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7 LONG TITLE
8 Committee Note:
9 The Business and Labor Interim Committee recommended this bill.
10 Legislative Vote: 10 voting for 0 voting against 11 absent
11 General Description:
12 This bill updates the Insurance Code.
13 Highlighted Provisions:
14 This bill:
15 ▸ defines terms;
16 ▸ exempts a health care sharing ministry from regulation under the Insurance Code,
17 provided the health care sharing ministry makes certain disclosures to participants
18 and the commissioner;
19 ▸ requires that the commissioner evaluate annually the state's health insurance market
20 and provide that evaluation to the Health and Human Services Interim Committee;
21 ▸ clarifies the scope of the consumer assistance that the commissioner provides;
22 ▸ updates the duties of the Office of Consumer Health Assistance;
23 ▸ modifies the commissioner's enforcement authority to allow the commissioner to
24 accept or compromise a forfeiture after the filing of a complaint;
25 ▸ removes the filing fee for a rate filing;
26 ▸ addresses the allowable amount of a rate or other charge used by a title insurer;
27 ▸ requires that motor vehicle liability coverage cover substitute transportation and
28 prohibits certain practices in providing the coverage;
29 ▸ describes the process for renewal, cancellation, and modification of a life insurance
30 policy;
31 ▸ requires that certain licensees and prospective licensees report to the commissioner
32 any civil action that is filed against the licensee or prospective licensee and involves
33 conduct related to a professional or occupational license;
34 ▸ institutes new capital and net worth requirements for title insurance producers;
35 ▸ removes the requirement that an individual title insurance producer file an annual
36 report with the commissioner;
37 ▸ allows a federal home loan bank to obtain collateral pledged by an insurer-member
38 when the member-insurer is in receivership;
39 ▸ increases the fee that the commissioner may assess certain admitted and
40 nonadmitted insurers;
41 ▸ authorizes an association captive insurance company to provide homeowners'
42 insurance, subject to commissioner approval; and
43 ▸ makes technical changes.
44 Money Appropriated in this Bill:
45 None
46 Other Special Clauses:
47 None
48 Utah Code Sections Affected:
49 AMENDS:
50 31A-1-103, as last amended by Laws of Utah 2021, Chapter 252
51 31A-1-301, as last amended by Laws of Utah 2023, Chapter 327
52 31A-2-201.2, as last amended by Laws of Utah 2019, Chapters 241, 439
53 31A-2-215, as last amended by Laws of Utah 2002, Chapter 308
54 31A-2-216, as last amended by Laws of Utah 2002, Chapter 308
55 31A-2-308, as last amended by Laws of Utah 2019, Chapter 193
56 31A-4-113.5, as last amended by Laws of Utah 2023, Chapter 194
57 31A-19a-203, as last amended by Laws of Utah 2004, Chapter 117
58 31A-19a-209, as last amended by Laws of Utah 2023, Chapter 194
59 31A-21-402, as last amended by Laws of Utah 2021, Chapter 252
60 31A-22-303, as last amended by Laws of Utah 2023, Chapter 415
61 31A-22-605, as last amended by Laws of Utah 2017, Chapter 168
62 31A-22-620, as last amended by Laws of Utah 2015, Chapter 244
63 31A-22-802, as last amended by Laws of Utah 2011, Chapter 366
64 31A-22-2002, as last amended by Laws of Utah 2021, Chapter 252
65 31A-23a-105, as last amended by Laws of Utah 2014, Chapters 290, 300
66 31A-23a-406, as last amended by Laws of Utah 2023, Chapter 194
67 31A-23a-413, as last amended by Laws of Utah 2015, Chapter 312
68 31A-28-113, as last amended by Laws of Utah 2018, Chapter 391
69 31A-31-108, as last amended by Laws of Utah 2013, Chapter 319
70 31A-35-202, as last amended by Laws of Utah 2016, Chapter 234
71 31A-35-406, as last amended by Laws of Utah 2021, Chapter 252
72 31A-37-202, as last amended by Laws of Utah 2023, Chapter 194
73 ENACTS:
74 31A-22-323, Utah Code Annotated 1953
75 31A-22-432, Utah Code Annotated 1953
76 31A-22-523, Utah Code Annotated 1953
77 31A-23a-119, Utah Code Annotated 1953
78 31A-27a-108.1, Utah Code Annotated 1953
79
80 Be it enacted by the Legislature of the state of Utah:
81 Section 1. Section 31A-1-103 is amended to read:
82 31A-1-103. Scope and applicability of title.
83 (1) This title does not apply to:
84 (a) a retainer contract made by an attorney-at-law:
85 (i) with an individual client; and
86 (ii) under which fees are based on estimates of the nature and amount of services to be
87 provided to the specific client;
88 (b) a contract similar to a contract described in Subsection (1)(a) made with a group of
89 clients involved in the same or closely related legal matters;
90 (c) an arrangement for providing benefits that do not exceed a limited amount of
91 consultations, advice on simple legal matters, either alone or in combination with referral
92 services, or the promise of fee discounts for handling other legal matters;
93 (d) limited legal assistance on an informal basis involving neither an express
94 contractual obligation nor reasonable expectations, in the context of an employment,
95 membership, educational, or similar relationship;
96 (e) legal assistance by employee organizations to their members in matters relating to
97 employment;
98 (f) death, accident, health, or disability benefits provided to a person by an organization
99 or its affiliate if:
100 (i) the organization is tax exempt under Section 501(c)(3) of the Internal Revenue
101 Code and has had its principal place of business in Utah for at least five years;
102 (ii) the person is not an employee of the organization; and
103 (iii) (A) substantially all the person's time in the organization is spent providing
104 voluntary services:
105 (I) in furtherance of the organization's purposes;
106 (II) for a designated period of time; and
107 (III) for which no compensation, other than expenses, is paid; or
108 (B) the time since the service under Subsection (1)(f)(iii)(A) was completed is no more
109 than 18 months; or
110 (g) a prepaid contract of limited duration that provides for scheduled maintenance only.
111 (2) (a) This title restricts otherwise legitimate business activity.
112 (b) What this title does not prohibit is permitted unless contrary to other provisions of
113 Utah law.
114 (3) Except as otherwise expressly provided, this title does not apply to:
115 (a) those activities of an insurer where state jurisdiction is preempted by Section 514 of
116 the federal Employee Retirement Income Security Act of 1974, as amended;
117 (b) ocean marine insurance;
118 (c) death, accident, health, or disability benefits provided by an organization [
119
120 (i) has as the organization's principal purpose to achieve charitable, educational, social,
121 or religious objectives rather than to provide death, accident, health, or disability benefits;
122 (ii) does not incur a legal obligation to pay a specified amount; [
123 (iii) does not create reasonable expectations of receiving a specified amount on the part
124 of an insured person; and
125 (iv) is not a health care sharing ministry.
126 (d) other business specified in rules adopted by the commissioner on a finding that:
127 (i) the transaction of the business in this state does not require regulation for the
128 protection of the interests of the residents of this state; or
129 (ii) it would be impracticable to require compliance with this title;
130 (e) except as provided in Subsection (4), a transaction independently procured through
131 negotiations under Section 31A-15-104;
132 (f) self-insurance;
133 (g) reinsurance;
134 (h) subject to Subsection (5), an employee or labor union group insurance policy
135 covering risks in this state or an employee or labor union blanket insurance policy covering
136 risks in this state, if:
137 (i) the policyholder exists primarily for purposes other than to procure insurance;
138 (ii) the policyholder:
139 (A) is not a resident of this state;
140 (B) is not a domestic corporation; or
141 (C) does not have the policyholder's principal office in this state;
142 (iii) no more than 25% of the certificate holders or insureds are residents of this state;
143 (iv) on request of the commissioner, the insurer files with the department a copy of the
144 policy and a copy of each form or certificate; and
145 (v) (A) the insurer agrees to pay premium taxes on the Utah portion of the insurer's
146 business, as if the insurer were authorized to do business in this state; and
147 (B) the insurer provides the commissioner with the security the commissioner
148 considers necessary for the payment of premium taxes under Title 59, Chapter 9, Taxation of
149 Admitted Insurers;
150 (i) to the extent provided in Subsection (6):
151 (i) a manufacturer's or seller's warranty; and
152 (ii) a manufacturer's or seller's service contract;
153 (j) except to the extent provided in Subsection (7), a public agency insurance mutual;
154 [
155 (k) except as provided in Chapter 6b, Guaranteed Asset Protection Waiver Act, a
156 guaranteed asset protection waiver[
157 (l) a health care sharing ministry, if the health care sharing ministry:
158 (i) provides to each participant upon enrollment and annually thereafter a written
159 statement of nationwide and Utah-specific data from the preceding calendar year that lists the
160 total dollar amount of:
161 (A) expenses submitted for sharing;
162 (B) expenses qualified for sharing;
163 (C) qualified expenses published or assigned to participants for sharing;
164 (D) contributions provided to participants toward qualified expenses; and
165 (E) denied expenses; and
166 (ii) includes a written disclaimer, titled "Notice", on or with each application and all
167 guideline materials that states:
168 (A) the health care sharing ministry is not an insurance company;
169 (B) nothing the health care sharing ministry offers or provides is an insurance policy,
170 including the health care sharing ministry's guidelines or plan of operations;
171 (C) participation in the health care sharing ministry is entirely voluntary and no
172 participant is compelled by law to contribute to another participant's expenses;
173 (D) participation in the health care sharing ministry or subscription to any of the health
174 care sharing ministry's services is not insurance; and
175 (E) each participant is always personally responsible for the participant's expenses
176 regardless of whether the participant receives payment for the expenses through the health care
177 sharing ministry or whether this health care sharing ministry continues to operate; and
178 (iii) submits to the commissioner no later than April 1 of each year:
179 (A) the information in Subsection (l)(i);
180 (B) nationwide and Utah-specific enrollment data from the prior calendar year; and
181 (C) the health care sharing ministry's contact information for consumers, providers, and
182 the commissioner.
183 (4) A transaction described in Subsection (3)(e) is subject to taxation under Section
184 31A-3-301.
185 (5) (a) After a hearing, the commissioner may order an insurer of certain group
186 insurance policies or blanket insurance policies to transfer the Utah portion of the business
187 otherwise exempted under Subsection (3)(h) to an authorized insurer if the contracts have been
188 written by an unauthorized insurer.
189 (b) If the commissioner finds that the conditions required for the exemption of a group
190 or blanket insurer are not satisfied or that adequate protection to residents of this state is not
191 provided, the commissioner may require:
192 (i) the insurer to be authorized to do business in this state; or
193 (ii) that any of the insurer's transactions be subject to this title.
194 (c) Subsection (3)(h) does not apply to a blanket insurance policy offering accident and
195 health insurance.
196 (6) (a) As used in Subsection (3)(i) and this Subsection (6):
197 (i) "manufacturer's or seller's service contract" means a service contract:
198 (A) made available by:
199 (I) a manufacturer of a product;
200 (II) a seller of a product; or
201 (III) an affiliate of a manufacturer or seller of a product;
202 (B) made available:
203 (I) on one or more specific products; or
204 (II) on products that are components of a system; and
205 (C) under which the person described in Subsection (6)(a)(i)(A) is liable for services to
206 be provided under the service contract including, if the manufacturer's or seller's service
207 contract designates, providing parts and labor;
208 (ii) "manufacturer's or seller's warranty" means the guaranty of:
209 (A) (I) the manufacturer of a product;
210 (II) a seller of a product; or
211 (III) an affiliate of a manufacturer or seller of a product;
212 (B) (I) on one or more specific products; or
213 (II) on products that are components of a system; and
214 (C) under which the person described in Subsection (6)(a)(ii)(A) is liable for services
215 to be provided under the warranty, including, if the manufacturer's or seller's warranty
216 designates, providing parts and labor; and
217 (iii) "service contract" means the same as that term is defined in Section 31A-6a-101.
218 (b) A manufacturer's or seller's warranty may be designated as:
219 (i) a warranty;
220 (ii) a guaranty; or
221 (iii) a term similar to a term described in Subsection (6)(b)(i) or (ii).
222 (c) This title does not apply to:
223 (i) a manufacturer's or seller's warranty;
224 (ii) a manufacturer's or seller's service contract paid for with consideration that is in
225 addition to the consideration paid for the product itself; and
226 (iii) a service contract that is not a manufacturer's or seller's warranty or manufacturer's
227 or seller's service contract if:
228 (A) the service contract is paid for with consideration that is in addition to the
229 consideration paid for the product itself;
230 (B) the service contract is for the repair or maintenance of goods;
231 (C) the purchase price of the product is $3,700 or less;
232 (D) the product is not a motor vehicle; and
233 (E) the product is not the subject of a home warranty service contract.
234 (d) This title does not apply to a manufacturer's or seller's warranty or service contract
235 paid for with consideration that is in addition to the consideration paid for the product itself
236 regardless of whether the manufacturer's or seller's warranty or service contract is sold:
237 (i) at the time of the purchase of the product; or
238 (ii) at a time other than the time of the purchase of the product.
239 (7) (a) For purposes of this Subsection (7), "public agency insurance mutual" means an
240 entity formed by two or more political subdivisions or public agencies of the state:
241 (i) under Title 11, Chapter 13, Interlocal Cooperation Act; and
242 (ii) for the purpose of providing for the political subdivisions or public agencies:
243 (A) subject to Subsection (7)(b), insurance coverage; or
244 (B) risk management.
245 (b) Notwithstanding Subsection (7)(a)(ii)(A), a public agency insurance mutual may
246 not provide health insurance unless the public agency insurance mutual provides the health
247 insurance using:
248 (i) a third party administrator licensed under Chapter 25, Third Party Administrators;
249 (ii) an admitted insurer; or
250 (iii) a program authorized by Title 49, Chapter 20, Public Employees' Benefit and
251 Insurance Program Act.
252 (c) Except for this Subsection (7), a public agency insurance mutual is exempt from
253 this title.
254 (d) A public agency insurance mutual is considered to be a governmental entity and
255 political subdivision of the state with all of the rights, privileges, and immunities of a
256 governmental entity or political subdivision of the state including all the rights and benefits of
257 Title 63G, Chapter 7, Governmental Immunity Act of Utah.
258 Section 2. Section 31A-1-301 is amended to read:
259 31A-1-301. Definitions.
260 As used in this title, unless otherwise specified:
261 (1) (a) "Accident and health insurance" means insurance to provide protection against
262 economic losses resulting from:
263 (i) a medical condition including:
264 (A) a medical care expense; or
265 (B) the risk of disability;
266 (ii) accident; or
267 (iii) sickness.
268 (b) "Accident and health insurance":
269 (i) includes a contract with disability contingencies including:
270 (A) an income replacement contract;
271 (B) a health care contract;
272 (C) a fixed indemnity contract;
273 (D) a credit accident and health contract;
274 (E) a continuing care contract; and
275 (F) a long-term care contract; and
276 (ii) may provide:
277 (A) hospital coverage;
278 (B) surgical coverage;
279 (C) medical coverage;
280 (D) loss of income coverage;
281 (E) prescription drug coverage;
282 (F) dental coverage; or
283 (G) vision coverage.
284 (c) "Accident and health insurance" does not include workers' compensation insurance.
285 (d) For purposes of a national licensing registry, "accident and health insurance" is the
286 same as "accident and health or sickness insurance."
