk-sharing plan under Section 31A-2-214 exists for the kind of coverage
2778 provided by the insurance being cancelled or nonrenewed, a notice of cancellation or
2779 nonrenewal required under Subsection (2)(c) or (4)(b)(i) may not be effective unless the notice
2780 contains instructions to the policyholder for applying for insurance through the available
2781 risk-sharing plan.
2782 (10) There is no liability on the part of, and no cause of action against, any insurer, its
2783 authorized representatives, agents, employees, or any other person furnishing to the insurer
2784 information relating to the reasons for cancellation or nonrenewal or for any statement made or
2785 information given by them in complying or enabling the insurer to comply with this section
2786 unless actual malice is proved by clear and convincing evidence.
2787 (11) This section does not alter any common law right of contract rescission for
2788 material misrepresentation.
2789 (12) If a person is required to pay a premium in accordance with this section:
2790 (a) the person may make the payment using:
2791 (i) the United States Postal Service;
2792 (ii) a delivery service the commissioner describes or designates by rule made in
2793 accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act; or
2794 (iii) electronic means; and
2795 (b) the payment is considered to be made:
2796 (i) for a payment that is mailed using the method described in Subsection (12)(a)(i), on
2797 the date on which the payment is postmarked;
2798 (ii) for a payment that is delivered using the method described in Subsection (12)(a)(ii),
2799 on the date on which the delivery service records or marks the payment as having been received
2800 by the delivery service; or
2801 (iii) for a payment that is made using the method described in Subsection (12)(a)(iii),
2802 on the date on which the payment is made electronically.
2803 Section 14. Section 31A-22-305.3 is amended to read:
2804 31A-22-305.3. Underinsured motorist coverage.
2805 (1) As used in this section:
2806 (a) "Covered person" has the same meaning as defined in Section 31A-22-305.
2807 (b) (i) "Underinsured motor vehicle" includes a motor vehicle, the operation,
2808 maintenance, or use of which is covered under a liability policy at the time of an injury-causing
2809 occurrence, but which has insufficient liability coverage to compensate fully the injured party
2810 for all special and general damages.
2811 (ii) The term "underinsured motor vehicle" does not include:
2812 (A) a motor vehicle that is covered under the liability coverage of the same policy that
2813 also contains the underinsured motorist coverage;
2814 (B) an uninsured motor vehicle as defined in Subsection 31A-22-305(2);
2815 (C) a motor vehicle owned or leased by:
2816 (I) a named insured;
2817 (II) a named insured's spouse; or
2818 (III) a dependent of a named insured.
2819 (2) (a) Underinsured motorist coverage under Subsection 31A-22-302(1)(c) provides
2820 coverage for a covered person who is legally entitled to recover damages from an owner or
2821 operator of an underinsured motor vehicle because of bodily injury, sickness, disease, or death.
2822 (b) A covered person occupying or using a motor vehicle owned, leased, or furnished
2823 to the covered person, the covered person's spouse, or covered person's resident relative may
2824 recover underinsured benefits only if the motor vehicle is:
2825 (i) described in the policy under which a claim is made; or
2826 (ii) a newly acquired or replacement motor vehicle covered under the terms of the
2827 policy.
2828 (3) (a) For purposes of this Subsection (3), "new policy" means:
2829 (i) any policy that is issued that does not include a renewal or reinstatement of an
2830 existing policy; or
2831 (ii) a change to an existing policy that results in:
2832 (A) a named insured being added to or deleted from the policy; or
2833 (B) a change in the limits of the named insured's motor vehicle liability coverage.
2834 (b) For new policies written on or after January 1, 2001, the limits of underinsured
2835 motorist coverage shall be equal to the lesser of the limits of the named insured's motor vehicle
2836 liability coverage or the maximum underinsured motorist coverage limits available by the
2837 insurer under the named insured's motor vehicle policy, unless a named insured rejects or
2838 purchases coverage in a lesser amount by signing an acknowledgment form that:
2839 (i) is filed with the department;
2840 (ii) is provided by the insurer;
2841 (iii) waives the higher coverage;
2842 (iv) need only state in this or similar language that "underinsured motorist coverage
2843 provides benefits or protection to you and other covered persons for bodily injury resulting
2844 from an accident caused by the fault of another party where the other party has insufficient
2845 liability insurance"; and
2846 (v) discloses the additional premiums required to purchase underinsured motorist
2847 coverage with limits equal to the lesser of the limits of the named insured's motor vehicle
2848 liability coverage or the maximum underinsured motorist coverage limits available by the
2849 insurer under the named insured's motor vehicle policy.
2850 (c) Any selection or rejection under Subsection (3)(b) continues for that issuer of the
2851 liability coverage until the insured requests, in writing, a change of underinsured motorist
2852 coverage from that liability insurer.
2853 (d) (i) Subsections (3)(b) and (c) apply retroactively to any claim arising on or after
2854 January 1, 2001, for which, as of May 14, 2013, an insured has not made a written demand for
2855 arbitration or filed a complaint in a court of competent jurisdiction.
2856 (ii) The Legislature finds that the retroactive application of Subsections (3)(b) and (c)
2857 clarifies legislative intent and does not enlarge, eliminate, or destroy vested rights.
2858 (e) (i) As used in this Subsection (3)(e), "additional motor vehicle" means a change
2859 that increases the total number of vehicles insured by the policy, and does not include
2860 replacement, substitute, or temporary vehicles.
2861 (ii) The adding of an additional motor vehicle to an existing personal lines or
2862 commercial lines policy does not constitute a new policy for purposes of Subsection (3)(a).
2863 (iii) If an additional motor vehicle is added to a personal lines policy where
2864 underinsured motorist coverage has been rejected, or where underinsured motorist limits are
2865 lower than the named insured's motor vehicle liability limits, the insurer shall provide a notice
2866 to a named insured within 30 days that:
2867 (A) in the same manner described in Subsection (3)(b)(iv), explains the purpose of
2868 underinsured motorist coverage; and
2869 (B) encourages the named insured to contact the insurance company or insurance
2870 producer for quotes as to the additional premiums required to purchase underinsured motorist
2871 coverage with limits equal to the lesser of the limits of the named insured's motor vehicle
2872 liability coverage or the maximum underinsured motorist coverage limits available by the
2873 insurer under the named insured's motor vehicle policy.
2874 (f) A change in policy number resulting from any policy change not identified under
2875 Subsection (3)(a)(ii) does not constitute a new policy.
2876 (g) (i) Subsection (3)(a) applies retroactively to any claim arising on or after January 1,
2877 2001 for which, as of May 1, 2012, an insured has not made a written demand for arbitration or
2878 filed a complaint in a court of competent jurisdiction.
2879 (ii) The Legislature finds that the retroactive application of Subsection (3)(a):
2880 (A) does not enlarge, eliminate, or destroy vested rights; and
2881 (B) clarifies legislative intent.
2882 (h) A self-insured, including a governmental entity, may elect to provide underinsured
2883 motorist coverage in an amount that is less than its maximum self-insured retention under
2884 Subsections (3)(b) and (l) by issuing a declaratory memorandum or policy statement from the
2885 chief financial officer or chief risk officer that declares the:
2886 (i) self-insured entity's coverage level; and
2887 (ii) process for filing an underinsured motorist claim.
2888 (i) Underinsured motorist coverage may not be sold with limits that are less than:
2889 (i) $10,000 for one person in any one accident; and
2890 (ii) at least $20,000 for two or more persons in any one accident.
2891 (j) An acknowledgment under Subsection (3)(b) continues for that issuer of the
2892 underinsured motorist coverage until the named insured, in writing, requests different
2893 underinsured motorist coverage from the insurer.