287 (2) "Actuary" is as defined by the commissioner by rule, made in accordance with Title
288 63G, Chapter 3, Utah Administrative Rulemaking Act.
289 (3) "Administrator" means the same as that term is defined in Subsection [
290 (187).
291 (4) "Adult" means an individual who is 18 years old or older.
292 (5) "Affiliate" means a person who controls, is controlled by, or is under common
293 control with, another person. A corporation is an affiliate of another corporation, regardless of
294 ownership, if substantially the same group of individuals manage the corporations.
295 (6) "Agency" means:
296 (a) a person other than an individual, including a sole proprietorship by which an
297 individual does business under an assumed name; and
298 (b) an insurance organization licensed or required to be licensed under Section
299 31A-23a-301, 31A-25-207, or 31A-26-209.
300 (7) "Alien insurer" means an insurer domiciled outside the United States.
301 (8) "Amendment" means an endorsement to an insurance policy or certificate.
302 (9) "Annuity" means an agreement to make periodical payments for a period certain or
303 over the lifetime of one or more individuals if the making or continuance of all or some of the
304 series of the payments, or the amount of the payment, is dependent upon the continuance of
305 human life.
306 (10) "Application" means a document:
307 (a) (i) completed by an applicant to provide information about the risk to be insured;
308 and
309 (ii) that contains information that is used by the insurer to evaluate risk and decide
310 whether to:
311 (A) insure the risk under:
312 (I) the coverage as originally offered; or
313 (II) a modification of the coverage as originally offered; or
314 (B) decline to insure the risk; or
315 (b) used by the insurer to gather information from the applicant before issuance of an
316 annuity contract.
317 (11) "Articles" or "articles of incorporation" means:
318 (a) the original articles;
319 (b) a special law;
320 (c) a charter;
321 (d) an amendment;
322 (e) restated articles;
323 (f) articles of merger or consolidation;
324 (g) a trust instrument;
325 (h) another constitutive document for a trust or other entity that is not a corporation;
326 and
327 (i) an amendment to an item listed in Subsections (11)(a) through (h).
328 (12) "Bail bond insurance" means a guarantee that a person will attend court when
329 required, up to and including surrender of the person in execution of a sentence imposed under
330 Subsection 77-20-501(1), as a condition to the release of that person from confinement.
331 (13) "Binder" means the same as that term is defined in Section 31A-21-102.
332 (14) "Blanket insurance policy" or "blanket contract" means a group insurance policy
333 covering a defined class of persons:
334 (a) without individual underwriting or application; and
335 (b) that is determined by definition without designating each person covered.
336 (15) "Board," "board of trustees," or "board of directors" means the group of persons
337 with responsibility over, or management of, a corporation, however designated.
338 (16) "Bona fide office" means a physical office in this state:
339 (a) that is open to the public;
340 (b) that is staffed during regular business hours on regular business days; and
341 (c) at which the public may appear in person to obtain services.
342 (17) "Business entity" means:
343 (a) a corporation;
344 (b) an association;
345 (c) a partnership;
346 (d) a limited liability company;
347 (e) a limited liability partnership; or
348 (f) another legal entity.
349 (18) "Business of insurance" means the same as that term is defined in Subsection
350 [
351 (19) "Business plan" means the information required to be supplied to the
352 commissioner under Subsections 31A-5-204(2)(i) and (j), including the information required
353 when these subsections apply by reference under:
354 (a) Section 31A-8-205; or
355 (b) Subsection 31A-9-205(2).
356 (20) (a) "Bylaws" means the rules adopted for the regulation or management of a
357 corporation's affairs, however designated.
358 (b) "Bylaws" includes comparable rules for a trust or other entity that is not a
359 corporation.
360 (21) "Captive insurance company" means:
361 (a) an insurer:
362 (i) owned by a parent organization; and
363 (ii) whose purpose is to insure risks of the parent organization and other risks as
364 authorized under:
365 (A) Chapter 37, Captive Insurance Companies Act; and
366 (B) Chapter 37a, Special Purpose Financial Captive Insurance Company Act; or
367 (b) in the case of a group or association, an insurer:
368 (i) owned by the insureds; and
369 (ii) whose purpose is to insure risks of:
370 (A) a member organization;
371 (B) a group member; or
372 (C) an affiliate of:
373 (I) a member organization; or
374 (II) a group member.
375 (22) "Casualty insurance" means liability insurance.
376 (23) "Certificate" means evidence of insurance given to:
377 (a) an insured under a group insurance policy; or
378 (b) a third party.
379 (24) "Certificate of authority" is included within the term "license."
380 (25) "Claim," unless the context otherwise requires, means a request or demand on an
381 insurer for payment of a benefit according to the terms of an insurance policy.
382 (26) "Claims-made coverage" means an insurance contract or provision limiting
383 coverage under a policy insuring against legal liability to claims that are first made against the
384 insured while the policy is in force.
385 (27) (a) "Commissioner" or "commissioner of insurance" means Utah's insurance
386 commissioner.
387 (b) When appropriate, the terms listed in Subsection (27)(a) apply to the equivalent
388 supervisory official of another jurisdiction.
389 (28) (a) "Continuing care insurance" means insurance that:
390 (i) provides board and lodging;
391 (ii) provides one or more of the following:
392 (A) a personal service;
393 (B) a nursing service;
394 (C) a medical service; or
395 (D) any other health-related service; and
396 (iii) provides the coverage described in this Subsection (28)(a) under an agreement
397 effective:
398 (A) for the life of the insured; or
399 (B) for a period in excess of one year.
400 (b) Insurance is continuing care insurance regardless of whether or not the board and
401 lodging are provided at the same location as a service described in Subsection (28)(a)(ii).
402 (29) (a) "Control," "controlling," "controlled," or "under common control" means the
403 direct or indirect possession of the power to direct or cause the direction of the management
404 and policies of a person. This control may be:
405 (i) by contract;
406 (ii) by common management;
407 (iii) through the ownership of voting securities; or
408 (iv) by a means other than those described in Subsections (29)(a)(i) through (iii).
409 (b) There is no presumption that an individual holding an official position with another
410 person controls that person solely by reason of the position.
411 (c) A person having a contract or arrangement giving control is considered to have
412 control despite the illegality or invalidity of the contract or arrangement.
413 (d) There is a rebuttable presumption of control in a person who directly or indirectly
414 owns, controls, holds with the power to vote, or holds proxies to vote 10% or more of the
415 voting securities of another person.
416 (30) "Controlled insurer" means a licensed insurer that is either directly or indirectly
417 controlled by a producer.
418 (31) "Controlling person" means a person that directly or indirectly has the power to
419 direct or cause to be directed, the management, control, or activities of a reinsurance
420 intermediary.
421 (32) "Controlling producer" means a producer who directly or indirectly controls an
422 insurer.
423 (33) "Corporate governance annual disclosure" means a report an insurer or insurance
424 group files in accordance with the requirements of Chapter 16b, Corporate Governance Annual
425 Disclosure Act.
426 (34) (a) "Corporation" means an insurance corporation, except when referring to:
427 (i) a corporation doing business:
428 (A) as:
429 (I) an insurance producer;
430 (II) a surplus lines producer;
431 (III) a limited line producer;
432 (IV) a consultant;
433 (V) a managing general agent;
434 (VI) a reinsurance intermediary;
435 (VII) a third party administrator; or
436 (VIII) an adjuster; and
437 (B) under:
438 (I) Chapter 23a, Insurance Marketing - Licensing Producers, Consultants, and
439 Reinsurance Intermediaries;
440 (II) Chapter 25, Third Party Administrators; or
441 (III) Chapter 26, Insurance Adjusters; or
442 (ii) a noninsurer that is part of a holding company system under Chapter 16, Insurance
443 Holding Companies.
444 (b) "Mutual" or "mutual corporation" means a mutual insurance corporation.
445 (c) "Stock corporation" means a stock insurance corporation.
446 (35) (a) "Creditable coverage" has the same meaning as provided in federal regulations
447 adopted pursuant to the Health Insurance Portability and Accountability Act.
448 (b) "Creditable coverage" includes coverage that is offered through a public health plan
449 such as:
450 (i) the Primary Care Network Program under a Medicaid primary care network
451 demonstration waiver obtained subject to Section 26B-3-108;
452 (ii) the Children's Health Insurance Program under Section 26B-3-904; or
453 (iii) the Ryan White Program Comprehensive AIDS Resources Emergency Act, Pub. L.
454 No. 101-381, and Ryan White HIV/AIDS Treatment Modernization Act of 2006, Pub. L. No.
455 109-415.
456 (36) "Credit accident and health insurance" means insurance on a debtor to provide
457 indemnity for payments coming due on a specific loan or other credit transaction while the
458 debtor has a disability.
459 (37) (a) "Credit insurance" means insurance offered in connection with an extension of
460 credit that is limited to partially or wholly extinguishing that credit obligation.
461 (b) "Credit insurance" includes:
462 (i) credit accident and health insurance;
463 (ii) credit life insurance;
464 (iii) credit property insurance;
465 (iv) credit unemployment insurance;
466 (v) guaranteed automobile protection insurance;
467 (vi) involuntary unemployment insurance;
468 (vii) mortgage accident and health insurance;
469 (viii) mortgage guaranty insurance; and
470 (ix) mortgage life insurance.
471 (38) "Credit life insurance" means insurance on the life of a debtor in connection with
472 an extension of credit that pays a person if the debtor dies.
473 (39) "Creditor" means a person, including an insured, having a claim, whether:
474 (a) matured;
475 (b) unmatured;
476 (c) liquidated;
477 (d) unliquidated;
478 (e) secured;
479 (f) unsecured;
480 (g) absolute;
481 (h) fixed; or
482 (i) contingent.
483 (40) "Credit property insurance" means insurance:
484 (a) offered in connection with an extension of credit; and
485 (b) that protects the property until the debt is paid.
486 (41) "Credit unemployment insurance" means insurance:
487 (a) offered in connection with an extension of credit; and
488 (b) that provides indemnity if the debtor is unemployed for payments coming due on a:
489 (i) specific loan; or
490 (ii) credit transaction.
491 (42) (a) "Crop insurance" means insurance providing protection against damage to
492 crops from unfavorable weather conditions, fire or lightning, flood, hail, insect infestation,
493 disease, or other yield-reducing conditions or perils that is:
494 (i) provided by the private insurance market; or
495 (ii) subsidized by the Federal Crop Insurance Corporation.
496 (b) "Crop insurance" includes multiperil crop insurance.
497 (43) (a) "Customer service representative" means a person that provides an insurance
498 service and insurance product information:
499 (i) for the customer service representative's:
500 (A) producer;
501 (B) surplus lines producer; or
502 (C) consultant employer; and
503 (ii) to the customer service representative's employer's:
504 (A) customer;
505 (B) client; or
506 (C) organization.
507 (b) A customer service representative may only operate within the scope of authority of
508 the customer service representative's producer, surplus lines producer, or consultant employer.
509 (44) "Deadline" means a final date or time:
510 (a) imposed by:
511 (i) statute;
512 (ii) rule; or
513 (iii) order; and
514 (b) by which a required filing or payment must be received by the department.
515 (45) "Deemer clause" means a provision under this title under which upon the
516 occurrence of a condition precedent, the commissioner is considered to have taken a specific
517 action. If the statute so provides, a condition precedent may be the commissioner's failure to
518 take a specific action.
519 (46) "Degree of relationship" means the number of steps between two persons
520 determined by counting the generations separating one person from a common ancestor and
521 then counting the generations to the other person.
522 (47) "Department" means the Insurance Department.
523 (48) (a) "Direct response solicitation" means an offer for life or accident and health
524 insurance coverage that allows the individual to apply for or enroll in the insurance coverage
525 on the basis of the offer.
526 (b) "Direct response solicitation" does not include an offer for:
527 (i) insurance through an employee benefit plan that is exempt from state regulation
528 under federal law; or
529 (ii) credit life insurance or credit accident and health insurance through a individual's
530 creditor.
531 (49) "Direct response insurance policy" means an insurance policy solicited and sold
532 without the policyholder having direct contact with a natural person intermediary.
533 [
534 [
535 or totally limits an individual's ability to:
536 (a) perform the duties of:
537 (i) that individual's occupation; or
538 (ii) an occupation for which the individual is reasonably suited by education, training,
539 or experience; or
540 (b) perform two or more of the following basic activities of daily living:
541 (i) eating;
542 (ii) toileting;
543 (iii) transferring;
544 (iv) bathing; or
545 (v) dressing.
546 [
547 Subsection [
548 [
549 [
550 (a) is incorporated;
551 (b) is organized; or
552 (c) in the case of an alien insurer, enters into the United States.
553 [
554 (i) an employee who:
555 (A) works on a full-time basis; and
556 (B) has a normal work week of 30 or more hours; or
557 (ii) a person described in Subsection [
558 (b) "Eligible employee" includes:
559 (i) an owner, sole proprietor, or partner who:
560 (A) works on a full-time basis;
561 (B) has a normal work week of 30 or more hours; and
562 (C) employs at least one common employee; and
563 (ii) an independent contractor if the individual is included under a health benefit plan
564 of a small employer.
565 (c) "Eligible employee" does not include, unless eligible under Subsection [
566 (55)(b):
567 (i) an individual who works on a temporary or substitute basis for a small employer;
568 (ii) an employer's spouse who does not meet the requirements of Subsection
569 [
570 (iii) a dependent of an employer who does not meet the requirements of Subsection
571 [
572 [
573 (a) manifests itself by acute symptoms, including severe pain; and
574 (b) would cause a prudent layperson possessing an average knowledge of medicine and
575 health to reasonably expect the absence of immediate medical attention through a hospital
576 emergency department to result in:
577 (i) placing the layperson's health or the layperson's unborn child's health in serious
578 jeopardy;
579 (ii) serious impairment to bodily functions; or
580 (iii) serious dysfunction of any bodily organ or part.
581 [
582 (a) an individual employed by an employer; or
583 (b) an individual who meets the requirements of Subsection [
584 [
585 (a) an employee; or
586 (b) a dependent of an employee.
587 [
588 (i) established or maintained, whether directly or through a trustee, by:
589 (A) one or more employers;
590 (B) one or more labor organizations; or
591 (C) a combination of employers and labor organizations; and
592 (ii) that provides employee benefits paid or contracted to be paid, other than income
593 from investments of the fund:
594 (A) by or on behalf of an employer doing business in this state; or
595 (B) for the benefit of a person employed in this state.
596 (b) "Employee welfare fund" includes a plan funded or subsidized by a user fee or tax
597 revenues.
598 [
599 to modify the policy or certificate coverage.
600 [
601 (i) a policyholder;
602 (ii) a certificate holder;
603 (iii) a subscriber; or
604 (iv) a covered individual:
605 (A) who has entered into a contract with an organization for health care; or
606 (B) on whose behalf an arrangement for health care has been made.
607 (b) "Enrollee" includes an insured.
608 [
609 (a) the first day of coverage; or
610 (b) if there is a waiting period, the first day of the waiting period.
611 [
612 involving one or more affiliates of an insurer that, if not remedied promptly, is likely to have a
613 material adverse effect upon the financial condition or liquidity of the insurer or its insurance
614 holding company system as a whole, including anything that would cause:
615 (a) the insurer's risk-based capital to fall into an action or control level as set forth in
616 Sections 31A-17-601 through 31A-17-613; or
617 (b) the insurer to be in hazardous financial condition set forth in Section 31A-27a-101.
618 [
619 (i) a transaction that effects the sale, transfer, encumbering, or leasing of real property,
620 when a person not a party to the transaction, and neither having nor acquiring an interest in the
621 title, performs, in accordance with the written instructions or terms of the written agreement
622 between the parties to the transaction, any of the following actions:
623 (A) the explanation, holding, or creation of a document; or
624 (B) the receipt, deposit, and disbursement of money; or
625 (ii) a settlement or closing involving:
626 (A) a mobile home;
627 (B) a grazing right;
628 (C) a water right; or
629 (D) other personal property authorized by the commissioner.
630 (b) "Escrow" does not include:
631 (i) the following notarial acts performed by a notary within the state:
632 (A) an acknowledgment;
633 (B) a copy certification;
634 (C) jurat; and
635 (D) an oath or affirmation;
636 (ii) the receipt or delivery of a document; or
637 (iii) the receipt of money for delivery to the escrow agent.
638 [
639 requirements of Sections 31A-4-107, 31A-14-211, and 31A-23a-204, who is acting through an
640 individual title insurance producer licensed with an escrow subline of authority.
641 [
642 also excluded.
643 (b) The items listed in a list using the term "excludes" are representative examples for
644 use in interpretation of this title.
645 [
646 insurer does not provide insurance coverage, for whatever reason, for one of the following:
647 (a) a specific physical condition;
648 (b) a specific medical procedure;
649 (c) a specific disease or disorder; or
650 (d) a specific prescription drug or class of prescription drugs.
651 [
652 holding a position of public or private trust.
653 [
654 (i) submitted to the department as required by and in accordance with applicable
655 statute, rule, or filing order;
656 (ii) received by the department within the time period provided in applicable statute,
657 rule, or filing order; and
658 (iii) accompanied by the appropriate fee in accordance with:
659 (A) Section 31A-3-103; or
660 (B) rule.
661 (b) "Filed" does not include a filing that is rejected by the department because it is not
662 submitted in accordance with Subsection [
663 [
664 department including:
665 (a) a policy;
666 (b) a rate;
667 (c) a form;
668 (d) a document;
669 (e) a plan;
670 (f) a manual;
671 (g) an application;
672 (h) a report;
673 (i) a certificate;
674 (j) an endorsement;
675 (k) an actuarial certification;
676 (l) a licensee annual statement;
677 (m) a licensee renewal application;
678 (n) an advertisement;
679 (o) a binder; or
680 (p) an outline of coverage.
681 [
682 insurer agrees to pay a claim submitted to it by the insured for the insured's losses.
683 [
684 written to provide a fixed amount for a specified event relating to or resulting from an illness or
685 injury.
686 (b) "Fixed indemnity insurance" includes hospital confinement indemnity insurance.
687 [
688 an alien insurer.
689 [
690 (i) a policy;
691 (ii) a certificate;
692 (iii) an application;
693 (iv) an outline of coverage; or
694 (v) an endorsement.
695 (b) "Form" does not include a document specially prepared for use in an individual
696 case.
697 [
698 through a mass marketing arrangement involving a defined class of persons related in some
699 way other than through the purchase of insurance.
700 [
701 (a) the general lines of insurance in Subsection [
702 (b) title insurance under one of the following sublines of authority:
703 (i) title examination, including authority to act as a title marketing representative;
704 (ii) escrow, including authority to act as a title marketing representative; and
705 (iii) title marketing representative only;
706 (c) surplus lines;
707 (d) workers' compensation; and
708 (e) another line of insurance that the commissioner considers necessary to recognize in
709 the public interest.
710 [
711 (a) accident and health;
712 (b) casualty;
713 (c) life;
714 (d) personal lines;
715 (e) property; and
716 (f) variable contracts, including variable life and annuity.
717 [
718 that the plan provides medical care:
719 (a) (i) to an employee; or
720 (ii) to a dependent of an employee; and
721 (b) (i) directly;
722 (ii) through insurance reimbursement; or
723 (iii) through another method.
724 [
725 that is issued:
726 (i) to a policyholder on behalf of the group; and
727 (ii) for the benefit of a member of the group who is selected under a procedure defined
728 in:
729 (A) the policy; or
730 (B) an agreement that is collateral to the policy.
731 (b) A group insurance policy may include a member of the policyholder's family or a
732 dependent.
733 [
734 official designated as the group-wide supervisor for an internationally active insurance group
735 under Section 31A-16-108.6.
736 [
737 connection with an extension of credit that pays the difference in amount between the
738 insurance settlement and the balance of the loan if the insured automobile is a total loss.
739 [
740 offered or issued by an insurer to provide, deliver, arrange for, pay for, or reimburse any of the
741 costs of health care, including major medical expense coverage.
742 (b) "Health benefit plan" does not include:
743 (i) coverage only for accident or disability income insurance, or any combination
744 thereof;
745 (ii) coverage issued as a supplement to liability insurance;
746 (iii) liability insurance, including general liability insurance and automobile liability
747 insurance;
748 (iv) workers' compensation or similar insurance;
749 (v) automobile medical payment insurance;
750 (vi) credit-only insurance;
751 (vii) coverage for on-site medical clinics;
752 (viii) other similar insurance coverage, specified in federal regulations issued pursuant
753 to Pub. L. No. 104-191, under which benefits for health care services are secondary or
754 incidental to other insurance benefits;
755 (ix) the following benefits if they are provided under a separate policy, certificate, or
756 contract of insurance or are otherwise not an integral part of the plan:
757 (A) limited scope dental or vision benefits;
758 (B) benefits for long-term care, nursing home care, home health care,
759 community-based care, or any combination thereof; or
760 (C) other similar limited benefits, specified in federal regulations issued pursuant to
761 Pub. L. No. 104-191;
762 (x) the following benefits if the benefits are provided under a separate policy,
763 certificate, or contract of insurance, there is no coordination between the provision of benefits
764 and any exclusion of benefits under any health plan, and the benefits are paid with respect to an
765 event without regard to whether benefits are provided under any health plan:
766 (A) coverage only for specified disease or illness; or
767 (B) fixed indemnity insurance;
768 (xi) the following if offered as a separate policy, certificate, or contract of insurance:
769 (A) Medicare [
770
771 (B) coverage supplemental to the coverage provided under United States Code,
772 Title 10, Chapter 55, Civilian Health and Medical Program of the Uniformed Services
773 (CHAMPUS); or
774 (C) similar supplemental coverage provided to coverage under a group health insurance
775 plan;
776 (xii) short-term limited duration health insurance; and
777 (xiii) student health insurance, except as required under 45 C.F.R. Sec. 147.145.
778 [
779 treatment, mitigation, or prevention of a human ailment or impairment:
780 (a) a professional service;
781 (b) a personal service;
782 (c) a facility;
783 (d) equipment;
784 (e) a device;
785 (f) supplies; or
786 (g) medicine.
787 [
788 providing:
789 (i) a health care benefit; or
790 (ii) payment of an incurred health care expense.
791 (b) "Health care insurance" or "health insurance" does not include accident and health
792 insurance providing a benefit for:
793 (i) replacement of income;
794 (ii) short-term accident;
795 (iii) fixed indemnity;
796 (iv) credit accident and health;
797 (v) supplements to liability;
798 (vi) workers' compensation;
799 (vii) automobile medical payment;
800 (viii) no-fault automobile;
801 (ix) equivalent self-insurance; or
802 (x) a type of accident and health insurance coverage that is a part of or attached to
803 another type of policy.
804 [
805 78B-3-403.
806 (86) "Health care sharing ministry" means an entity that:
807 (a) is a tax-exempt nonprofit entity under the Internal Revenue Code;
808 (b) limits participants to those who are of a similar faith;
809 (c) facilitates the sharing of a participant's qualified expenses, as defined by the entity,
810 among other participants by:
811 (i) matching a participant who has qualified expenses with one or more participants
812 who are able to contribute to paying for the qualified expenses; and
813 (ii) arranging, directly or indirectly, for each contributing participant's contribution to
814 be used to pay for the qualified expenses;
815 (d) provides that a participant make a contribution to pay another participant's qualified
816 expenses with no assumption of risk or promise to pay;
817 (e) requires an individual to make one or more minimum payments or contributions as
818 a condition of one or more of the following:
819 (i) becoming a participant;
820 (ii) remaining a participant; or
821 (iii) receiving a contribution to pay qualified expenses; and
822 (f) in carrying out the functions described in this Subsection (86), makes no
823 assumption of risk or promise to pay any qualified expenses.
824 [
825 Sec. 155.20.
826 [
827 Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191, 110 Stat. 1936, as
828 amended.
829 [
830 insurance written to provide payments to replace income lost from accident or sickness.
831 [
832 insured loss.
833 [
834 under Section 31A-26-201 who engages in insurance adjusting as a representative of an insurer.
835 [
836 Section 31A-15-104.
837 [
838 [
839 (a) property in transit on or over land;
840 (b) property in transit over water by means other than boat or ship;
841 (c) bailee liability;
842 (d) fixed transportation property such as bridges, electric transmission systems, radio
843 and television transmission towers and tunnels; and
844 (e) personal and commercial property floaters.
845 [
846 (a) an insurer is unable to pay the insurer's obligations as the obligations are due;
847 (b) an insurer's total adjusted capital is less than the insurer's mandatory control level
848 RBC under Subsection 31A-17-601(8)(c); or
849 (c) an insurer's admitted assets are less than the insurer's liabilities.
850 [
851 (i) an arrangement, contract, or plan for the transfer of a risk or risks from one or more
852 persons to one or more other persons; or
853 (ii) an arrangement, contract, or plan for the distribution of a risk or risks among a
854 group of persons that includes the person seeking to distribute that person's risk.
855 (b) "Insurance" includes:
856 (i) a risk distributing arrangement providing for compensation or replacement for
857 damages or loss through the provision of a service or a benefit in kind;
858 (ii) a contract of guaranty or suretyship entered into by the guarantor or surety as a
859 business and not as merely incidental to a business transaction; and
860 (iii) a plan in which the risk does not rest upon the person who makes an arrangement,
861 but with a class of persons who have agreed to share the risk.
862 [
863 investigation, negotiation, or settlement of a claim under an insurance policy other than life
864 insurance or an annuity, on behalf of an insurer, policyholder, or a claimant under an insurance
865 policy.
866 [
867 (a) providing health care insurance by an organization that is or is required to be
868 licensed under this title;
869 (b) providing a benefit to an employee in the event of a contingency not within the
870 control of the employee, in which the employee is entitled to the benefit as a right, which
871 benefit may be provided either:
872 (i) by a single employer or by multiple employer groups; or
873 (ii) through one or more trusts, associations, or other entities;
874 (c) providing an annuity:
875 (i) including an annuity issued in return for a gift; and
876 (ii) except an annuity provided by a person specified in Subsections 31A-22-1305(2)
877 and (3);
878 (d) providing the characteristic services of a motor club;
879 (e) providing another person with insurance;
880 (f) making as insurer, guarantor, or surety, or proposing to make as insurer, guarantor,
881 or surety, a contract or policy offering title insurance;
882 (g) transacting or proposing to transact any phase of title insurance, including:
883 (i) solicitation;
884 (ii) negotiation preliminary to execution;
885 (iii) execution of a contract of title insurance;
886 (iv) insuring; and
887 (v) transacting matters subsequent to the execution of the contract and arising out of
888 the contract, including reinsurance;
889 (h) transacting or proposing a life settlement; and
890 (i) doing, or proposing to do, any business in substance equivalent to Subsections
891 [
892 [
893 (a) advises another person about insurance needs and coverages;
894 (b) is compensated by the person advised on a basis not directly related to the insurance
895 placed; and
896 (c) except as provided in Section 31A-23a-501, is not compensated directly or
897 indirectly by an insurer or producer for advice given.
898 [
899 company system.
900 [
901 affiliated persons, at least one of whom is an insurer.
902 [
903 required to be licensed under the laws of this state to sell, solicit, or negotiate insurance.
904 (b) (i) "Producer for the insurer" means a producer who is compensated directly or
905 indirectly by an insurer for selling, soliciting, or negotiating an insurance product of that
906 insurer.
907 (ii) "Producer for the insurer" may be referred to as an "agent."
908 (c) (i) "Producer for the insured" means a producer who:
909 (A) is compensated directly and only by an insurance customer or an insured; and
910 (B) receives no compensation directly or indirectly from an insurer for selling,
911 soliciting, or negotiating an insurance product of that insurer to an insurance customer or
912 insured.
913 (ii) "Producer for the insured" may be referred to as a "broker."
914 [
915 makes a promise in an insurance policy and includes:
916 (i) a policyholder;
917 (ii) a subscriber;
918 (iii) a member; and
919 (iv) a beneficiary.
920 (b) The definition in Subsection [
921 (i) applies only to this title;
922 (ii) does not define the meaning of "insured" as used in an insurance policy or
923 certificate; and
924 (iii) includes an enrollee.
925 [
926 means a person doing an insurance business as a principal including:
927 (i) a fraternal benefit society;
928 (ii) an issuer of a gift annuity other than an annuity specified in Subsections
929 31A-22-1305(2) and (3);
930 (iii) a motor club;
931 (iv) an employee welfare plan;
932 (v) a person purporting or intending to do an insurance business as a principal on that
933 person's own account; and
934 (vi) a health maintenance organization.
935 (b) "Insurer," "carrier," "insurance carrier," or "insurance company" does not include a
936 governmental entity.
937 [
938 Subsection [
939 [
940 company system:
941 (a) that includes an insurer registered under Section 31A-16-105;
942 (b) that has premiums written in at least three countries;
943 (c) whose percentage of gross premiums written outside the United States is at least
944 10% of its total gross written premiums; and
945 (d) that, based on a three-year rolling average, has:
946 (i) total assets of at least $50,000,000,000; or
947 (ii) total gross written premiums of at least $10,000,000,000.
948 [
949 (a) offered in connection with an extension of credit; and
950 (b) that provides indemnity if the debtor is involuntarily unemployed for payments
951 coming due on a:
952 (i) specific loan; or
953 (ii) credit transaction.
954 [
955 employer who, with respect to a calendar year and to a plan year:
956 (a) employed an average of at least 51 employees on business days during the
957 preceding calendar year; and
958 (b) employs at least one employee on the first day of the plan year.
959 [
960 an individual whose enrollment is a late enrollment.
961 [
962 enrollment of an individual other than:
963 (a) on the earliest date on which coverage can become effective for the individual
964 under the terms of the plan; or
965 (b) through special enrollment.
966 [
967 31A-1-103, "legal expense insurance" means insurance written to indemnify or pay for a
968 specified legal expense.
969 (b) "Legal expense insurance" includes an arrangement that creates a reasonable
970 expectation of an enforceable right.
971 (c) "Legal expense insurance" does not include the provision of, or reimbursement for,
972 legal services incidental to other insurance coverage.