2894 (k) (i) The named insured's underinsured motorist coverage, as described in Subsection
2895 (2), is secondary to the liability coverage of an owner or operator of an underinsured motor
2896 vehicle, as described in Subsection (1).
2897 (ii) Underinsured motorist coverage may not be set off against the liability coverage of
2898 the owner or operator of an underinsured motor vehicle, but shall be added to, combined with,
2899 or stacked upon the liability coverage of the owner or operator of the underinsured motor
2900 vehicle to determine the limit of coverage available to the injured person.
2901 (l) (i) In conjunction with the first two renewal notices sent after January 1, 2001, for
2902 policies existing on that date, the insurer shall disclose in the same medium as the premium
2903 renewal notice, an explanation of:
2904 (A) the purpose of underinsured motorist coverage in the same manner as described in
2905 Subsection (3)(b)(iv); and
2906 (B) a disclosure of the additional premiums required to purchase underinsured motorist
2907 coverage with limits equal to the lesser of the limits of the named insured's motor vehicle
2908 liability coverage or the maximum underinsured motorist coverage limits available by the
2909 insurer under the named insured's motor vehicle policy.
2910 (ii) The disclosure required under this Subsection (3)(l) shall be sent to all named
2911 insureds that carry underinsured motorist coverage limits in an amount less than the named
2912 insured's motor vehicle liability policy limits or the maximum underinsured motorist coverage
2913 limits available by the insurer under the named insured's motor vehicle policy.
2914 (m) For purposes of this Subsection (3), a notice or disclosure sent to a named insured
2915 in a household constitutes notice or disclosure to all insureds within the household.
2916 (4) (a) (i) Except as provided in this Subsection (4), a covered person injured in a
2917 motor vehicle described in a policy that includes underinsured motorist benefits may not elect
2918 to collect underinsured motorist coverage benefits from another motor vehicle insurance policy.
2919 (ii) The limit of liability for underinsured motorist coverage for two or more motor
2920 vehicles may not be added together, combined, or stacked to determine the limit of insurance
2921 coverage available to an injured person for any one accident.
2922 (iii) Subsection (4)(a)(ii) applies to all persons except a covered person described
2923 under Subsections (4)(b)(i) and (ii).
2924 (b) (i) A covered person injured as a pedestrian by an underinsured motor vehicle may
2925 recover underinsured motorist benefits under any one other policy in which they are described
2926 as a covered person.
2927 (ii) Except as provided in Subsection (4)(b)(iii), a covered person injured while
2928 occupying, using, or maintaining a motor vehicle that is not owned, leased, or furnished to the
2929 covered person, the covered person's spouse, or the covered person's resident parent or resident
2930 sibling, may also recover benefits under any one other policy under which the covered person is
2931 also a covered person.
2932 (iii) (A) A covered person may recover benefits from no more than two additional
2933 policies, one additional policy from each parent's household if the covered person is:
2934 (I) a dependent minor of parents who reside in separate households; and
2935 (II) injured while occupying or using a motor vehicle that is not owned, leased, or
2936 furnished to the covered person, the covered person's resident parent, or the covered person's
2937 resident sibling.
2938 (B) Each parent's policy under this Subsection (4)(b)(iii) is liable only for the
2939 percentage of the damages that the limit of liability of each parent's policy of underinsured
2940 motorist coverage bears to the total of both parents' underinsured coverage applicable to the
2941 accident.
2942 (iv) A covered person's recovery under any available policies may not exceed the full
2943 amount of damages.
2944 (v) Underinsured coverage on a motor vehicle occupied at the time of an accident is
2945 primary coverage, and the coverage elected by a person described under Subsections
2946 31A-22-305(1)(a), (b), and (c) is secondary coverage.
2947 (vi) The primary and the secondary coverage may not be set off against the other.
2948 (vii) A covered person as described under Subsection (4)(b)(i) or is entitled to the
2949 highest limits of underinsured motorist coverage under only one additional policy per
2950 household applicable to that covered person as a named insured, spouse, or relative.
2951 (viii) A covered injured person is not barred against making subsequent elections if
2952 recovery is unavailable under previous elections.
2953 (ix) (A) As used in this section, "interpolicy stacking" means recovering benefits for a
2954 single incident of loss under more than one insurance policy.
2955 (B) Except to the extent permitted by this Subsection (4), interpolicy stacking is
2956 prohibited for underinsured motorist coverage.
2957 (c) Underinsured motorist coverage:
2958 (i) does not cover any benefit paid or payable under Title 34A, Chapter 2, Workers'
2959 Compensation Act, except that the covered person is credited an amount described in
2960 Subsection 34A-2-106(5);
2961 (ii) may not be subrogated by a workers' compensation insurance carrier;
2962 (iii) may not be reduced by benefits provided by workers' compensation insurance;
2963 (iv) may be reduced by health insurance subrogation only after the covered person is
2964 made whole;
2965 (v) may not be collected for bodily injury or death sustained by a person:
2966 (A) while committing a violation of Section 41-1a-1314;
2967 (B) who, as a passenger in a vehicle, has knowledge that the vehicle is being operated
2968 in violation of Section 41-1a-1314; or
2969 (C) while committing a felony; and
2970 (vi) notwithstanding Subsection (4)(c)(v), may be recovered:
2971 (A) for a person [
2972 within the scope of Subsection (4)(c)(v), but is limited to medical and funeral expenses; or
2973 (B) by a law enforcement officer as defined in Section 53-13-103, who is injured
2974 within the course and scope of the law enforcement officer's duties.
2975 (5) The inception of the loss under Subsection 31A-21-313(1) for underinsured
2976 motorist claims occurs upon the date of the last liability policy payment.
2977 (6) An underinsured motorist insurer does not have a right of reimbursement against a
2978 person liable for the damages resulting from an injury-causing occurrence if the person's
2979 liability insurer has tendered the policy limit and the limits have been accepted by the claimant.
2980 (7) Except as otherwise provided in this section, a covered person may seek, subject to
2981 the terms and conditions of the policy, additional coverage under any policy:
2982 (a) that provides coverage for damages resulting from motor vehicle accidents; and
2983 (b) that is not required to conform to Section 31A-22-302.
2984 (8) (a) When a claim is brought by a named insured or a person described in
2985 Subsection 31A-22-305(1) and is asserted against the covered person's underinsured motorist
2986 carrier, the claimant may elect to resolve the claim:
2987 (i) by submitting the claim to binding arbitration; or
2988 (ii) through litigation.
2989 (b) Unless otherwise provided in the policy under which underinsured benefits are
2990 claimed, the election provided in Subsection (8)(a) is available to the claimant only, except that
2991 if the policy under which insured benefits are claimed provides that either an insured or the
2992 insurer may elect arbitration, the insured or the insurer may elect arbitration and that election to
2993 arbitrate shall stay the litigation of the claim under Subsection (8)(a)(ii).
2994 (c) Once a claimant elects to commence litigation under Subsection (8)(a)(ii), the
2995 claimant may not elect to resolve the claim through binding arbitration under this section
2996 without the written consent of the underinsured motorist coverage carrier.
2997 (d) For purposes of the statute of limitations applicable to a claim described in
2998 Subsection (8)(a), if the claimant does not elect to resolve the claim through litigation, the
2999 claim is considered filed when the claimant submits the claim to binding arbitration in
3000 accordance with this Subsection (8).
3001 (e) (i) Unless otherwise agreed to in writing by the parties, a claim that is submitted to
3002 binding arbitration under Subsection (8)(a)(i) shall be resolved by a single arbitrator.
3003 (ii) All parties shall agree on the single arbitrator selected under Subsection (8)(e)(i).
3004 (iii) If the parties are unable to agree on a single arbitrator as required under Subsection
3005 (8)(e)(ii), the parties shall select a panel of three arbitrators.