973 [
974 (i) for death, injury, or disability of a human being, or for damage to property,
975 exclusive of the coverages under:
976 (A) medical malpractice insurance;
977 (B) professional liability insurance; and
978 (C) workers' compensation insurance;
979 (ii) for a medical, hospital, surgical, and funeral benefit to a person other than the
980 insured who is injured, irrespective of legal liability of the insured, when issued with or
981 supplemental to insurance against legal liability for the death, injury, or disability of a human
982 being, exclusive of the coverages under:
983 (A) medical malpractice insurance;
984 (B) professional liability insurance; and
985 (C) workers' compensation insurance;
986 (iii) for loss or damage to property resulting from an accident to or explosion of a
987 boiler, pipe, pressure container, machinery, or apparatus;
988 (iv) for loss or damage to property caused by:
989 (A) the breakage or leakage of a sprinkler, water pipe, or water container; or
990 (B) water entering through a leak or opening in a building; or
991 (v) for other loss or damage properly the subject of insurance not within another kind
992 of insurance as defined in this chapter, if the insurance is not contrary to law or public policy.
993 (b) "Liability insurance" includes:
994 (i) vehicle liability insurance;
995 (ii) residential dwelling liability insurance; and
996 (iii) making inspection of, and issuing a certificate of inspection upon, an elevator,
997 boiler, machinery, or apparatus of any kind when done in connection with insurance on the
998 elevator, boiler, machinery, or apparatus.
999 [
1000 in an activity that is part of or related to the insurance business.
1001 (b) "License" includes a certificate of authority issued to an insurer.
1002 [
1003 (i) insurance on a human life; and
1004 (ii) insurance pertaining to or connected with human life.
1005 (b) The business of life insurance includes:
1006 (i) granting a death benefit;
1007 (ii) granting an annuity benefit;
1008 (iii) granting an endowment benefit;
1009 (iv) granting an additional benefit in the event of death by accident;
1010 (v) granting an additional benefit to safeguard the policy against lapse; and
1011 (vi) providing an optional method of settlement of proceeds.
1012 [
1013 (a) is issued for a specific product of insurance; and
1014 (b) limits an individual or agency to transact only for that product or insurance.
1015 [
1016 insurance:
1017 (a) credit life;
1018 (b) credit accident and health;
1019 (c) credit property;
1020 (d) credit unemployment;
1021 (e) involuntary unemployment;
1022 (f) mortgage life;
1023 (g) mortgage guaranty;
1024 (h) mortgage accident and health;
1025 (i) guaranteed automobile protection; and
1026 (j) another form of insurance offered in connection with an extension of credit that:
1027 (i) is limited to partially or wholly extinguishing the credit obligation; and
1028 (ii) the commissioner determines by rule should be designated as a form of limited line
1029 credit insurance.
1030 [
1031 solicits, or negotiates one or more forms of limited line credit insurance coverage to an
1032 individual through a master, corporate, group, or individual policy.
1033 [
1034 (a) bail bond;
1035 (b) limited line credit insurance;
1036 (c) legal expense insurance;
1037 (d) motor club insurance;
1038 (e) car rental related insurance;
1039 (f) travel insurance;
1040 (g) crop insurance;
1041 (h) self-service storage insurance;
1042 (i) guaranteed asset protection waiver;
1043 (j) portable electronics insurance; and
1044 (k) another form of limited insurance that the commissioner determines by rule should
1045 be designated a form of limited line insurance.
1046 [
1047 Subsection [
1048 [
1049 limited lines insurance.
1050 [
1051 advertised, marketed, offered, or designated to provide coverage:
1052 (i) in a setting other than an acute care unit of a hospital;
1053 (ii) for not less than 12 consecutive months for a covered person on the basis of:
1054 (A) expenses incurred;
1055 (B) indemnity;
1056 (C) prepayment; or
1057 (D) another method;
1058 (iii) for one or more necessary or medically necessary services that are:
1059 (A) diagnostic;
1060 (B) preventative;
1061 (C) therapeutic;
1062 (D) rehabilitative;
1063 (E) maintenance; or
1064 (F) personal care; and
1065 (iv) that may be issued by:
1066 (A) an insurer;
1067 (B) a fraternal benefit society;
1068 (C) (I) a nonprofit health hospital; and
1069 (II) a medical service corporation;
1070 (D) a prepaid health plan;
1071 (E) a health maintenance organization; or
1072 (F) an entity similar to the entities described in Subsections [
1073 (121)(a)(iv)(A) through (E) to the extent that the entity is otherwise authorized to issue life or
1074 health care insurance.
1075 (b) "Long-term care insurance" includes:
1076 (i) any of the following that provide directly or supplement long-term care insurance:
1077 (A) a group or individual annuity or rider; or
1078 (B) a life insurance policy or rider;
1079 (ii) a policy or rider that provides for payment of benefits on the basis of:
1080 (A) cognitive impairment; or
1081 (B) functional capacity; or
1082 (iii) a qualified long-term care insurance contract.
1083 (c) "Long-term care insurance" does not include:
1084 (i) a policy that is offered primarily to provide basic Medicare supplement [
1085 insurance;
1086 (ii) basic hospital expense coverage;
1087 (iii) basic medical/surgical expense coverage;
1088 (iv) hospital confinement indemnity coverage;
1089 (v) major medical expense coverage;
1090 (vi) income replacement or related asset-protection coverage;
1091 (vii) accident only coverage;
1092 (viii) coverage for a specified:
1093 (A) disease; or
1094 (B) accident;
1095 (ix) limited benefit health coverage;
1096 (x) a life insurance policy that accelerates the death benefit to provide the option of a
1097 lump sum payment:
1098 (A) if the following are not conditioned on the receipt of long-term care:
1099 (I) benefits; or
1100 (II) eligibility; and
1101 (B) the coverage is for one or more the following qualifying events:
1102 (I) terminal illness;
1103 (II) medical conditions requiring extraordinary medical intervention; or
1104 (III) permanent institutional confinement; or
1105 (xi) limited long-term care as defined in Section 31A-22-2002.
1106 [
1107 (a) licensed as a health maintenance organization under Chapter 8, Health Maintenance
1108 Organizations and Limited Health Plans; or
1109 (b) (i) licensed under:
1110 (A) Chapter 5, Domestic Stock and Mutual Insurance Corporations;
1111 (B) Chapter 7, Nonprofit Health Service Insurance Corporations; or
1112 (C) Chapter 14, Foreign Insurers; and
1113 (ii) that requires an enrollee to use, or offers incentives, including financial incentives,
1114 for an enrollee to use, network providers.
1115 [
1116 incident to the practice and provision of a medical service other than the practice and provision
1117 of a dental service.
1118 (124) "Medicare" means the "Health Insurance for the Aged Act," Title XVIII of the
1119 federal Social Security Act, as then constituted or later amended.
1120 (125) (a) "Medicare supplement insurance" means health insurance coverage that is
1121 advertised, marketed, or designed primarily as a supplement to reimbursements under Medicare
1122 for the hospital, medical, or surgical expenses of individuals eligible for Medicare, including a
1123 Medicare supplement policy.
1124 (b) "Medicare supplement insurance" does not include:
1125 (i) a policy issued pursuant to a contract under Section 1876 of the federal Social
1126 Security Act;
1127 (ii) a policy issued under a demonstration project specified in 42 U.S.C. Sec.
1128 1395ss(g)(1);
1129 (iii) a Medicare Advantage plan established under Medicare Part C;
1130 (iv) an outpatient prescription drug plan established under Medicare Part D; or
1131 (v) any health care prepayment plan that provides benefits pursuant to an agreement
1132 under Section 1833(a)(1)(A) of the Social Security Act.
1133 [
1134 corporation.
1135 [
1136 must be constantly maintained by a stock insurance corporation as required by statute.
1137 [
1138 connection with an extension of credit that provides indemnity for payments coming due on a
1139 mortgage while the debtor has a disability.
1140 [
1141 mortgagee or other creditor is indemnified against losses caused by the default of a debtor.
1142 [
1143 connection with an extension of credit that pays if the debtor dies.
1144 [
1145 (a) licensed under:
1146 (i) Chapter 5, Domestic Stock and Mutual Insurance Corporations;
1147 (ii) Chapter 11, Motor Clubs; or
1148 (iii) Chapter 14, Foreign Insurers; and
1149 (b) that promises for an advance consideration to provide for a stated period of time
1150 one or more:
1151 (i) legal services under Subsection 31A-11-102(1)(b);
1152 (ii) bail services under Subsection 31A-11-102(1)(c); or
1153 (iii) (A) trip reimbursement;
1154 (B) towing services;
1155 (C) emergency road services;
1156 (D) stolen automobile services;
1157 (E) a combination of the services listed in Subsections [
1158 (131)(b)(iii)(A) through (D); or
1159 (F) other services given in Subsections 31A-11-102(1)(b) through (f).
1160 [
1161 [
1162 [
1163 includes:
1164 (a) a history of the NAIC's development of regulatory liquidity stress testing;
1165 (b) the scope criteria applicable for a specific data year; and
1166 (c) the liquidity stress test instructions and reporting templates for a specific data year,
1167 as adopted by the NAIC and as amended by the NAIC in accordance with NAIC procedures.
1168 [
1169 (a) that is issued by an insurer; and
1170 (b) under which the financing and delivery of medical care is provided, in whole or in
1171 part, through a defined set of providers under contract with the insurer, including the financing
1172 and delivery of an item paid for as medical care.
1173 [
1174 with a managed care organization to provide health care services to an enrollee with an
1175 expectation of receiving payment, other than coinsurance, copayments, or deductibles, directly
1176 from the managed care organization.
1177 [
1178 not entitled to receive a dividend representing a share of the surplus of the insurer.
1179 [
1180 (a) ships or hulls of ships;
1181 (b) goods, freight, cargoes, merchandise, effects, disbursements, profits, money,
1182 securities, choses in action, evidences of debt, valuable papers, bottomry, respondentia
1183 interests, or other cargoes in or awaiting transit over the oceans or inland waterways;
1184 (c) earnings such as freight, passage money, commissions, or profits derived from
1185 transporting goods or people upon or across the oceans or inland waterways; or
1186 (d) a vessel owner or operator as a result of liability to employees, passengers, bailors,
1187 owners of other vessels, owners of fixed objects, customs or other authorities, or other persons
1188 in connection with maritime activity.
1189 [
1190 [
1191 and Solvency Assessment Guidance Manual developed and adopted by the National
1192 Association of Insurance Commissioners and as amended from time to time.
1193 [
1194 insurer or insurance group's own risk and solvency assessment.
1195 [
1196 health insurance policy.
1197 [
1198 group's confidential internal assessment:
1199 (a) (i) of each material and relevant risk associated with the insurer or insurance group;
1200 (ii) of the insurer or insurance group's current business plan to support each risk
1201 described in Subsection [
1202 (iii) of the sufficiency of capital resources to support each risk described in Subsection
1203 [
1204 (b) that is appropriate to the nature, scale, and complexity of an insurer or insurance
1205 group.
1206 [
1207 entitled to receive a dividend representing a share of the surplus of the insurer.
1208 [
1209 relating to the minimum percentage of eligible employees that must be enrolled in relation to
1210 the total number of eligible employees of an employer reduced by each eligible employee who
1211 voluntarily declines coverage under the plan because the employee:
1212 (a) has other group health care insurance coverage; or
1213 (b) receives:
1214 (i) Medicare, under the Health Insurance for the Aged Act, Title XVIII of the Social
1215 Security Amendments of 1965; or
1216 (ii) another government health benefit.
1217 [
1218 (a) an individual;
1219 (b) a partnership;
1220 (c) a corporation;
1221 (d) an incorporated or unincorporated association;
1222 (e) a joint stock company;
1223 (f) a trust;
1224 (g) a limited liability company;
1225 (h) a reciprocal;
1226 (i) a syndicate; or
1227 (j) another similar entity or combination of entities acting in concert.
1228 [
1229 coverage sold for primarily noncommercial purposes to:
1230 (a) an individual; or
1231 (b) a family.
1232 [
1233 1002(16)(B).
1234 [
1235 (a) the year that is designated as the plan year in:
1236 (i) the plan document of a group health plan; or
1237 (ii) a summary plan description of a group health plan;
1238 (b) if the plan document or summary plan description does not designate a plan year or
1239 there is no plan document or summary plan description:
1240 (i) the year used to determine deductibles or limits;
1241 (ii) the policy year, if the plan does not impose deductibles or limits on a yearly basis;
1242 or
1243 (iii) the employer's taxable year if:
1244 (A) the plan does not impose deductibles or limits on a yearly basis; and
1245 (B) (I) the plan is not insured; or
1246 (II) the insurance policy is not renewed on an annual basis; or
1247 (c) in a case not described in Subsection [
1248 [
1249 application that:
1250 (i) purports to be an enforceable contract; and
1251 (ii) memorializes in writing some or all of the terms of an insurance contract.
1252 (b) "Policy" includes a service contract issued by:
1253 (i) a motor club under Chapter 11, Motor Clubs;
1254 (ii) a service contract provided under Chapter 6a, Service Contracts; and
1255 (iii) a corporation licensed under:
1256 (A) Chapter 7, Nonprofit Health Service Insurance Corporations; or
1257 (B) Chapter 8, Health Maintenance Organizations and Limited Health Plans.
1258 (c) "Policy" does not include:
1259 (i) a certificate under a group insurance contract; or
1260 (ii) a document that does not purport to have legal effect.
1261 [
1262 contract by ownership, premium payment, or otherwise.
1263 [
1264 nonguaranteed elements of a policy offering life insurance over a period of years.
1265 [
1266 insurance policy.
1267 [
1268 No. 111-148 and the Health Care Education Reconciliation Act of 2010, Pub. L. No. 111-152,
1269 and related federal regulations and guidance.
1270 [
1271 (a) means a condition that was present before the effective date of coverage, whether or
1272 not medical advice, diagnosis, care, or treatment was recommended or received before that day;
1273 and
1274 (b) does not include a condition indicated by genetic information unless an actual
1275 diagnosis of the condition by a physician has been made.
1276 [
1277 (b) "Premium" includes, however designated:
1278 (i) an assessment;
1279 (ii) a membership fee;
1280 (iii) a required contribution; or
1281 (iv) monetary consideration.
1282 (c) (i) "Premium" does not include consideration paid to a third party administrator for
1283 the third party administrator's services.
1284 (ii) "Premium" includes an amount paid by a third party administrator to an insurer for
1285 insurance on the risks administered by the third party administrator.
1286 [
1287 Subsection 31A-5-203(3).
1288 [
1289 [
1290 incident to the practice of a profession and provision of a professional service.
1291 [
1292 or personal property of every kind and any interest in that property:
1293 (i) from all hazards or causes; and
1294 (ii) against loss consequential upon the loss or damage including vehicle
1295 comprehensive and vehicle physical damage coverages.
1296 (b) "Property insurance" does not include:
1297 (i) inland marine insurance; and
1298 (ii) ocean marine insurance.