3006 (f) If the parties select a panel of three arbitrators under Subsection (8)(e)(iii):
3007 (i) each side shall select one arbitrator; and
3008 (ii) the arbitrators appointed under Subsection (8)(f)(i) shall select one additional
3009 arbitrator to be included in the panel.
3010 (g) Unless otherwise agreed to in writing:
3011 (i) each party shall pay an equal share of the fees and costs of the arbitrator selected
3012 under Subsection (8)(e)(i); or
3013 (ii) if an arbitration panel is selected under Subsection (8)(e)(iii):
3014 (A) each party shall pay the fees and costs of the arbitrator selected by that party; and
3015 (B) each party shall pay an equal share of the fees and costs of the arbitrator selected
3016 under Subsection (8)(f)(ii).
3017 (h) Except as otherwise provided in this section or unless otherwise agreed to in
3018 writing by the parties, an arbitration proceeding conducted under this section is governed by
3019 Title 78B, Chapter 11, Utah Uniform Arbitration Act.
3020 (i) (i) The arbitration shall be conducted in accordance with Rules 26(a)(4) through (f),
3021 27 through 37, 54, and 68 of the Utah Rules of Civil Procedure, once the requirements of
3022 Subsections (9)(a) through (c) are satisfied.
3023 (ii) The specified tier as defined by Rule 26(c)(3) of the Utah Rules of Civil Procedure
3024 shall be determined based on the claimant's specific monetary amount in the written demand
3025 for payment of uninsured motorist coverage benefits as required in Subsection (9)(a)(i)(A).
3026 (iii) Rules 26.1 and 26.2 of the Utah Rules of Civil Procedure do not apply to
3027 arbitration claims under this part.
3028 (j) An issue of discovery shall be resolved by the arbitrator or the arbitration panel.
3029 (k) A written decision by a single arbitrator or by a majority of the arbitration panel
3030 constitutes a final decision.
3031 (l) (i) Except as provided in Subsection (9), the amount of an arbitration award may not
3032 exceed the underinsured motorist policy limits of all applicable underinsured motorist policies,
3033 including applicable underinsured motorist umbrella policies.
3034 (ii) If the initial arbitration award exceeds the underinsured motorist policy limits of all
3035 applicable underinsured motorist policies, the arbitration award shall be reduced to an amount
3036 equal to the combined underinsured motorist policy limits of all applicable underinsured
3037 motorist policies.
3038 (m) The arbitrator or arbitration panel may not decide an issue of coverage or
3039 extra-contractual damages, including:
3040 (i) whether the claimant is a covered person;
3041 (ii) whether the policy extends coverage to the loss; or
3042 (iii) an allegation or claim asserting consequential damages or bad faith liability.
3043 (n) The arbitrator or arbitration panel may not conduct arbitration on a class-wide or
3044 class-representative basis.
3045 (o) If the arbitrator or arbitration panel finds that the arbitration is not brought, pursued,
3046 or defended in good faith, the arbitrator or arbitration panel may award reasonable attorney fees
3047 and costs against the party that failed to bring, pursue, or defend the arbitration in good faith.
3048 (p) An arbitration award issued under this section shall be the final resolution of all
3049 claims not excluded by Subsection (8)(m) between the parties unless:
3050 (i) the award is procured by corruption, fraud, or other undue means; or
3051 (ii) either party, within 20 days after service of the arbitration award:
3052 (A) files a complaint requesting a trial de novo in the district court; and
3053 (B) serves the nonmoving party with a copy of the complaint requesting a trial de novo
3054 under Subsection (8)(p)(ii)(A).
3055 (q) (i) Upon filing a complaint for a trial de novo under Subsection (8)(p), a claim shall
3056 proceed through litigation pursuant to the Utah Rules of Civil Procedure and Utah Rules of
3057 Evidence in the district court.
3058 (ii) In accordance with Rule 38, Utah Rules of Civil Procedure, either party may
3059 request a jury trial with a complaint requesting a trial de novo under Subsection (8)(p)(ii)(A).
3060 (r) (i) If the claimant, as the moving party in a trial de novo requested under Subsection
3061 (8)(p), does not obtain a verdict that is at least $5,000 and is at least 20% greater than the
3062 arbitration award, the claimant is responsible for all of the nonmoving party's costs.
3063 (ii) If the underinsured motorist carrier, as the moving party in a trial de novo requested
3064 under Subsection (8)(p), does not obtain a verdict that is at least 20% less than the arbitration
3065 award, the underinsured motorist carrier is responsible for all of the nonmoving party's costs.
3066 (iii) Except as provided in Subsection (8)(r)(iv), the costs under this Subsection (8)(r)
3067 shall include:
3068 (A) any costs set forth in Rule 54(d), Utah Rules of Civil Procedure; and
3069 (B) the costs of expert witnesses and depositions.
3070 (iv) An award of costs under this Subsection (8)(r) may not exceed $2,500 unless
3071 Subsection (9)(h)(iii) applies.
3072 (s) For purposes of determining whether a party's verdict is greater or less than the
3073 arbitration award under Subsection (8)(r), a court may not consider any recovery or other relief
3074 granted on a claim for damages if the claim for damages:
3075 (i) was not fully disclosed in writing prior to the arbitration proceeding; or
3076 (ii) was not disclosed in response to discovery contrary to the Utah Rules of Civil
3077 Procedure.
3078 (t) If a district court determines, upon a motion of the nonmoving party, that a moving
3079 party's use of the trial de novo process is filed in bad faith in accordance with Section
3080 78B-5-825, the district court may award reasonable attorney fees to the nonmoving party.
3081 (u) Nothing in this section is intended to limit a claim under another portion of an
3082 applicable insurance policy.
3083 (v) If there are multiple underinsured motorist policies, as set forth in Subsection (4),
3084 the claimant may elect to arbitrate in one hearing the claims against all the underinsured
3085 motorist carriers.
3086 (9) (a) Within 30 days after a covered person elects to submit a claim for underinsured
3087 motorist benefits to binding arbitration or files litigation, the covered person shall provide to
3088 the underinsured motorist carrier:
3089 (i) a written demand for payment of underinsured motorist coverage benefits, setting
3090 forth:
3091 (A) subject to Subsection (9)(l), the specific monetary amount of the demand,
3092 including a computation of the covered person's claimed past medical expenses, claimed past
3093 lost wages, and all other claimed past economic damages; and
3094 (B) the factual and legal basis and any supporting documentation for the demand;
3095 (ii) a written statement under oath disclosing:
3096 (A) (I) the names and last known addresses of all health care providers who have
3097 rendered health care services to the covered person that are material to the claims for which the
3098 underinsured motorist benefits are sought for a period of five years preceding the date of the
3099 event giving rise to the claim for underinsured motorist benefits up to the time the election for
3100 arbitration or litigation has been exercised; and
3101 (II) the names and last known addresses of the health care providers who have rendered
3102 health care services to the covered person, which the covered person claims are immaterial to
3103 the claims for which underinsured motorist benefits are sought, for a period of five years
3104 preceding the date of the event giving rise to the claim for underinsured motorist benefits up to
3105 the time the election for arbitration or litigation has been exercised that have not been disclosed
3106 under Subsection (9)(a)(ii)(A)(I);
3107 (B) (I) the names and last known addresses of all health insurers or other entities to
3108 whom the covered person has submitted claims for health care services or benefits material to
3109 the claims for which underinsured motorist benefits are sought, for a period of five years
3110 preceding the date of the event giving rise to the claim for underinsured motorist benefits up to
3111 the time the election for arbitration or litigation has been exercised; and
3112 (II) the names and last known addresses of the health insurers or other entities to whom
3113 the covered person has submitted claims for health care services or benefits, which the covered
3114 person claims are immaterial to the claims for which underinsured motorist benefits are sought,
3115 for a period of five years preceding the date of the event giving rise to the claim for
3116 underinsured motorist benefits up to the time the election for arbitration or litigation have not
3117 been disclosed;
3118 (C) if lost wages, diminished earning capacity, or similar damages are claimed, all
3119 employers of the covered person for a period of five years preceding the date of the event
3120 giving rise to the claim for underinsured motorist benefits up to the time the election for
3121 arbitration or litigation has been exercised;
3122 (D) other documents to reasonably support the claims being asserted; and
3123 (E) all state and federal statutory lienholders including a statement as to whether the
3124 covered person is a recipient of Medicare or Medicaid benefits or Utah Children's Health
3125 Insurance Program benefits under Title 26, Chapter 40, Utah Children's Health Insurance Act,
3126 or if the claim is subject to any other state or federal statutory liens; and
3127 (iii) signed authorizations to allow the underinsured motorist carrier to only obtain
3128 records and billings from the individuals or entities disclosed under Subsections
3129 (9)(a)(ii)(A)(I), (B)(I), and (C).
3130 (b) (i) If the underinsured motorist carrier determines that the disclosure of undisclosed
3131 health care providers or health care insurers under Subsection (9)(a)(ii) is reasonably necessary,
3132 the underinsured motorist carrier may:
3133 (A) make a request for the disclosure of the identity of the health care providers or
3134 health care insurers; and
3135 (B) make a request for authorizations to allow the underinsured motorist carrier to only
3136 obtain records and billings from the individuals or entities not disclosed.
3137 (ii) If the covered person does not provide the requested information within 10 days:
3138 (A) the covered person shall disclose, in writing, the legal or factual basis for the
3139 failure to disclose the health care providers or health care insurers; and
3140 (B) either the covered person or the underinsured motorist carrier may request the
3141 arbitrator or arbitration panel to resolve the issue of whether the identities or records are to be
3142 provided if the covered person has elected arbitration.
3143 (iii) The time periods imposed by Subsection (9)(c)(i) are tolled pending resolution of
3144 the dispute concerning the disclosure and production of records of the health care providers or
3145 health care insurers.
3146 (c) (i) An underinsured motorist carrier that receives an election for arbitration or a
3147 notice of filing litigation and the demand for payment of underinsured motorist benefits under
3148 Subsection (9)(a)(i) shall have a reasonable time, not to exceed 60 days from the date of the
3149 demand and receipt of the items specified in Subsections (9)(a)(i) through (iii), to:
3150 (A) provide a written response to the written demand for payment provided for in
3151 Subsection (9)(a)(i);
3152 (B) except as provided in Subsection (9)(c)(i)(C), tender the amount, if any, of the
3153 underinsured motorist carrier's determination of the amount owed to the covered person; and
3154 (C) if the covered person is a recipient of Medicare or Medicaid benefits or Utah
3155 Children's Health Insurance Program benefits under Title 26, Chapter 40, Utah Children's
3156 Health Insurance Act, or if the claim is subject to any other state or federal statutory liens,
3157 tender the amount, if any, of the underinsured motorist carrier's determination of the amount
3158 owed to the covered person less:
3159 (I) if the amount of the state or federal statutory lien is established, the amount of the
3160 lien; or
3161 (II) if the amount of the state or federal statutory lien is not established, two times the
3162 amount of the medical expenses subject to the state or federal statutory lien until such time as
3163 the amount of the state or federal statutory lien is established.
3164 (ii) If the amount tendered by the underinsured motorist carrier under Subsection
3165 (9)(c)(i) is the total amount of the underinsured motorist policy limits, the tendered amount
3166 shall be accepted by the covered person.
3167 (d) A covered person who receives a written response from an underinsured motorist
3168 carrier as provided for in Subsection (9)(c)(i), may:
3169 (i) elect to accept the amount tendered in Subsection (9)(c)(i) as payment in full of all
3170 underinsured motorist claims; or
3171 (ii) elect to:
3172 (A) accept the amount tendered in Subsection (9)(c)(i) as partial payment of all
3173 underinsured motorist claims; and
3174 (B) continue to litigate or arbitrate the remaining claim in accordance with the election
3175 made under Subsections (8)(a), (b), and (c).
3176 (e) If a covered person elects to accept the amount tendered under Subsection (9)(c)(i)
3177 as partial payment of all underinsured motorist claims, the final award obtained through
3178 arbitration, litigation, or later settlement shall be reduced by any payment made by the
3179 underinsured motorist carrier under Subsection (9)(c)(i).
3180 (f) In an arbitration proceeding on the remaining underinsured claims:
3181 (i) the parties may not disclose to the arbitrator or arbitration panel the amount paid
3182 under Subsection (9)(c)(i) until after the arbitration award has been rendered; and
3183 (ii) the parties may not disclose the amount of the limits of underinsured motorist
3184 benefits provided by the policy.
3185 (g) If the final award obtained through arbitration or litigation is greater than the
3186 average of the covered person's initial written demand for payment provided for in Subsection
3187 (9)(a)(i) and the underinsured motorist carrier's initial written response provided for in
3188 Subsection (9)(c)(i), the underinsured motorist carrier shall pay:
3189 (i) the final award obtained through arbitration or litigation, except that if the award
3190 exceeds the policy limits of the subject underinsured motorist policy by more than $15,000, the
3191 amount shall be reduced to an amount equal to the policy limits plus $15,000; and
3192 (ii) any of the following applicable costs:
3193 (A) any costs as set forth in Rule 54(d), Utah Rules of Civil Procedure;
3194 (B) the arbitrator or arbitration panel's fee; and
3195 (C) the reasonable costs of expert witnesses and depositions used in the presentation of
3196 evidence during arbitration or litigation.
3197 (h) (i) The covered person shall provide an affidavit of costs within five days of an
3198 arbitration award.
3199 (ii) (A) Objection to the affidavit of costs shall specify with particularity the costs to
3200 which the underinsured motorist carrier objects.
3201 (B) The objection shall be resolved by the arbitrator or arbitration panel.
3202 (iii) The award of costs by the arbitrator or arbitration panel under Subsection (9)(g)(ii)
3203 may not exceed $5,000.
3204 (i) (i) A covered person shall disclose all material information, other than rebuttal
3205 evidence, within 30 days after a covered person elects to submit a claim for underinsured
3206 motorist coverage benefits to binding arbitration or files litigation as specified in Subsection
3207 (9)(a).
3208 (ii) If the information under Subsection (9)(i)(i) is not disclosed, the covered person
3209 may not recover costs or any amounts in excess of the policy under Subsection (9)(g).
3210 (j) This Subsection (9) does not limit any other cause of action that arose or may arise
3211 against the underinsured motorist carrier from the same dispute.
3212 (k) The provisions of this Subsection (9) only apply to motor vehicle accidents that
3213 occur on or after March 30, 2010.
3214 (l) (i) The written demand requirement in Subsection (9)(a)(i)(A) does not affect the
3215 covered person's requirement to provide a computation of any other economic damages
3216 claimed, and the one or more respondents shall have a reasonable time after the receipt of the
3217 computation of any other economic damages claimed to conduct fact and expert discovery as to
3218 any additional damages claimed. The changes made by Laws of Utah 2014, Chapter 290,
3219 Section 11, and Chapter 300, Section 11, to this Subsection (9)(l) and Subsection (9)(a)(i)(A)
3220 apply to a claim submitted to binding arbitration or through litigation on or after May 13, 2014.
3221 (ii) The changes made by Laws of Utah 2014, Chapter 290, Section 11, and Chapter
3222 300, Section 11, under Subsections (9)(a)(ii)(A)(II) and (B)(II) apply to a claim submitted to
3223 binding arbitration or through litigation on or after May 13, 2014.