1299 [
1300 long-term care insurance contract" means:
1301 (a) an individual or group insurance contract that meets the requirements of Section
1302 7702B(b), Internal Revenue Code; or
1303 (b) the portion of a life insurance contract that provides long-term care insurance:
1304 (i) (A) by rider; or
1305 (B) as a part of the contract; and
1306 (ii) that satisfies the requirements of Sections 7702B(b) and (e), Internal Revenue
1307 Code.
1308 [
1309 (a) is:
1310 (i) organized under the laws of the United States or any state; or
1311 (ii) in the case of a United States office of a foreign banking organization, licensed
1312 under the laws of the United States or any state;
1313 (b) is regulated, supervised, and examined by a United States federal or state authority
1314 having regulatory authority over a bank or trust company; and
1315 (c) meets the standards of financial condition and standing that are considered
1316 necessary and appropriate to regulate the quality of a financial institution whose letters of credit
1317 will be acceptable to the commissioner as determined by:
1318 (i) the commissioner by rule; or
1319 (ii) the Securities Valuation Office of the National Association of Insurance
1320 Commissioners.
1321 [
1322 (i) the cost of a given unit of insurance; or
1323 (ii) for property or casualty insurance, that cost of insurance per exposure unit either
1324 expressed as:
1325 (A) a single number; or
1326 (B) a pure premium rate, adjusted before the application of individual risk variations
1327 based on loss or expense considerations to account for the treatment of:
1328 (I) expenses;
1329 (II) profit; and
1330 (III) individual insurer variation in loss experience.
1331 (b) "Rate" does not include a minimum premium.
1332 [
1333 rate making or filing by:
1334 (i) collecting, compiling, and furnishing loss or expense statistics;
1335 (ii) recommending, making, or filing rates or supplementary rate information; or
1336 (iii) advising about rate questions, except as an attorney giving legal advice.
1337 (b) "Rate service organization" does not include:
1338 (i) an employee of an insurer;
1339 (ii) a single insurer or group of insurers under common control;
1340 (iii) a joint underwriting group; or
1341 (iv) an individual serving as an actuarial or legal consultant.
1342 [
1343 renewal policy premiums:
1344 (a) a manual of rates;
1345 (b) a classification;
1346 (c) a rate-related underwriting rule; and
1347 (d) a rating formula that describes steps, policies, and procedures for determining
1348 initial and renewal policy premiums.
1349 [
1350 pay, allow, or give, directly or indirectly:
1351 (i) a refund of premium or portion of premium;
1352 (ii) a refund of commission or portion of commission;
1353 (iii) a refund of all or a portion of a consultant fee; or
1354 (iv) providing services or other benefits not specified in an insurance or annuity
1355 contract.
1356 (b) "Rebate" does not include:
1357 (i) a refund due to termination or changes in coverage;
1358 (ii) a refund due to overcharges made in error by the licensee; or
1359 (iii) savings or wellness benefits as provided in the contract by the licensee.
1360 [
1361 (a) the date delivered to and stamped received by the department, if delivered in
1362 person;
1363 (b) the post mark date, if delivered by mail;
1364 (c) the delivery service's post mark or pickup date, if delivered by a delivery service;
1365 (d) the received date recorded on an item delivered, if delivered by:
1366 (i) facsimile;
1367 (ii) email; or
1368 (iii) another electronic method; or
1369 (e) a date specified in:
1370 (i) a statute;
1371 (ii) a rule; or
1372 (iii) an order.
1373 [
1374 association of persons:
1375 (a) operating through an attorney-in-fact common to all of the persons; and
1376 (b) exchanging insurance contracts with one another that provide insurance coverage
1377 on each other.
1378 [
1379 consideration, transfers any portion of the risk it has assumed to another insurer. In referring to
1380 reinsurance transactions, this title sometimes refers to:
1381 (a) the insurer transferring the risk as the "ceding insurer"; and
1382 (b) the insurer assuming the risk as the:
1383 (i) "assuming insurer"; or
1384 (ii) "assuming reinsurer."
1385 [
1386 authority to assume reinsurance.
1387 [
1388 liability resulting from or incident to the ownership, maintenance, or use of a residential
1389 dwelling that is a detached single family residence or multifamily residence up to four units.
1390 [
1391 assumed under a reinsurance contract.
1392 (b) A reinsurer "retrocedes" when the reinsurer reinsures with another insurer part of a
1393 liability assumed under a reinsurance contract.
1394 [
1395 (a) an insurance policy; or
1396 (b) an insurance certificate.
1397 [
1398 magnitudes for a specified data year that are used to establish a preliminary list of insurers
1399 considered scoped into the NAIC liquidity stress test framework for that data year.
1400 [
1401 exclusion from coverage in accident and health insurance.
1402 [
1403 (i) note;
1404 (ii) stock;
1405 (iii) bond;
1406 (iv) debenture;
1407 (v) evidence of indebtedness;
1408 (vi) certificate of interest or participation in a profit-sharing agreement;
1409 (vii) collateral-trust certificate;
1410 (viii) preorganization certificate or subscription;
1411 (ix) transferable share;
1412 (x) investment contract;
1413 (xi) voting trust certificate;
1414 (xii) certificate of deposit for a security;
1415 (xiii) certificate of interest of participation in an oil, gas, or mining title or lease or in
1416 payments out of production under such a title or lease;
1417 (xiv) commodity contract or commodity option;
1418 (xv) certificate of interest or participation in, temporary or interim certificate for,
1419 receipt for, guarantee of, or warrant or right to subscribe to or purchase any of the items listed
1420 in Subsections [
1421 (xvi) another interest or instrument commonly known as a security.
1422 (b) "Security" does not include:
1423 (i) any of the following under which an insurance company promises to pay money in a
1424 specific lump sum or periodically for life or some other specified period:
1425 (A) insurance;
1426 (B) an endowment policy; or
1427 (C) an annuity contract; or
1428 (ii) a burial certificate or burial contract.
1429 [
1430 person, including:
1431 (a) common stock;
1432 (b) preferred stock;
1433 (c) debt obligations; and
1434 (d) any other security convertible into or evidencing the right of any of the items listed
1435 in this Subsection [
1436 [
1437 provides for spreading the person's own risks by a systematic plan.
1438 (b) "Self-insurance" includes:
1439 (i) an arrangement under which a governmental entity undertakes to indemnify an
1440 employee for liability arising out of the employee's employment; and
1441 (ii) an arrangement under which a person with a managed program of self-insurance
1442 and risk management undertakes to indemnify the person's affiliate, subsidiary, director,
1443 officer, or employee for liability or risk that arises out of the person's relationship with the
1444 affiliate, subsidiary, director, officer, or employee.
1445 (c) "Self-insurance" does not include:
1446 (i) an arrangement under which a number of persons spread their risks among
1447 themselves; or
1448 (ii) an arrangement with an independent contractor.
1449 [
1450 (a) by any means;
1451 (b) for money or its equivalent; and
1452 (c) on behalf of an insurance company.
1453 [
1454 product that:
1455 (a) after taking into account any renewals or extensions, has a total duration of no more
1456 than 36 months; and
1457 (b) has an expiration date specified in the contract that is less than 12 months after the
1458 original effective date of coverage under the health benefit product.
1459 [
1460 during each of which an individual does not have creditable coverage.
1461 [
1462 with respect to a calendar year and to a plan year, an employer who:
1463 (i) (A) employed at least one but not more than 50 eligible employees on business days
1464 during the preceding calendar year; or
1465 (B) if the employer did not exist for the entirety of the preceding calendar year,
1466 reasonably expects to employ an average of at least one but not more than 50 eligible
1467 employees on business days during the current calendar year;
1468 (ii) employs at least one employee on the first day of the plan year; and
1469 (iii) for an employer who has common ownership with one or more other employers, is
1470 treated as a single employer under 26 U.S.C. Sec. 414(b), (c), (m), or (o).
1471 (b) "Small employer" does not include an owner or a sole proprietor that does not
1472 employ at least one employee.
1473 [
1474 the same meaning as provided in federal regulations adopted pursuant to the Health Insurance
1475 Portability and Accountability Act.
1476 [
1477 either directly or indirectly through one or more affiliates or intermediaries.
1478 (b) "Wholly owned subsidiary" of a person is a subsidiary of which all of the voting
1479 shares are owned by that person either alone or with its affiliates, except for the minimum
1480 number of shares the law of the subsidiary's domicile requires to be owned by directors or
1481 others.
1482 [
1483 (a) a guarantee against loss or damage resulting from the failure of a principal to pay or
1484 perform the principal's obligations to a creditor or other obligee;
1485 (b) bail bond insurance; and
1486 (c) fidelity insurance.
1487 [
1488 and liabilities.
1489 (b) (i) "Permanent surplus" means the surplus of an insurer or organization that is
1490 designated by the insurer or organization as permanent.
1491 (ii) Sections 31A-5-211, 31A-7-201, 31A-8-209, 31A-9-209, and 31A-14-205 require
1492 that insurers or organizations doing business in this state maintain specified minimum levels of
1493 permanent surplus.
1494 (iii) Except for assessable mutuals, the minimum permanent surplus requirement is the
1495 same as the minimum required capital requirement that applies to stock insurers.
1496 (c) "Excess surplus" means:
1497 (i) for a life insurer, accident and health insurer, health organization, or property and
1498 casualty insurer as defined in Section 31A-17-601, the lesser of:
1499 (A) that amount of an insurer's or health organization's total adjusted capital that
1500 exceeds the product of:
1501 (I) 2.5; and
1502 (II) the sum of the insurer's or health organization's minimum capital or permanent
1503 surplus required under Section 31A-5-211, 31A-9-209, or 31A-14-205; or
1504 (B) that amount of an insurer's or health organization's total adjusted capital that
1505 exceeds the product of:
1506 (I) 3.0; and
1507 (II) the authorized control level RBC as defined in Subsection 31A-17-601(8)(a); and
1508 (ii) for a monoline mortgage guaranty insurer, financial guaranty insurer, or title insurer
1509 that amount of an insurer's paid-in-capital and surplus that exceeds the product of:
1510 (A) 1.5; and
1511 (B) the insurer's total adjusted capital required by Subsection 31A-17-609(1).
1512 [
1513 collects charges or premiums from, or who, for consideration, adjusts or settles claims of
1514 residents of the state in connection with insurance coverage, annuities, or service insurance
1515 coverage, except:
1516 (a) a union on behalf of its members;
1517 (b) a person administering a:
1518 (i) pension plan subject to the federal Employee Retirement Income Security Act of
1519 1974;
1520 (ii) governmental plan as defined in Section 414(d), Internal Revenue Code; or
1521 (iii) nonelecting church plan as described in Section 410(d), Internal Revenue Code;
1522 (c) an employer on behalf of the employer's employees or the employees of one or
1523 more of the subsidiary or affiliated corporations of the employer;
1524 (d) an insurer licensed under the following, but only for a line of insurance for which
1525 the insurer holds a license in this state:
1526 (i) Chapter 5, Domestic Stock and Mutual Insurance Corporations;
1527 (ii) Chapter 7, Nonprofit Health Service Insurance Corporations;
1528 (iii) Chapter 8, Health Maintenance Organizations and Limited Health Plans;
1529 (iv) Chapter 9, Insurance Fraternals; or
1530 (v) Chapter 14, Foreign Insurers;
1531 (e) a person:
1532 (i) licensed or exempt from licensing under:
1533 (A) Chapter 23a, Insurance Marketing - Licensing Producers, Consultants, and
1534 Reinsurance Intermediaries; or
1535 (B) Chapter 26, Insurance Adjusters; and
1536 (ii) whose activities are limited to those authorized under the license the person holds
1537 or for which the person is exempt; or
1538 (f) an institution, bank, or financial institution:
1539 (i) that is:
1540 (A) an institution whose deposits and accounts are to any extent insured by a federal
1541 deposit insurance agency, including the Federal Deposit Insurance Corporation or National
1542 Credit Union Administration; or
1543 (B) a bank or other financial institution that is subject to supervision or examination by
1544 a federal or state banking authority; and
1545 (ii) that does not adjust claims without a third party administrator license.
1546 [
1547 owner of real or personal property or the holder of liens or encumbrances on that property, or
1548 others interested in the property against loss or damage suffered by reason of liens or
1549 encumbrances upon, defects in, or the unmarketability of the title to the property, or invalidity
1550 or unenforceability of any liens or encumbrances on the property.
1551 [
1552 organization's statutory capital and surplus as determined in accordance with:
1553 (a) the statutory accounting applicable to the annual financial statements required to be
1554 filed under Section 31A-4-113; and
1555 (b) another item provided by the RBC instructions, as RBC instructions is defined in
1556 Section 31A-17-601.
1557 [
1558 a corporation.
1559 (b) "Trustee," when used in reference to an employee welfare fund, means an
1560 individual, firm, association, organization, joint stock company, or corporation, whether acting
1561 individually or jointly and whether designated by that name or any other, that is charged with
1562 or has the overall management of an employee welfare fund.
1563 [
1564 insurer" means an insurer:
1565 (i) not holding a valid certificate of authority to do an insurance business in this state;
1566 or
1567 (ii) transacting business not authorized by a valid certificate.
1568 (b) "Admitted insurer" or "authorized insurer" means an insurer:
1569 (i) holding a valid certificate of authority to do an insurance business in this state; and
1570 (ii) transacting business as authorized by a valid certificate.
1571 [
1572 insurer.
1573 [
1574 from or incident to ownership, maintenance, or use of a land vehicle or aircraft, exclusive of a
1575 vehicle comprehensive or vehicle physical damage coverage described in Subsection [
1576 (160).
1577 [
1578 security convertible into a security with a voting right associated with the security.
1579 [
1580 pass before coverage for an individual, who is otherwise eligible to enroll under the terms of
1581 the health benefit plan, can become effective.
1582 [
1583 (a) insurance for indemnification of an employer against liability for compensation
1584 based on:
1585 (i) a compensable accidental injury; and
1586 (ii) occupational disease disability;
1587 (b) employer's liability insurance incidental to workers' compensation insurance and
1588 written in connection with workers' compensation insurance; and
1589 (c) insurance assuring to a person entitled to workers' compensation benefits the
1590 compensation provided by law.
1591 Section 3. Section 31A-2-201.2 is amended to read:
1592 31A-2-201.2. Evaluation of health insurance market.
1593 (1) (a) Each year the commissioner shall:
1594 [
1595 [
1596
1597 February 1 of each year; and
1598 [
1599 (b) After the president of the Senate and the speaker of the House of Representatives
1600 appoint members to the Health and Human Services Interim Committee for the year in which
1601 the Office of Legislative Research and General Counsel receives a report under this subsection,
1602 the Office of Legislative Research and General Counsel shall provide a copy of the report to
1603 each member of the committee.
1604 (2) The evaluation required by this section shall:
1605 (a) analyze the effectiveness of the insurance regulations and statutes in promoting a
1606 healthy, competitive health insurance market that meets the needs of the state, and includes an
1607 analysis of:
1608 (i) the availability and marketing of individual and group products;
1609 (ii) rate changes;
1610 (iii) coverage and demographic changes;
1611 (iv) benefit trends;
1612 (v) market share changes; and
1613 (vi) accessibility;
1614 (b) assess complaint ratios and trends within the health insurance market, which
1615 assessment shall include complaint data from the Office of Consumer Health Assistance within
1616 the department;
1617 (c) contain recommendations for action to improve the overall effectiveness of the
1618 health insurance market, administrative rules, and statutes;
1619 (d) include claims loss ratio data for each health insurance company doing business in
1620 the state;
1621 (e) include information about pharmacy benefit managers collected under Section
1622 31A-46-301; and
1623 (f) include information, for each health insurance company doing business in the state,
1624 regarding:
1625 (i) preauthorization determinations; and
1626 (ii) adverse benefit determinations.
1627 (3) When preparing the evaluation and report required by this section, the
1628 commissioner may seek the input of insurers, employers, insured persons, providers, and others
1629 with an interest in the health insurance market.