3224 Section 15. Section 31A-22-602 is amended to read:
3225 31A-22-602. Premium rates.
3226 (1) Except as provided in Subsection 31A-22-701(4), this section does not apply to
3227 group accident and health insurance.
3228 (2) The benefits in an accident and health insurance policy shall be reasonable in
3229 relation to the premiums charged.
3230 (3) The commissioner shall prohibit the use of [
3231 health insurance form or rates if the form or rates do not satisfy Subsection (2).
3232 Section 16. Section 31A-22-627 is amended to read:
3233 31A-22-627. Coverage of emergency medical services.
3234 (1) A health insurance policy or managed care organization contract:
3235 (a) shall provide coverage of emergency services; and
3236 (b) may not:
3237 (i) require any form of preauthorization for treatment of an emergency medical
3238 condition until after the insured's condition has been stabilized;
3239 (ii) deny a claim for any covered evaluation, covered diagnostic test, or other covered
3240 treatment considered medically necessary to stabilize the emergency medical condition of an
3241 insured; or
3242 (iii) impose any cost-sharing requirement for out-of-network that exceeds the
3243 cost-sharing requirement imposed for in-network.
3244 (2) (a) A health insurance policy or managed care organization contract may require
3245 authorization for the continued treatment of an emergency medical condition after the insured's
3246 condition has been stabilized.
3247 (b) If authorization described in Subsection (2)(a) is required, an insurer who does not
3248 accept or reject a request for authorization may not deny a claim for any evaluation, diagnostic
3249 testing, or other treatment considered medically necessary that occurred between the time the
3250 request was received and the time the insurer rejected the request for authorization.
3251 (3) For purposes of this section:
3252 [
3253
3254
3255
3256 [
3257
3258 [
3259 [
3260 [
3261 emergency services are provided on a 24-hour-a-day basis.
3262 [
3263 1395dd(e)(3).
3264 (4) Nothing in this section may be construed as:
3265 (a) altering the level or type of benefits that are provided under the terms of a contract
3266 or policy; or
3267 (b) restricting a policy or contract from providing enhanced benefits for certain
3268 emergency medical conditions that are identified in the policy or contract.
3269 (5) Notwithstanding Section 31A-2-308, if the commissioner finds an insurer has
3270 violated this section, the commissioner may:
3271 (a) work with the insurer to improve the insurer's compliance with this section; or
3272 (b) impose the following fines:
3273 (i) not more than $5,000; or
3274 (ii) twice the amount of any profit gained from violations of this section.
3275 Section 17. Section 31A-22-727 is enacted to read:
3276 31A-22-727. Renewal, cancellation, and modification.
3277 (1) Except as provided in Section 31A-22-618.6, for a group insurance policy offering
3278 accident and health insurance or a blanket insurance policy offering accident and health
3279 insurance, an insurer may:
3280 (a) decline to renew the policy on the date the policy term expires for a reason stated in
3281 the policy; or
3282 (b) cancel the policy at any time for:
3283 (i) nonpayment of a premium when due;
3284 (ii) intentional misrepresentation of a material fact in connection with the coverage;
3285 (iii) performance of an act or practice that constitutes fraud in connection with the
3286 coverage; or
3287 (iv) noncompliance with an employer eligibility provision.
3288 (2) Except for a modification required by law, an insurer may only modify a policy at
3289 renewal.
3290 (3) Subsection (2) does not apply to an endorsement by which the insurer:
3291 (a) effectuates a request the policyholder made in writing; or
3292 (b) exercises a specifically reserved right under the policy.
3293 Section 18. Section 31A-23a-111 is amended to read:
3294 31A-23a-111. Revoking, suspending, surrendering, lapsing, limiting, or otherwise
3295 terminating a license -- Forfeiture -- Rulemaking for renewal or reinstatement.
3296 (1) A license type issued under this chapter remains in force until:
3297 (a) revoked or suspended under Subsection (5);
3298 (b) surrendered to the commissioner and accepted by the commissioner in lieu of
3299 administrative action;
3300 (c) the licensee dies or is adjudicated incompetent as defined under:
3301 (i) Title 75, Chapter 5, Part 3, Guardians of Incapacitated Persons; or
3302 (ii) Title 75, Chapter 5, Part 4, Protection of Property of Persons Under Disability and
3303 Minors;
3304 (d) lapsed under Section 31A-23a-113; or
3305 (e) voluntarily surrendered.
3306 (2) The following may be reinstated within one year after the day on which the license
3307 is no longer in force:
3308 (a) a lapsed license; or
3309 (b) a voluntarily surrendered license, except that a voluntarily surrendered license may
3310 not be reinstated after the license period in which the license is voluntarily surrendered.
3311 (3) Unless otherwise stated in a written agreement for the voluntary surrender of a
3312 license, submission and acceptance of a voluntary surrender of a license does not prevent the
3313 department from pursuing additional disciplinary or other action authorized under:
3314 (a) this title; or
3315 (b) rules made under this title in accordance with Title 63G, Chapter 3, Utah
3316 Administrative Rulemaking Act.
3317 (4) A line of authority issued under this chapter remains in force until:
3318 (a) the qualifications pertaining to a line of authority are no longer met by the licensee;
3319 or
3320 (b) the supporting license type:
3321 (i) is revoked or suspended under Subsection (5);
3322 (ii) is surrendered to the commissioner and accepted by the commissioner in lieu of
3323 administrative action;
3324 (iii) lapses under Section 31A-23a-113; or
3325 (iv) is voluntarily surrendered; or
3326 (c) the licensee dies or is adjudicated incompetent as defined under:
3327 (i) Title 75, Chapter 5, Part 3, Guardians of Incapacitated Persons; or
3328 (ii) Title 75, Chapter 5, Part 4, Protection of Property of Persons Under Disability and
3329 Minors.
3330 (5) (a) If the commissioner makes a finding under Subsection (5)(b), as part of an
3331 adjudicative proceeding under Title 63G, Chapter 4, Administrative Procedures Act, the
3332 commissioner may:
3333 (i) revoke:
3334 (A) a license; or
3335 (B) a line of authority;
3336 (ii) suspend for a specified period of 12 months or less:
3337 (A) a license; or
3338 (B) a line of authority;
3339 (iii) limit in whole or in part:
3340 (A) a license; or
3341 (B) a line of authority;
3342 (iv) deny a license application;
3343 (v) assess a forfeiture under Subsection 31A-2-308(1)(b)(i) or (1)(c)(i); or
3344 (vi) take a combination of actions under Subsections (5)(a)(i) through (iv) and
3345 Subsection (5)(a)(v).
3346 (b) The commissioner may take an action described in Subsection (5)(a) if the
3347 commissioner finds that the licensee or license applicant:
3348 (i) is unqualified for a license or line of authority under Section 31A-23a-104,
3349 31A-23a-105, or 31A-23a-107;
3350 (ii) violates:
3351 (A) an insurance statute;
3352 (B) a rule that is valid under Subsection 31A-2-201(3); or
3353 (C) an order that is valid under Subsection 31A-2-201(4);
3354 (iii) is insolvent or the subject of receivership, conservatorship, rehabilitation, or other
3355 delinquency proceedings in any state;
3356 (iv) fails to pay a final judgment rendered against the person [
3357 days after the day on which the judgment became final;
3358 (v) fails to meet the same good faith obligations in claims settlement that is required of
3359 admitted insurers;
3360 (vi) is affiliated with and under the same general management or interlocking
3361 directorate or ownership as another insurance producer that transacts business in this state
3362 without a license;
3363 (vii) refuses:
3364 (A) to be examined; or
3365 (B) to produce its accounts, records, and files for examination;
3366 (viii) has an officer who refuses to:
3367 (A) give information with respect to the insurance producer's affairs; or
3368 (B) perform any other legal obligation as to an examination;
3369 (ix) provides information in the license application that is:
3370 (A) incorrect;
3371 (B) misleading;
3372 (C) incomplete; or
3373 (D) materially untrue;
3374 (x) violates an insurance law, valid rule, or valid order of another regulatory agency in
3375 any jurisdiction;
3376 (xi) obtains or attempts to obtain a license through misrepresentation or fraud;
3377 (xii) improperly withholds, misappropriates, or converts money or properties received
3378 in the course of doing insurance business;
3379 (xiii) intentionally misrepresents the terms of an actual or proposed:
3380 (A) insurance contract;
3381 (B) application for insurance; or
3382 (C) life settlement;
3383 (xiv) has been convicted of:
3384 (A) a felony; or
3385 (B) a misdemeanor involving fraud, misrepresentation, theft, or dishonesty;
3386 (xv) admits or is found to have committed an insurance unfair trade practice or fraud;
3387 (xvi) in the conduct of business in this state or elsewhere:
3388 (A) uses fraudulent, coercive, or dishonest practices; or
3389 (B) demonstrates incompetence, untrustworthiness, or financial irresponsibility;
3390 (xvii) has had an insurance license or other professional or occupational license, or an
3391 equivalent to an insurance license or registration, or other professional or occupational license
3392 or registration:
3393 (A) denied;
3394 (B) suspended;
3395 (C) revoked; or
3396 (D) surrendered to resolve an administrative action;
3397 (xviii) forges another's name to:
3398 (A) an application for insurance; or
3399 (B) a document related to an insurance transaction;
3400 (xix) improperly uses notes or another reference material to complete an examination
3401 for an insurance license;
3402 (xx) knowingly accepts insurance business from an individual who is not licensed;
3403 (xxi) fails to comply with an administrative or court order imposing a child support
3404 obligation;
3405 (xxii) fails to:
3406 (A) pay state income tax; or
3407 (B) comply with an administrative or court order directing payment of state income
3408 tax;
3409 (xxiii) has been convicted of violating the federal Violent Crime Control and Law
3410 Enforcement Act of 1994, 18 U.S.C. Sec. 1033 and has not obtained written consent to engage
3411 in the business of insurance or participate in such business as required by 18 U.S.C. Sec. 1033;
3412 (xxiv) engages in a method or practice in the conduct of business that endangers the
3413 legitimate interests of customers and the public; or
3414 (xxv) has been convicted of any criminal felony involving dishonesty or breach of trust
3415 and has not obtained written consent to engage in the business of insurance or participate in
3416 such business as required by 18 U.S.C. Sec. 1033.
3417 (c) For purposes of this section, if a license is held by an agency, both the agency itself
3418 and any individual designated under the license are considered to be the holders of the license.
3419 (d) If an individual designated under the agency license commits an act or fails to
3420 perform a duty that is a ground for suspending, revoking, or limiting the individual's license,
3421 the commissioner may suspend, revoke, or limit the license of:
3422 (i) the individual;
3423 (ii) the agency, if the agency:
3424 (A) is reckless or negligent in its supervision of the individual; or
3425 (B) knowingly participates in the act or failure to act that is the ground for suspending,
3426 revoking, or limiting the license; or
3427 (iii) (A) the individual; and
3428 (B) the agency if the agency meets the requirements of Subsection (5)(d)(ii).
3429 (6) A licensee under this chapter is subject to the penalties for acting as a licensee
3430 without a license if:
3431 (a) the licensee's license is:
3432 (i) revoked;
3433 (ii) suspended;
3434 (iii) limited;
3435 (iv) surrendered in lieu of administrative action;
3436 (v) lapsed; or
3437 (vi) voluntarily surrendered; and
3438 (b) the licensee:
3439 (i) continues to act as a licensee; or
3440 (ii) violates the terms of the license limitation.
3441 (7) A licensee under this chapter shall immediately report to the commissioner:
3442 (a) a revocation, suspension, or limitation of the person's license in another state, the
3443 District of Columbia, or a territory of the United States;
3444 (b) the imposition of a disciplinary sanction imposed on that person by another state,
3445 the District of Columbia, or a territory of the United States; or
3446 (c) a judgment or injunction entered against that person on the basis of conduct
3447 involving:
3448 (i) fraud;
3449 (ii) deceit;
3450 (iii) misrepresentation; or
3451 (iv) a violation of an insurance law or rule.
3452 (8) (a) An order revoking a license under Subsection (5) or an agreement to surrender a
3453 license in lieu of administrative action may specify a time, not to exceed five years, within
3454 which the former licensee may not apply for a new license.
3455 (b) If no time is specified in an order or agreement described in Subsection (8)(a), the
3456 former licensee may not apply for a new license for five years from the day on which the order
3457 or agreement is made without the express approval by the commissioner.
3458 (9) The commissioner shall promptly withhold, suspend, restrict, or reinstate the use of
3459 a license issued under this part if so ordered by a court.
3460 (10) The commissioner shall by rule prescribe the license renewal and reinstatement
3461 procedures in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
3462 Section 19. Section 31A-27a-104 is amended to read:
3463 31A-27a-104. Persons covered.
3464 (1) This chapter applies to:
3465 (a) an insurer who:
3466 (i) is doing, or has done, an insurance business in this state; and
3467 (ii) against whom a claim arising from that business may exist;
3468 (b) a person subject to examination by the commissioner;
3469 (c) an insurer who purports to do an insurance business in this state;
3470 (d) an insurer who has an insured who is resident in this state; and
3471 (e) in addition to Subsections (1)(a) through (d), a person doing business as follows:
3472 (i) under Chapter 6a, Service Contracts;
3473 (ii) under Chapter 7, Nonprofit Health Service Insurance Corporations;
3474 (iii) under Chapter 8a, Health Discount Program Consumer Protection Act;
3475 (iv) under Chapter 9, Insurance Fraternals;
3476 (v) under Chapter 11, Motor Clubs;
3477 (vi) under Chapter 15, Unauthorized Insurers, Surplus Lines, and Risk Retention
3478 Groups;
3479 (vii) as a bail bond surety company under Chapter 35, Bail Bond Act;
3480 (viii) under Chapter 37, Captive Insurance Companies Act;
3481 (ix) a title insurance company;
3482 (x) a prepaid health care delivery plan; and
3483 (xi) a person not described in Subsections (1)(e)(i) through (x) that is organized or
3484 doing insurance business, or in the process of organizing with the intent to do insurance
3485 business in this state.
3486 (2) Notwithstanding Sections 31A-1-301 and 31A-27a-102, this chapter does not apply
3487 to a person licensed by the insurance commissioner as one or more of the following in this state
3488 unless the person engages in the business of insurance as an insurer, is an affiliate as defined in
3489 Subsection 31A-1-301(5), or is a person under the control of an affiliate:
3490 (a) an insurance agency;
3491 (b) an insurance producer;
3492 (c) a limited line producer;
3493 (d) an insurance consultant;
3494 (e) a managing general agent;
3495 (f) reinsurance intermediary;
3496 (g) an individual title insurance producer or agency title insurance producer;
3497 (h) a third party administrator;
3498 (i) an insurance adjustor;
3499 (j) a life settlement provider; or
3500 (k) a life settlement producer.
3501 Section 20. Section 31A-27a-111 is amended to read:
3502 31A-27a-111. Actions by and against the receiver.
3503 (1) (a) An allegation by the receiver of improper or fraudulent conduct against a person
3504 may not be the basis of a defense to the enforcement of a contractual obligation owed to the
3505 insurer by a third party.
3506 (b) Notwithstanding Subsection (1)(a), a third party described in this Subsection (1) is
3507 not barred by this section from seeking to establish independently as a defense that the conduct
3508 is materially and substantially related to the contractual obligation for which enforcement is
3509 sought.