1630 (4) The commissioner may adopt administrative rules for the purpose of collecting the
1631 data required by this section, taking into account the business confidentiality of the insurers.
1632 (5) Records submitted to the commissioner under this section shall be maintained by
1633 the commissioner as protected records under Title 63G, Chapter 2, Government Records
1634 Access and Management Act.
1635 Section 4. Section 31A-2-215 is amended to read:
1636 31A-2-215. Consumer education.
1637 (1) In furtherance of the purposes in Section 31A-1-102, the commissioner may
1638 educate consumers about insurance and provide consumer assistance.
1639 (2) Consumer education may include:
1640 (a) outreach activities; and
1641 (b) the production or collection and dissemination of educational materials.
1642 (3) [
1643 (a) explaining:
1644 (i) the terms of a policy;
1645 (ii) a policy's complaint, grievance, or adverse benefit determination procedure; and
1646 (iii) the fundamentals of self-advocacy[
1647 (b) informal efforts to negotiate a resolution of a dispute between a consumer and a
1648 licensee.
1649 (4) (a) Notwithstanding Subsection [
1650 assistance may not include:
1651 (i) commencing an administrative, judicial, or other proceeding against a licensee to
1652 obtain specific relief from the licensee for a specific consumer; or
1653 (ii) [
1654
1655
1656 representing a consumer in any administrative, judicial, or other proceeding.
1657 (5) Nothing in this section prohibits the commissioner from taking enforcement action
1658 for violations under Section 31A-2-308.
1659 [
1660 of this section.
1661 Section 5. Section 31A-2-216 is amended to read:
1662 31A-2-216. Office of Consumer Health Assistance.
1663 (1) The commissioner shall establish[
1664 before July 1, 1999[
1665 [
1666
1667 (2) The office shall:
1668 (a) be a resource for health [
1669 insurance coverage or the need for such coverage;
1670 (b) help health [
1671 (i) contractual rights and responsibilities;
1672 (ii) statutory protections; and
1673 (iii) available remedies, including adverse benefit determination processes;
1674 (c) educate health [
1675 (i) by producing or collecting and disseminating educational materials to consumers[
1676 and health insurers[
1677 (ii) through outreach and other educational activities;
1678 (d) for health [
1679 insurance policies because of language, disability, age, or ethnicity, provide information and
1680 services, directly or through referral[
1681 [
1682 [
1683 (e) analyze and monitor federal and state consumer health[
1684 rules, and regulations; and
1685 (f) summarize information gathered under this section and make the summaries
1686 available to the public, government agencies, and the Legislature.
1687 (3) The office may:
1688 (a) obtain data from health [
1689 office's duties under this section;
1690 (b) investigate complaints and attempt to resolve complaints at the lowest possible
1691 level; and
1692 (c) assist, but not testify or represent, a consumer in an adverse benefit determination,
1693 arbitration, judicial, or related proceeding, unless the proceeding is in connection with an
1694 enforcement action [
1695 (4) The commissioner may adopt rules necessary to implement the requirements of this
1696 section.
1697 Section 6. Section 31A-2-308 is amended to read:
1698 31A-2-308. Enforcement penalties and procedures.
1699 (1) (a) A person who violates any insurance statute or rule or any order issued under
1700 Subsection 31A-2-201(4) shall forfeit to the state up to twice the amount of any profit gained
1701 from the violation, in addition to any other forfeiture or penalty imposed.
1702 (b) (i) The commissioner may order an individual producer, surplus line producer,
1703 limited line producer, managing general agent, reinsurance intermediary, adjuster, third party
1704 administrator, navigator, or insurance consultant who violates an insurance statute or rule to
1705 forfeit to the state not more than $2,500 for each violation.
1706 (ii) The commissioner may order any other person who violates an insurance statute or
1707 rule to forfeit to the state not more than $5,000 for each violation.
1708 (c) (i) The commissioner may order an individual producer, surplus line producer,
1709 limited line producer, managing general agent, reinsurance intermediary, adjuster, third party
1710 administrator, navigator, or insurance consultant who violates an order issued under Subsection
1711 31A-2-201(4) to forfeit to the state not more than $2,500 for each violation. Each day the
1712 violation continues is a separate violation.
1713 (ii) The commissioner may order any other person who violates an order issued under
1714 Subsection 31A-2-201(4) to forfeit to the state not more than $5,000 for each violation. Each
1715 day the violation continues is a separate violation.
1716 (d) The commissioner may accept or compromise any forfeiture [
1717
1718
1719 (2) When a person fails to comply with an order issued under Subsection
1720 31A-2-201(4), including a forfeiture order, the commissioner may file an action in any court of
1721 competent jurisdiction or obtain a court order or judgment:
1722 (a) enforcing the commissioner's order;
1723 (b) (i) directing compliance with the commissioner's order and restraining further
1724 violation of the order; and
1725 (ii) subjecting the person ordered to the procedures and sanctions available to the court
1726 for punishing contempt if the failure to comply continues; or
1727 (c) imposing a forfeiture in an amount the court considers just, up to $10,000 for each
1728 day the failure to comply continues after the filing of the complaint until judgment is rendered.
1729 (3) (a) The Utah Rules of Civil Procedure govern actions brought under Subsection (2),
1730 except that the commissioner may file a complaint seeking a court-ordered forfeiture under
1731 Subsection (2)(c) no sooner than two weeks after giving written notice of the commissioner's
1732 intention to proceed under Subsection (2)(c).
1733 (b) The commissioner's order issued under Subsection 31A-2-201(4) may contain a
1734 notice of intention to seek a court-ordered forfeiture if the commissioner's order is disobeyed.
1735 (4) If, after a court order is issued under Subsection (2), the person fails to comply with
1736 the commissioner's order or judgment:
1737 (a) the commissioner may certify the fact of the failure to the court by affidavit; and
1738 (b) the court may, after a hearing following at least five days written notice to the
1739 parties subject to the order or judgment, amend the order or judgment to add the forfeiture or
1740 forfeitures, as prescribed in Subsection (2)(c), until the person complies.
1741 (5) (a) The proceeds of the forfeitures under this section, including collection expenses,
1742 shall be paid into the General Fund.
1743 (b) The expenses of collection shall be credited to the department's budget.
1744 (c) The attorney general's budget shall be credited to the extent the department
1745 reimburses the attorney general's office for its collection expenses under this section.
1746 (6) (a) Forfeitures and judgments under this section bear interest at the rate charged by
1747 the United States Internal Revenue Service for past due taxes on the:
1748 (i) date of entry of the commissioner's order under Subsection (1); or
1749 (ii) date of judgment under Subsection (2).
1750 (b) Interest accrues from the later of the dates described in Subsection (6)(a) until the
1751 forfeiture and accrued interest are fully paid.
1752 (7) A forfeiture may not be imposed under Subsection (2)(c) if:
1753 (a) at the time the forfeiture action is commenced, the person was in compliance with
1754 the commissioner's order; or
1755 (b) the violation of the order occurred during the order's suspension.
1756 (8) The commissioner may seek an injunction as an alternative to issuing an order
1757 under Subsection 31A-2-201(4).
1758 (9) (a) A person is guilty of a class B misdemeanor if that person:
1759 (i) intentionally violates:
1760 (A) an insurance statute of this state; or
1761 (B) an order issued under Subsection 31A-2-201(4);
1762 (ii) intentionally permits a person over whom that person has authority to violate:
1763 (A) an insurance statute of this state; or
1764 (B) an order issued under Subsection 31A-2-201(4); or
1765 (iii) intentionally aids any person in violating:
1766 (A) an insurance statute of this state; or
1767 (B) an order issued under Subsection 31A-2-201(4).
1768 (b) Unless a specific criminal penalty is provided elsewhere in this title, the person may
1769 be fined not more than:
1770 (i) $10,000 if a corporation; or
1771 (ii) $5,000 if a person other than a corporation.
1772 (c) If the person is an individual, the person may, in addition, be imprisoned for up to
1773 one year.
1774 (d) As used in this Subsection (9), "intentionally" has the same meaning as under
1775 Subsection 76-2-103(1).
1776 (10) (a) A person who knowingly and intentionally violates Section 31A-4-102,
1777 31A-8a-208, 31A-15-105, 31A-23a-116, or 31A-31-111 is guilty of a felony as provided in this
1778 Subsection (10).
1779 (b) When the value of the property, money, or other things obtained or sought to be
1780 obtained in violation of Subsection (10)(a):
1781 (i) is less than $5,000, a person is guilty of a third degree felony; or
1782 (ii) is or exceeds $5,000, a person is guilty of a second degree felony.
1783 (11) (a) After a hearing, the commissioner may, in whole or in part, revoke, suspend,
1784 place on probation, limit, or refuse to renew the licensee's license or certificate of authority:
1785 (i) when a licensee of the department, other than a domestic insurer:
1786 (A) persistently or substantially violates the insurance law; or
1787 (B) violates an order of the commissioner under Subsection 31A-2-201(4);
1788 (ii) if there are grounds for delinquency proceedings against the licensee under Section
1789 31A-27a-207; or
1790 (iii) if the licensee's methods and practices in the conduct of the licensee's business
1791 endanger, or the licensee's financial resources are inadequate to safeguard, the legitimate
1792 interests of the licensee's customers and the public.
1793 (b) Additional license termination or probation provisions for licensees other than
1794 insurers are set forth in Sections 31A-19a-303, 31A-19a-304, 31A-23a-111, 31A-23a-112,
1795 31A-25-208, 31A-25-209, 31A-26-213, 31A-26-214, 31A-35-501, and 31A-35-503.
1796 (12) The enforcement penalties and procedures set forth in this section are not
1797 exclusive, but are cumulative of other rights and remedies the commissioner has pursuant to
1798 applicable law.
1799 Section 7. Section 31A-4-113.5 is amended to read:
1800 31A-4-113.5. Filing requirements -- National Association of Insurance
1801 Commissioners.
1802 (1) (a) Each domestic, foreign, and alien insurer who is authorized to transact insurance
1803 business in this state shall annually file with the NAIC a copy of the insurer's:
1804 (i) annual statement convention blank on or before March 1;
1805 (ii) market conduct annual statements[
1806 the NAIC; and
1807 [
1808 [
1809 (iii) any additional filings required by the commissioner for the preceding year.
1810 (b) (i) The information filed with the NAIC under Subsection (1)(a)(i) shall:
1811 (A) be prepared in accordance with the NAIC's:
1812 (I) annual statement instructions; and
1813 (II) Accounting Practices and Procedures Manual; and
1814 (B) include:
1815 (I) the signed jurat page; and
1816 (II) the actuarial certification.
1817 (ii) An insurer shall file with the NAIC amendments and addenda to information filed
1818 with the commissioner under Subsection (1)(a)(i).
1819 (c) The information filed with the NAIC under Subsection (1)(a)(ii) shall be prepared
1820 in accordance with the NAIC's Market Conduct Annual Statement Industry User Guide.
1821 (d) At the time an insurer makes a filing under this Subsection (1), the insurer shall pay
1822 any filing fees assessed by the NAIC.
1823 (e) A foreign insurer that is domiciled in a state that has a law substantially similar to
1824 this section shall be considered to be in compliance with this section.
1825 (2) All financial analysis ratios and examination synopses concerning insurance
1826 companies that are submitted to the department by the Insurance Regulatory Information
1827 System are confidential and may not be disclosed by the department.
1828 (3) The commissioner may suspend, revoke, or refuse to renew the certificate of
1829 authority of any insurer failing to:
1830 (a) submit the filings under Subsection (1)(a) when due or within any extension of time
1831 granted for good cause by:
1832 (i) the commissioner; or
1833 (ii) the NAIC; or
1834 (b) pay by the time specified in Subsection (3)(a) a fee the insurer is required to pay
1835 under this section to:
1836 (i) the commissioner; or
1837 (ii) the NAIC.
1838 Section 8. Section 31A-19a-203 is amended to read:
1839 31A-19a-203. Rate filings.
1840 (1) (a) Except as provided in Subsections (4) and (5), every authorized insurer and
1841 every rate service organization licensed under Section 31A-19a-301 that has been designated
1842 by any insurer for the filing of pure premium rates under Subsection 31A-19a-205(2) shall file
1843 with the commissioner the following for use in this state:
1844 (i) all rates;
1845 (ii) all supplementary information; and
1846 (iii) all changes and amendments to rates and supplementary information.
1847 (b) An insurer shall file its rates by filing:
1848 (i) its final rates; or
1849 (ii) either of the following to be applied to pure premium rates that have been filed by a
1850 rate service organization on behalf of the insurer as permitted by Section 31A-19a-205:
1851 (A) a multiplier; or
1852 (B) (I) a multiplier; and
1853 (II) an expense constant adjustment.
1854 (c) Every filing under this Subsection (1) shall state:
1855 (i) the effective date of the rates; and
1856 (ii) the character and extent of the coverage contemplated.
1857 (d) Except for workers' compensation rates filed under Sections 31A-19a-405 and
1858 31A-19a-406, each filing shall be within 30 days after the rates and supplementary information,
1859 changes, and amendments are effective.
1860 (e) A rate filing is considered filed when it has been received[
1861
1862 by the commissioner.
1863 (f) The commissioner may by rule prescribe procedures for submitting rate filings by
1864 electronic means.
1865 (2) (a) To show compliance with Section 31A-19a-201, at the same time as the filing
1866 of the rate and supplementary rate information, an insurer shall file all supporting information
1867 to be used in support of or in conjunction with a rate.
1868 (b) If the rate filing provides for a modification or revision of a previously filed rate,
1869 the insurer is required to file only the supporting information that supports the modification or
1870 revision.
1871 (c) If the commissioner determines that the insurer did not file sufficient supporting
1872 information, the commissioner shall inform the insurer in writing of the lack of sufficient
1873 supporting information.
1874 (d) If the insurer does not provide the necessary supporting information within 45
1875 calendar days of the date on which the commissioner mailed notice under Subsection (2)(c), the
1876 rate filing may be:
1877 (i) considered incomplete and unfiled; and
1878 (ii) returned to the insurer as:
1879 (A) not filed; and
1880 (B) not available for use.
1881 (e) Notwithstanding Subsection (2)(d), the commissioner may extend the time period
1882 for filing supporting information.
1883 (f) If a rate filing is returned to an insurer as not filed and not available for use under
1884 Subsection (2)(d), the insurer may not use the rate filing for any policy issued or renewed on or
1885 after 60 calendar days from the date the rate filing was returned.
1886 (3) At the request of the commissioner, an insurer using the services of a rate service
1887 organization shall provide a description of the rationale for using the services of the rate service
1888 organization, including the insurer's:
1889 (a) own information; and
1890 (b) method of use of the rate service organization's information.
1891 (4) (a) An insurer may not make or issue a contract or policy except in accordance with
1892 the rate filings that are in effect for the insurer as provided in this chapter.
1893 (b) Subsection (4)(a) does not apply to contracts or policies for inland marine risks for
1894 which filings are not required.
1895 (5) Subsection (1) does not apply to inland marine risks, which, by general custom, are
1896 not written according to standardized manual rules or rating plans.
1897 (6) (a) The insurer may file a written application, stating the insurer's reasons for using
1898 a higher rate than that otherwise applicable to a specific risk.