3510 (2) (a) Subject to Subsection (2)(b), a prior wrongful or negligent action of any present
3511 or former receiver, receiver's assistant, receiver's contractor, officer, manager, director, trustee,
3512 owner, employee, or agent of the insurer may not be asserted as a defense to a claim by the
3513 receiver:
3514 (i) under a theory of:
3515 (A) estoppel;
3516 (B) comparative fault;
3517 (C) intervening cause;
3518 (D) proximate cause;
3519 (E) reliance; or
3520 (F) mitigation of damages; or
3521 (ii) otherwise.
3522 (b) Notwithstanding Subsection (2)(a):
3523 (i) the affirmative defense of fraud in the inducement may be asserted against the
3524 receiver in a claim based on a contract; and
3525 (ii) a principal under a surety bond or a surety undertaking is entitled to credit against
3526 any reimbursement obligation to the receiver for the value of any property pledged to secure the
3527 reimbursement obligation to the extent that:
3528 (A) the receiver has possession or control of the property; or
3529 (B) the insurer or its agents misappropriated, including commingling, the property.
3530 (c) Evidence of fraud in the inducement is admissible only if it is contained in the
3531 records of the insurer.
3532 (3) Action or inaction by an insurance regulatory authority may not be asserted as a
3533 defense to a claim by the receiver.
3534 (4) (a) Subject to Subsection (4)(b), a judgment or order entered against an insured or
3535 the insurer in contravention of a stay or injunction under this chapter, or at any time by default
3536 or collusion, may not be considered as evidence of liability or of the quantum of damages in
3537 adjudicating claims filed in the estate arising out of the subject matter of the judgment or order.
3538 (b) Subsection (4)(a) does not apply to an affected guaranty association's claim for
3539 amounts paid on a settlement or judgment in pursuit of the affected guaranty association's
3540 statutory obligations.
3541 (5) (a) Subject to Subsection (5)(b), the following do not affect the amount that a
3542 receiver may recover from a third party, regardless of any provision in an agreement to the
3543 contrary:
3544 (i) the insurer's insolvency; or
3545 (ii) the insurer's or receiver's failure to pay all or a portion of an amount or a claim to
3546 the third party.
3547 (b) If an agreement between the insurer and a third party requires a payment by the
3548 insurer before the insurer may recover from the third party, the amount the receiver may
3549 recover from the third party under Subsection (5)(a) is limited to an amount equal to the greater
3550 of:
3551 (i) the amount paid by the insurer or by another person on behalf of the insurer to the
3552 third party; or
3553 (ii) the amount allowed as a claim for payment under:
3554 (A) an approved report described in Section 31A-27a-608;
3555 (B) an order of the receivership court; or
3556 (C) a plan of rehabilitation.
3557 (6) The receiver may not be considered a governmental entity for the purposes of any
3558 state law awarding fees to a litigant who prevails against a governmental entity.
3559 Section 21. Section 31A-30-103 is amended to read:
3560 31A-30-103. Definitions.
3561 As used in this chapter:
3562 (1) "Actuarial certification" means a written statement by a member of the American
3563 Academy of Actuaries or other individual approved by the commissioner that a covered carrier
3564 is in compliance with this chapter, based upon the examination of the covered carrier, including
3565 review of the appropriate records and of the actuarial assumptions and methods used by the
3566 covered carrier in establishing premium rates for applicable health benefit plans.
3567 (2) "Affiliate" or "affiliated" means a person who directly or indirectly through one or
3568 more intermediaries, controls or is controlled by, or is under common control with, a specified
3569 person.
3570 (3) "Base premium rate" means, for each class of business as to a rating period, the
3571 lowest premium rate charged or that could have been charged under a rating system for that
3572 class of business by the covered carrier to covered insureds with similar case characteristics for
3573 health benefit plans with the same or similar coverage.
3574 (4) (a) "Bona fide employer association" means an association of employers:
3575 (i) that meets the requirements of [
3576 (ii) in which the employers of the association, either directly or indirectly, exercise
3577 control over the plan;
3578 (iii) that is organized:
3579 (A) based on a commonality of interest between the employers and their employees
3580 that participate in the plan by some common economic or representation interest or genuine
3581 organizational relationship unrelated to the provision of benefits; and
3582 (B) to act in the best interests of its employers to provide benefits for the employer's
3583 employees and their spouses and dependents, and other benefits relating to employment; and
3584 (iv) whose association sponsored health plan complies with 45 C.F.R. 146.121.
3585 (b) The commissioner shall consider the following with regard to determining whether
3586 an association of employers is a bona fide employer association under Subsection (4)(a):
3587 (i) how association members are solicited;
3588 (ii) who participates in the association;
3589 (iii) the process by which the association was formed;
3590 (iv) the purposes for which the association was formed, and what, if any, were the
3591 pre-existing relationships of its members;
3592 (v) the powers, rights and privileges of employer members; and
3593 (vi) who actually controls and directs the activities and operations of the benefit
3594 programs.
3595 (5) "Carrier" means a person that provides health insurance in this state including:
3596 (a) an insurance company;
3597 (b) a prepaid hospital or medical care plan;
3598 (c) a health maintenance organization;
3599 (d) a multiple employer welfare arrangement; and
3600 (e) another person providing a health insurance plan under this title.
3601 (6) (a) Except as provided in Subsection (6)(b), "case characteristics" means
3602 demographic or other objective characteristics of a covered insured that are considered by the
3603 carrier in determining premium rates for the covered insured.
3604 (b) "Case characteristics" do not include:
3605 (i) duration of coverage since the policy was issued;
3606 (ii) claim experience; and
3607 (iii) health status.
3608 (7) "Class of business" means all or a separate grouping of covered insureds that is
3609 permitted by the commissioner in accordance with Section 31A-30-105.
3610 (8) "Covered carrier" means an individual carrier or small employer carrier subject to
3611 this chapter.
3612 (9) "Covered individual" means an individual who is covered under a health benefit
3613 plan subject to this chapter.
3614 (10) "Covered insureds" means small employers and individuals who are issued a
3615 health benefit plan that is subject to this chapter.
3616 (11) "Dependent" means an individual to the extent that the individual is defined to be
3617 a dependent by:
3618 (a) the health benefit plan covering the covered individual; and
3619 (b) Chapter 22, Part 6, Accident and Health Insurance.
3620 (12) "Established geographic service area" means a geographical area approved by the
3621 commissioner within which the carrier is authorized to provide coverage.
3622 (13) "Index rate" means, for each class of business as to a rating period for covered
3623 insureds with similar case characteristics, the arithmetic average of the applicable base
3624 premium rate and the corresponding highest premium rate.
3625 (14) "Individual carrier" means a carrier that provides coverage on an individual basis
3626 through a health benefit plan regardless of whether:
3627 (a) coverage is offered through:
3628 (i) an association;
3629 (ii) a trust;
3630 (iii) a discretionary group; or
3631 (iv) other similar groups; or
3632 (b) the policy or contract is situated out-of-state.
3633 (15) "Individual conversion policy" means a conversion policy issued to:
3634 (a) an individual; or
3635 (b) an individual with a family.
3636 (16) "New business premium rate" means, for each class of business as to a rating
3637 period, the lowest premium rate charged or offered, or that could have been charged or offered,
3638 by the carrier to covered insureds with similar case characteristics for newly issued health
3639 benefit plans with the same or similar coverage.
3640 (17) "Premium" means money paid by covered insureds and covered individuals as a
3641 condition of receiving coverage from a covered carrier, including fees or other contributions
3642 associated with the health benefit plan.
3643 (18) (a) "Rating period" means the calendar period for which premium rates
3644 established by a covered carrier are assumed to be in effect, as determined by the carrier.