1899 (b) If the application described in Subsection (6)(a) is filed with and not disapproved
1900 by the commissioner within 10 days after filing, the higher rate may be applied to the specific
1901 risk.
1902 (c) The rate described in this Subsection (6) may be disapproved without a hearing.
1903 (d) If disapproved, the rate otherwise applicable applies from the effective date of the
1904 policy, but the insurer may cancel the policy pro rata on 10 days' notice to the policyholder.
1905 (e) If the insurer does not cancel the policy under Subsection (6)(d), the insurer shall
1906 refund any excess premium from the effective date of the policy.
1907 (7) (a) Agreements may be made between insurers on the use of reasonable rate
1908 modifications for insurance provided under Section 31A-22-310.
1909 (b) The rate modifications described in Subsection (7)(a) shall be filed immediately
1910 upon agreement by the insurers.
1911 Section 9. Section 31A-19a-209 is amended to read:
1912 31A-19a-209. Special provisions for title insurance.
1913 (1) (a) (i) The Title and Escrow Commission may make rules, in accordance with Title
1914 63G, Chapter 3, Utah Administrative Rulemaking Act, and subject to Section 31A-2-404,
1915 establishing rate standards and rating methods.
1916 (ii) The commissioner shall determine compliance with rate standards and rating
1917 methods for title insurers, individual title insurance producers, and agency title insurance
1918 producers.
1919 (b) In addition to the considerations in determining compliance with rate standards and
1920 rating methods as set forth in Sections 31A-19a-201 and 31A-19a-202, including for title
1921 insurers, the commissioner and the Title and Escrow Commission shall consider the costs and
1922 expenses incurred by title insurers, individual title insurance producers, and agency title
1923 insurance producers pertaining to the business of title insurance including:
1924 (i) the maintenance of title plants; and
1925 (ii) the examining of public records to determine insurability of title to real property.
1926 (2) A title insurer[
1927
1928
1929
1930
1931 policy.
1932 Section 10. Section 31A-21-402 is amended to read:
1933 31A-21-402. Definitions.
1934 [
1935 [
1936
1937
1938
1939 [
1940 [
1941
1942 [
1943
1944 [
1945 means the insurance under any individual, franchise, group, or blanket insurance policy
1946 offering life or accident and health insurance:
1947 [
1948 [
1949 [
1950 [
1951 person's insurance.
1952 Section 11. Section 31A-22-303 is amended to read:
1953 31A-22-303. Motor vehicle liability coverage.
1954 (1) (a) In addition to complying with the requirements of Chapter 21, Insurance
1955 Contracts in General, and Part 2, Liability Insurance in General, a policy of motor vehicle
1956 liability coverage under Subsection 31A-22-302(1)(a) shall:
1957 (i) name the motor vehicle owner or operator in whose name the policy was purchased,
1958 state that named insured's address, the coverage afforded, the premium charged, the policy
1959 period, and the limits of liability;
1960 (ii) (A) if it is an owner's policy, designate by appropriate reference all the motor
1961 vehicles on which coverage is granted, insure the person named in the policy, insure any other
1962 person using any named motor vehicle with the express or implied permission of the named
1963 insured, and, except as provided in Section 31A-22-302.5, insure any person included in
1964 Subsection (1)(a)(iii) against loss from the liability imposed by law for damages arising out of
1965 the ownership, maintenance, or use of these motor vehicles within the United States and
1966 Canada, subject to limits exclusive of interest and costs, for each motor vehicle, in amounts not
1967 less than the minimum limits specified under Section 31A-22-304; or
1968 (B) if it is an operator's policy, insure the person named as insured against loss from
1969 the liability imposed upon him by law for damages arising out of the insured's use of any motor
1970 vehicle not owned by him, within the same territorial limits and with the same limits of liability
1971 as in an owner's policy under Subsection (1)(a)(ii)(A);
1972 (iii) except as provided in Section 31A-22-302.5, insure persons related to the named
1973 insured by blood, marriage, adoption, or guardianship who are residents of the named insured's
1974 household, including those who usually make their home in the same household but
1975 temporarily live elsewhere, to the same extent as the named insured;
1976 (iv) where a claim is brought by the named insured or a person described in Subsection
1977 (1)(a)(iii), the available coverage of the policy may not be reduced or stepped-down because:
1978 (A) a permissive user driving a covered motor vehicle is at fault in causing an accident;
1979 or
1980 (B) the named insured or any of the persons described in Subsection (1)(a)(iii) driving
1981 a covered motor vehicle is at fault in causing an accident; [
1982 (v) cover damages or injury resulting from a covered driver of a motor vehicle who is
1983 stricken by an unforeseeable paralysis, seizure, or other unconscious condition and who is not
1984 reasonably aware that paralysis, seizure, or other unconscious condition is about to occur to the
1985 extent that a person of ordinary prudence would not attempt to continue driving[
1986 (vi) cover substitute transportation as defined in Section 31A-22-323.
1987 (b) The driver's liability under Subsection (1)(a)(v) is limited to the insurance
1988 coverage.
1989 (c) (i) "Guardianship" under Subsection (1)(a)(iii) includes the relationship between a
1990 foster parent and a minor who is in the legal custody of the Division of Child and Family
1991 Services if:
1992 (A) the minor resides in a foster home, as defined in Section 62A-2-101, with a foster
1993 parent who is the named insured; and
1994 (B) the foster parent has signed to be jointly and severally liable for compensatory
1995 damages caused by the minor's operation of a motor vehicle in accordance with Section
1996 53-3-211.
1997 (ii) "Guardianship" as defined under this Subsection (1)(c) ceases to exist when a
1998 minor described in Subsection (1)(c)(i)(A) is no longer a resident of the named insured's
1999 household.
2000 (2) (a) A policy containing motor vehicle liability coverage under Subsection
2001 31A-22-302(1)(a) may:
2002 (i) provide for the prorating of the insurance under that policy with other valid and
2003 collectible insurance;
2004 (ii) grant any lawful coverage in addition to the required motor vehicle liability
2005 coverage;
2006 (iii) if the policy is issued to a person other than a motor vehicle business, limit the
2007 coverage afforded to a motor vehicle business or its officers, agents, or employees to the
2008 minimum limits under Section 31A-22-304, and to those instances when there is no other valid
2009 and collectible insurance with at least those limits, whether the other insurance is primary,
2010 excess, or contingent; and
2011 (iv) if issued to a motor vehicle business, restrict coverage afforded to anyone other
2012 than the motor vehicle business or its officers, agents, or employees to the minimum limits
2013 under Section 31A-22-304, and to those instances when there is no other valid and collectible
2014 insurance with at least those limits, whether the other insurance is primary, excess, or
2015 contingent.
2016 (b) (i) The liability insurance coverage of a permissive user of a motor vehicle owned
2017 by a motor vehicle business shall be primary coverage.
2018 (ii) The liability insurance coverage of a motor vehicle business shall be secondary to
2019 the liability insurance coverage of a permissive user as specified under Subsection (2)(b)(i).
2020 (3) Motor vehicle liability coverage need not insure any liability:
2021 (a) under any workers' compensation law under Title 34A, Utah Labor Code;
2022 (b) resulting from bodily injury to or death of an employee of the named insured, other
2023 than a domestic employee, while engaged in the employment of the insured, or while engaged
2024 in the operation, maintenance, or repair of a designated vehicle; or
2025 (c) resulting from damage to property owned by, rented to, bailed to, or transported by
2026 the insured.
2027 (4) An insurance carrier providing motor vehicle liability coverage has the right to
2028 settle any claim covered by the policy, and if the settlement is made in good faith, the amount
2029 of the settlement is deductible from the limits of liability specified under Section 31A-22-304.
2030 (5) A policy containing motor vehicle liability coverage imposes on the insurer the
2031 duty to defend, in good faith, any person insured under the policy against any claim or suit
2032 seeking damages which would be payable under the policy.
2033 (6) (a) If a policy containing motor vehicle liability coverage provides an insurer with
2034 the defense of lack of cooperation on the part of the insured, that defense is not effective
2035 against a third person making a claim against the insurer, unless there was collusion between
2036 the third person and the insured.
2037 (b) If the defense of lack of cooperation is not effective against the claimant, after
2038 payment, the insurer is subrogated to the injured person's claim against the insured to the extent
2039 of the payment and is entitled to reimbursement by the insured after the injured third person has
2040 been made whole with respect to the claim against the insured.
2041 (7) (a) A policy of motor vehicle coverage may limit coverage to the policy minimum
2042 limits under Section 31A-22-304 if the policy or a specifically reduced premium was extended
2043 to the insured upon express written declaration executed by the insured that the insured motor
2044 vehicle would not be operated by a person described in Subsection (7)(c) operating in a manner
2045 described in Subsection (7)(b)(i).
2046 (b) (i) A policy of motor vehicle liability coverage may limit coverage as described in
2047 Subsection (7)(a) if the insured motor vehicle is operated by an individual described in
2048 Subsection (7)(c) if the individual described in Subsection (7)(c) is guilty of:
2049 (A) driving under the influence as described in Section 41-6a-502;
2050 (B) impaired driving as described in Section 41-6a-502.5; or
2051 (C) operating a vehicle with a measurable controlled substance in the individual's body
2052 as described in Section 41-6a-517.
2053 (ii) An individual's refusal to submit to a chemical test as described in Sections
2054 41-6a-520 and 41-6a-520.1 is admissible evidence, but not conclusive, that the individual is
2055 guilty of an offense described in Subsection (7)(b)(i).
2056 (c) A reduction in coverage as described in Subsection (7)(a) applies to the following
2057 individuals:
2058 (i) the insured;
2059 (ii) the spouse of the insured; or
2060 (iii) if the individual has a separate policy as a secondary source of coverage, and:
2061 (A) the individual is over the age of 21 and resides in the household of the insured; or
2062 (B) the individual is a permissible user of the motor vehicle.
2063 (d) A reduction in coverage as described in Subsection (7)(a) does not apply to an
2064 individual under the age of 21 who is a relative of the insured and a resident of the insured's
2065 household.
2066 (8) (a) When a claim is brought exclusively by a named insured or a person described
2067 in Subsection (1)(a)(iii) and asserted exclusively against a named insured or an individual
2068 described in Subsection (1)(a)(iii), the claimant may elect to resolve the claim:
2069 (i) by submitting the claim to binding arbitration; or
2070 (ii) through litigation.
2071 (b) Once the claimant has elected to commence litigation under Subsection (8)(a)(ii),
2072 the claimant may not elect to resolve the claim through binding arbitration under this section
2073 without the written consent of both parties and the defendant's liability insurer.
2074 (c) (i) Unless otherwise agreed on in writing by the parties, a claim that is submitted to
2075 binding arbitration under Subsection (8)(a)(i) shall be resolved by a panel of three arbitrators.
2076 (ii) Unless otherwise agreed on in writing by the parties, each party shall select an
2077 arbitrator. The arbitrators selected by the parties shall select a third arbitrator.
2078 (d) Unless otherwise agreed on in writing by the parties, each party will pay the fees
2079 and costs of the arbitrator that party selects. Both parties shall share equally the fees and costs
2080 of the third arbitrator.
2081 (e) Except as otherwise provided in this section, an arbitration procedure conducted
2082 under this section shall be governed by Title 78B, Chapter 11, Utah Uniform Arbitration Act,
2083 unless otherwise agreed on in writing by the parties.
2084 (f) (i) Discovery shall be conducted in accordance with Rules 26b through 36, Utah
2085 Rules of Civil Procedure.
2086 (ii) All issues of discovery shall be resolved by the arbitration panel.
2087 (g) A written decision of two of the three arbitrators shall constitute a final decision of
2088 the arbitration panel.
2089 (h) Prior to the rendering of the arbitration award:
2090 (i) the existence of a liability insurance policy may be disclosed to the arbitration
2091 panel; and
2092 (ii) the amount of all applicable liability insurance policy limits may not be disclosed to
2093 the arbitration panel.
2094 (i) The amount of the arbitration award may not exceed the liability limits of all the
2095 defendant's applicable liability insurance policies, including applicable liability umbrella
2096 policies. If the initial arbitration award exceeds the liability limits of all applicable liability
2097 insurance policies, the arbitration award shall be reduced to an amount equal to the liability
2098 limits of all applicable liability insurance policies.
2099 (j) The arbitration award is the final resolution of all claims between the parties unless
2100 the award was procured by corruption, fraud, or other undue means.
2101 (k) If the arbitration panel finds that the action was not brought, pursued, or defended
2102 in good faith, the arbitration panel may award reasonable fees and costs against the party that
2103 failed to bring, pursue, or defend the claim in good faith.
2104 (l) Nothing in this section is intended to limit any claim under any other portion of an
2105 applicable insurance policy.
2106 (9) An at-fault driver or an insurer issuing a policy of insurance under this part that is
2107 covering an at-fault driver may not reduce compensation to an injured party based on the
2108 injured party not being covered by a policy of insurance that provides personal injury
2109 protection coverage under Sections 31A-22-306 through 31A-22-309.
2110 Section 12. Section 31A-22-323 is enacted to read:
2111 31A-22-323. Special provisions applicable to third-party claims for substitute
2112 transportation.
2113 (1) As used in this section:
2114 (a) "Substitute transportation" means transportation that:
2115 (i) a third-party claimant uses while the third-party claimant's motor vehicle is
2116 inoperable or unavailable as described in Subsection (1)(b)(ii); and
2117 (ii) subject to market availability, is comparable to the third-party claimant's damaged
2118 motor vehicle provided by an insurer to an injured individual, including a third-party claimant;
2119 and
2120 (b) "Third-party claimant" means an individual:
2121 (i) who is involved in a motor vehicle accident for which another individual is solely at
2122 fault; and
2123 (ii) whose motor vehicle is:
2124 (A) damaged in the motor vehicle accident; and
2125 (B) inoperable or unavailable for a period of time after the motor vehicle accident and
2126 before the motor vehicle is repaired or replaced.
2127 (2) In providing substitute transportation as required under Section 31A-22-303, an
2128 insurer may not require that the third-party claimant rent a motor vehicle at the third-party
2129 claimant's expense and later seek reimbursement for the rental from the insurer.
2130 (3) An insurer that violates this section is subject to:
2131 (a) a forfeiture under Section 31A-2-308; and
2132 (b) a financial penalty equal to two times the cost of substitute transportation due to the
2133 third-party claimant.
2134 (4) The commissioner shall waive the financial penalty if the insurer pays to the
2135 third-party claimant 150% of the financial penalty described in Subsection (3)(b).
2136 Section 13. Section 31A-22-432 is enacted to read:
2137 31A-22-432. Renewal, cancellation, and modification.
2138 (1) Except as provided in this section, a life insurance policy is renewable and
2139 continues in force at the option of the policyholder.
2140 (2) An insurer may:
2141 (a) decline to renew the policy on the date the policy term expires for a reason stated in
2142 the policy; or
2143 (b) cancel the policy at any time for:
2144 (i) nonpayment of a premium when due; or
2145 (ii) intentional misrepresentation of a material fact in connection with the coverage.
2146 (3) (a) Except for a modification required by law, an insurer may only modify a policy
2147 at renewal.
2148 (b) This subsection does not apply to an endorsement by which the insurer:
2149 (i) effectuates a request the policyholder made in writing; or
2150 (ii) exercises a specifically reserved right under the policy.