3645 (b) A covered carrier may not have:
3646 (i) more than one rating period in any calendar month; and
3647 (ii) no more than 12 rating periods in any calendar year.
3648 (19) "Small employer carrier" means a carrier that provides health benefit plans
3649 covering eligible employees of one or more small employers in this state, regardless of
3650 whether:
3651 (a) coverage is offered through:
3652 (i) an association;
3653 (ii) a trust;
3654 (iii) a discretionary group; or
3655 (iv) other similar grouping; or
3656 (b) the policy or contract is situated out-of-state.
3657 Section 22. Section 31A-35-404 is amended to read:
3658 31A-35-404. Minimum financial requirements for bail bond agency license.
3659 (1) (a) A bail bond agency that pledges the assets of a letter of credit from a Utah
3660 depository institution in connection with a judicial proceeding shall maintain an irrevocable
3661 letter of credit with a minimum face value of $300,000 assigned to the state from a Utah
3662 depository institution.
3663 (b) Notwithstanding Subsection (1)(a), a bail bond agency described in Subsection
3664 (1)(a) that is licensed under this chapter on or before December 31, 1999, shall maintain an
3665 irrevocable letter of credit with a minimum face value of $250,000 assigned to the state from a
3666 Utah depository institution.
3667 (2) (a) A bail bond agency that pledges personal or real property, or both, as security
3668 for a bail bond in connection with a judicial proceeding shall maintain a verified financial
3669 statement for the [
3670 (i) reviewed by a certified public accountant; and
3671 (ii) showing a minimum net worth of:
3672 (A) $300,000, at least $100,000 of which is in liquid assets; or
3673 (B) if the bail bond agency is licensed under this chapter on or before December 31,
3674 1999, $250,000, at least $50,000 of which is in liquid assets.
3675 (b) For purposes of this Subsection (2), only real or personal property located in Utah
3676 may be included in the net worth of the bail bond agency.
3677 (3) A bail bond agency shall maintain a qualifying power of attorney issued by a surety
3678 insurer if:
3679 (a) the bail bond agency is the agent of the surety insurer; and
3680 (b) the surety insurer:
3681 (i) sells bail bonds;
3682 (ii) is in good standing in its state of domicile; and
3683 (iii) is granted a certificate to write bail bonds in Utah.
3684 (4) The commissioner may revoke the license of a bail bond agency that fails to
3685 maintain the minimum financial requirements required under this section.
3686 (5) The commissioner may set by rule the limits on the aggregate amounts of bail
3687 bonds issued by a bail bond agency.
3688 Section 23. Section 58-13-2.5 is amended to read:
3689 58-13-2.5. Standard of proof for emergency care when immunity does not apply.
3690 (1) A person who is a health care provider as defined in Section 78B-3-403 who
3691 provides emergency care in good faith, but is not immune from suit because of an expectation
3692 of payment, a legal duty to respond, or other reason under Section 58-13-2, may only be liable
3693 for civil damages if fault, as defined in Section 78B-5-817, is established by clear and
3694 convincing evidence.
3695 (2) For purposes of Subsection (1), "emergency care" means the treatment of an
3696 emergency medical condition, as defined in Section [
3697 that the person presents at the emergency department of a hospital and including any
3698 subsequent transfer to another hospital, until the condition has been stabilized and the patient is
3699 either discharged from the emergency department or admitted to another department of the
3700 hospital.
3701 (3) This section does not apply to emergency care provided by a physician if:
3702 (a) the physician has a previously established physician/patient relationship with the
3703 patient outside of the emergency room;
3704 (b) the patient has been seen in the last three months by the physician for the same
3705 condition for which emergency care is sought; and
3706 (c) the physician can access and consult the patient's relevant medical care records
3707 while the physician is making decisions about and providing the emergency care.
3708 (4) (a) Nothing in this section may be construed as:
3709 (i) altering the applicable standard of care for determining fault; or
3710 (ii) applying the standard of proof of clear and convincing evidence to care outside of
3711 emergency care and the mandatory legal duty to treat.
3712 (b) This section applies to emergency care given after June 1, 2009.
3713 (5) This section sunsets in accordance with Section 63I-1-258.
3714 Section 24. Section 63I-1-231 is amended to read:
3715 63I-1-231. Repeal dates, Title 31A.
3716 (1) Section 31A-2-217, Coordination with other states, is repealed July 1, 2023.
3717 (2) Subsections 31A-19a-209(2) and (3) are repealed July 1, 2027.
3718 [
3719 Section 25. Section 76-6-521 is amended to read:
3720 76-6-521. Fraudulent insurance act.
3721 (1) A person commits a fraudulent insurance act if that person with intent to deceive or
3722 defraud:
3723 (a) presents or causes to be presented any oral or written statement or representation
3724 knowing that the statement or representation contains false or fraudulent information
3725 concerning any fact material to an application for the issuance or renewal of an insurance
3726 policy, certificate, or contract, as part of or in support of:
3727 (i) obtaining an insurance policy the insurer would otherwise not issue on the basis of
3728 underwriting criteria applicable to the person;
3729 (ii) a scheme or artifice to avoid paying the premium that an insurer charges on the
3730 basis of underwriting criteria applicable to the person; or
3731 (iii) a scheme or artifice to file an insurance claim for a loss that has already occurred;
3732 (b) presents, or causes to be presented, any oral or written statement or representation:
3733 (i) (A) as part of or in support of a claim for payment or other benefit pursuant to an
3734 insurance policy, certificate, or contract; or
3735 (B) in connection with any civil claim asserted for recovery of damages for personal or
3736 bodily injuries or property damage; and
3737 (ii) knowing that the statement or representation contains false, incomplete, or
3738 fraudulent information concerning any fact or thing material to the claim;
3739 (c) knowingly accepts a benefit from proceeds derived from a fraudulent insurance act;
3740 (d) intentionally, knowingly, or recklessly devises a scheme or artifice to obtain fees
3741 for professional services, or anything of value by means of false or fraudulent pretenses,
3742 representations, promises, or material omissions;
3743 (e) knowingly employs, uses, or acts as a runner, as defined in Section 31A-31-102, for
3744 the purpose of committing a fraudulent insurance act;
3745 (f) knowingly assists, abets, solicits, or conspires with another to commit a fraudulent
3746 insurance act;
3747 (g) knowingly supplies false or fraudulent material information in any document or
3748 statement required by the Department of Insurance; or
3749 (h) knowingly fails to forward a premium to an insurer in violation of Section
3750 31A-23a-411.1.
3751 (2) (a) A violation of Subsection (1)(a) (i) is a class A misdemeanor.
3752 (b) A violation of Subsections (1)(a)(ii) or (1)(b) through (1) (h) is punishable as in the
3753 manner prescribed by Section 76-10-1801 for communication fraud for property of like value.
3754 (c) A violation of Subsection (1)(a)(iii):
3755 (i) is a class A misdemeanor if the value of the loss is less than $1,500 or unable to be
3756 determined; or
3757 (ii) if the value of the loss is $1,500 or more, is punishable as in the manner prescribed
3758 by Section 76-10-1801 for communication fraud for property of like value.
3759 (3) A corporation or association is guilty of the offense of insurance fraud under the
3760 same conditions as those set forth in Section 76-2-204.
3761 (4) The determination of the degree of any offense under Subsections (1)(a)(ii) and
3762 (1)(b) through (1)(h) shall be measured by the total value of all property, money, or other things
3763 obtained or sought to be obtained by the fraudulent insurance act or acts described in
3764 Subsections (1)(a)(ii) and (1)(b) through (1)(h).
3765 Section 26. Repealer.
3766 This bill repeals:
3767 Section 31A-17-519, Small company exemption.