2151 Section 14. Section 31A-22-523 is enacted to read:
2152 31A-22-523. Renewal, cancellation, and modification.
2153 (1) Except as provided in this section, a life insurance policy is renewable and
2154 continues in force at the option of the policyholder.
2155 (2) An insurer may:
2156 (a) decline to renew the policy on the date the policy term expires for a reason stated in
2157 the policy; or
2158 (b) cancel the policy at any time for:
2159 (i) nonpayment of a premium when due;
2160 (ii) intentional misrepresentation of a material fact in connection with the coverage; or
2161 (iii) noncompliance with an employer eligibility provision.
2162 (3) (a) Except for a modification required by law, an insurer may only modify a policy
2163 at renewal.
2164 (b) This subsection does not apply to an endorsement by which the insurer:
2165 (i) effectuates a request the policyholder made in writing; or
2166 (ii) exercises a specifically reserved right under the policy.
2167 Section 15. Section 31A-22-605 is amended to read:
2168 31A-22-605. Accident and health insurance standards.
2169 (1) The purposes of this section include:
2170 (a) reasonable standardization and simplification of terms and coverages of individual
2171 and franchise accident and health insurance policies, including accident and health insurance
2172 contracts of insurers licensed under Chapter 7, Nonprofit Health Service Insurance
2173 Corporations, and Chapter 8, Health Maintenance Organizations and Limited Health Plans, to
2174 facilitate public understanding and comparison in purchasing;
2175 (b) elimination of provisions contained in individual and franchise accident and health
2176 insurance contracts that may be misleading or confusing in connection with either the purchase
2177 of those types of coverages or the settlement of claims; and
2178 (c) full disclosure in the sale of individual and franchise accident and health insurance
2179 contracts.
2180 [
2181 [
2182
2183 [
2184
2185 [
2186
2187 [
2188 policies.
2189 [
2190 Chapter 3, Utah Administrative Rulemaking Act, relating to the following matters:
2191 (a) standards for the manner and content of policy provisions, and disclosures to be
2192 made in connection with the sale of policies covered by this section, dealing with at least the
2193 following matters:
2194 (i) terms of renewability;
2195 (ii) initial and subsequent conditions of eligibility;
2196 (iii) nonduplication of coverage provisions;
2197 (iv) coverage of dependents;
2198 (v) preexisting conditions;
2199 (vi) termination of insurance;
2200 (vii) probationary periods;
2201 (viii) limitations;
2202 (ix) exceptions;
2203 (x) reductions;
2204 (xi) elimination periods;
2205 (xii) requirements for replacement;
2206 (xiii) recurrent conditions;
2207 (xiv) coverage of persons eligible for Medicare; and
2208 (xv) definition of terms;
2209 (b) minimum standards for benefits under each of the following categories of coverage
2210 in policies covered in this section:
2211 (i) basic hospital expense coverage;
2212 (ii) basic medical-surgical expense coverage;
2213 (iii) hospital confinement indemnity coverage;
2214 (iv) major medical expense coverage;
2215 (v) income replacement coverage;
2216 (vi) accident only coverage;
2217 (vii) specified disease or specified accident coverage;
2218 (viii) limited benefit health coverage; and
2219 (ix) nursing home and long-term care coverage;
2220 (c) the content and format of the outline of coverage, in addition to that required under
2221 Subsection [
2222 (d) the method of identification of policies and contracts based upon coverages
2223 provided; and
2224 (e) rating practices.
2225 [
2226 combine categories of coverage in Subsection [
2227 categories meets the standards of a component category of coverage.
2228 [
2229 Chapter 3, Utah Administrative Rulemaking Act, relating to the following matters:
2230 (a) establishing disclosure requirements for insurance policies covered in this section,
2231 designed to adequately inform the prospective insured of the need for and extent of the
2232 coverage offered, and requiring that this disclosure be furnished to the prospective insured with
2233 the application form, unless it is a direct response insurance policy;
2234 (b) (i) prescribing caption or notice requirements designed to inform prospective
2235 insureds that particular insurance coverages are not [
2236 Medicare supplement insurance; and
2237 (ii) applying the requirements of Subsection [
2238 policies and certificates sold to persons eligible for Medicare; and
2239 (c) requiring the disclosures or information brochures to be furnished to the
2240 prospective insured on direct response insurance policies, upon his request or, in any event, no
2241 later than the time of the policy delivery.
2242 [
2243 standards established by the commissioner under Subsection [
2244 accompanies the policy or is delivered to the applicant at the time of the application, and,
2245 except with respect to direct response insurance policies, an acknowledged receipt is provided
2246 to the insurer. The outline of coverage shall include:
2247 (a) a statement identifying the applicable categories of coverage provided by the policy
2248 as prescribed under Subsection [
2249 (b) a description of the principal benefits and coverage;
2250 (c) a statement of the exceptions, reductions, and limitations contained in the policy;
2251 (d) a statement of the renewal provisions, including any reservation by the insurer of a
2252 right to change premiums;
2253 (e) a statement that the outline is a summary of the policy issued or applied for and that
2254 the policy should be consulted to determine governing contractual provisions; and
2255 (f) any other contents the commissioner prescribes.
2256 [
2257 coverage shall accompany the policy when it is delivered and it shall clearly state that it is not
2258 the policy for which application was made.
2259 [
2260 policies or certificates issued to persons eligible for Medicare shall contain a notice
2261 prominently printed on or attached to the cover or front page which states that the policyholder
2262 or certificate holder has the right to return the policy for any reason within 30 days after its
2263 delivery and to have the premium refunded.
2264 (b) This Subsection [
2265 Section 16. Section 31A-22-620 is amended to read:
2266 31A-22-620. Medicare Supplement Insurance Minimum Standards Act.
2267 (1) As used in this section:
2268 (a) "Applicant" means:
2269 (i) in the case of [
2270 insurance, the person who seeks to contract for insurance benefits; and
2271 (ii) in the case of [
2272 insurance, the proposed certificate holder.
2273 (b) "Certificate" means any certificate delivered or issued for delivery in this state
2274 under [
2275 (c) "Certificate form" means the form on which the certificate is delivered or issued for
2276 delivery by the issuer.
2277 (d) "Issuer" includes insurance companies, fraternal benefit societies, health care
2278 service plans, health maintenance organizations, and any other entity delivering, or issuing for
2279 delivery in this state, [
2280 certificates.
2281 [
2282
2283 [
2284 [
2285
2286
2287
2288
2289
2290 [
2291
2292
2293
2294 [
2295 delivery by the issuer.
2296 (2) (a) Except as otherwise specifically provided, this section applies to:
2297 (i) all [
2298 issued for delivery in this state on or after the effective date of this section;
2299 (ii) all certificates issued under group [
2300 supplement insurance, that have been delivered or issued for delivery in this state on or after
2301 the effective date of this section; and
2302 (iii) policies or certificates that were in force prior to the effective date of this section,
2303 with respect to requirements for benefits, claims payment, and policy reporting practice under
2304 Subsection (3)(d), and loss ratios under Subsection (4).
2305 (b) This section does not apply to a policy of one or more employers or labor
2306 organizations, or of the trustees of a fund established by one or more employers or labor
2307 organizations, or a combination of employers and labor unions, for employees or former
2308 employees or a combination of employees and former employees, or for members or former
2309 members of the labor organizations, or a combination of members and former members of
2310 labor organizations.
2311 (c) This section does not prohibit, nor does it apply to insurance policies or health care
2312 benefit plans, including group conversion policies, provided to Medicare eligible persons that
2313 are not marketed or held out to be [
2314 insurance or benefit plans.
2315 (3) (a) [
2316 in force in the state may not contain benefits that duplicate benefits provided by Medicare.
2317 (b) Notwithstanding any other provision of law of this state, [
2318
2319 loss incurred more than six months from the effective date of coverage because it involved a
2320 preexisting condition. The policy or certificate may not define a preexisting condition more
2321 restrictively than: "A condition for which medical advice was given or treatment was
2322 recommended by or received from a physician within six months before the effective date of
2323 coverage."
2324 (c) The commissioner shall adopt rules to establish specific standards for policy
2325 provisions of [
2326 The standards adopted shall be in addition to and in accordance with applicable laws of this
2327 state. A requirement of this title relating to minimum required policy benefits, other than the
2328 minimum standards contained in this section, may not apply to [
2329 Medicare supplement insurance and certificates. The standards may include:
2330 (i) terms of renewability;
2331 (ii) initial and subsequent conditions of eligibility;
2332 (iii) nonduplication of coverage;
2333 (iv) probationary periods;
2334 (v) benefit limitations, exceptions, and reductions;
2335 (vi) elimination periods;
2336 (vii) requirements for replacement;
2337 (viii) recurrent conditions; and
2338 (ix) definitions of terms.
2339 (d) The commissioner shall adopt rules establishing minimum standards for benefits,
2340 claims payment, marketing practices, compensation arrangements, and reporting practices for
2341 [
2342 (e) The commissioner may adopt rules to conform [
2343 Medicare supplement insurance and certificates to the requirements of federal law and
2344 regulations, including:
2345 (i) requiring refunds or credits if the policies do not meet loss ratio requirements;
2346 (ii) establishing a uniform methodology for calculating and reporting loss ratios;
2347 (iii) assuring public access to policies, premiums, and loss ratio information of issuers
2348 of Medicare supplement insurance;
2349 (iv) establishing a process for approving or disapproving policy forms and certificate
2350 forms and proposed premium increases;
2351 (v) establishing a policy for holding public hearings prior to approval of premium
2352 increases;
2353 (vi) establishing standards for Medicare select policies and certificates; and
2354 (vii) nondiscrimination for genetic testing or genetic information.
2355 (f) The commissioner may adopt rules that prohibit policy provisions not otherwise
2356 specifically authorized by statute that, in the opinion of the commissioner, are unjust, unfair, or
2357 unfairly discriminatory to any person insured or proposed to be insured under [
2358
2359 (4) [
2360 policyholders benefits that are reasonable in relation to the premium charged. The
2361 commissioner shall make rules to establish minimum standards for loss ratios of [
2362
2363 experience, or incurred health care expenses where coverage is provided by a health
2364 maintenance organization on a service basis rather than on a reimbursement basis, and earned
2365 premiums in accordance with accepted actuarial principles and practices.
2366 (5) (a) To provide for full and fair disclosure in the sale of [
2367
2368 insurance or a certificate may not be delivered in this state unless an outline of coverage is
2369 delivered to the applicant at the time application is made.
2370 (b) The commissioner shall prescribe the format and content of the outline of coverage
2371 required by Subsection (5)(a).
2372 (c) For purposes of this section, "format" means style arrangements and overall
2373 appearance, including such items as the size, color, and prominence of type and arrangement of
2374 text and captions. The outline of coverage shall include:
2375 (i) a description of the principal benefits and coverage provided in the policy;
2376 (ii) a statement of the renewal provisions, including any reservation by the issuer of a
2377 right to change premiums; and disclosure of the existence of any automatic renewal premium
2378 increases based on the policyholder's age; and
2379 (iii) a statement that the outline of coverage is a summary of the policy issued or
2380 applied for and that the policy should be consulted to determine governing contractual
2381 provisions.
2382 (d) The commissioner may make rules for captions or notice if the commissioner finds
2383 that the rules are:
2384 (i) in the public interest; and
2385 (ii) designed to inform prospective insureds that particular insurance coverages are not
2386 Medicare supplement coverages, for all accident and health insurance policies sold to persons
2387 eligible for Medicare, other than:
2388 (A) [
2389 (B) a disability income policy.
2390 (e) The commissioner may prescribe by rule a standard form and the contents of an
2391 informational brochure for persons eligible for Medicare, that is intended to improve the
2392 buyer's ability to select the most appropriate coverage and improve the buyer's understanding of
2393 Medicare. Except in the case of direct response insurance policies, the commissioner may
2394 require by rule that the informational brochure be provided concurrently with delivery of the
2395 outline of coverage to any prospective insureds eligible for Medicare. With respect to direct
2396 response insurance policies, the commissioner may require by rule that the prescribed brochure
2397 be provided upon request to any prospective insureds eligible for Medicare, but in no event
2398 later than the time of policy delivery.
2399 (f) The commissioner may adopt reasonable rules to govern the full and fair disclosure
2400 of the information in connection with the replacement of accident and health policies,
2401 subscriber contracts, or certificates by persons eligible for Medicare.
2402 (6) Notwithstanding Subsection (1), [
2403 supplement insurance and certificates shall have a notice prominently printed on the first page
2404 of the policy or certificate, or attached to the front page, stating in substance that the applicant
2405 has the right to return the policy or certificate within 30 days of its delivery and to have the
2406 premium refunded if, after examination of the policy or certificate, the applicant is not satisfied
2407 for any reason. Any refund made pursuant to this section shall be paid directly to the applicant
2408 by the issuer in a timely manner.
2409 (7) Every issuer of Medicare supplement insurance policies or certificates in this state
2410 shall provide a copy of any Medicare supplement advertisement intended for use in this state,
2411 whether through written or broadcast medium, to the commissioner for review.
2412 (8) The commissioner may adopt rules to conform Medicare and [
2413
2414 requirements of federal law and regulation.
2415 Section 17. Section 31A-22-802 is amended to read:
2416 31A-22-802. Definitions.
2417 As used in this part:
2418 [
2419
2420
2421 [
2422
2423 [
2424 money loaned or for goods, services, or properties sold or leased is to be made on future dates.
2425 [
2426 services, or property, for which payment is arranged through a credit transaction, or any
2427 successor to the right, title, or interest of any lender or vendor.
2428 [
2429 a lease intended as security, of goods, services, or property, for which payment is arranged
2430 through a credit transaction.
2431 [
2432 connection with a credit transaction, including principal finance charges and interest.
2433 [
2434 indebtedness, exclusive of any unearned interest, any insurance on the monthly outstanding
2435 balance coverage, or any finance charge.
2436 [
2437 termination.
2438 Section 18. Section 31A-22-2002 is amended to read:
2439 31A-22-2002. Definitions.
2440 As used in this part:
2441 (1) "Applicant" means:
2442 (a) when referring to an individual limited long-term care insurance policy, the person
2443 who seeks to contract for benefits; and
2444 (b) when referring to a group limited long-term care insurance policy, the proposed
2445 certificate holder.
2446 (2) "Elimination period" means the length of time between meeting the eligibility for
2447 benefit payment and receiving benefit payments from an insurer.
2448 (3) "Group limited long-term care insurance" means a limited long-term care insurance
2449 policy that is delivered or issued for delivery:
2450 (a) in this state; and
2451 (b) to an eligible group, as described under Subsection [
2452 31A-22-701(1).
2453 (4) (a) "Limited long-term care insurance" means an insurance policy, endorsement, or
2454 rider that is advertised, marketed, offered, or designed to provide coverage:
2455 (i) for less than 12 consecutive months for each covered person;
2456 (ii) on an expense-incurred, indemnity, prepaid or other basis; and
2457 (iii) for one or more necessary or medically necessary diagnostic, preventative,
2458 therapeutic, rehabilitative, maintenance, or personal care services that is provided in a setting
2459 other than an acute care unit of a hospital.
2460 (b) "Limited long-term care insurance" includes a policy or rider described in
2461 Subsection (4)(a) that provides for payment of benefits based on cognitive impairment or the
2462 loss of functional capacity.
2463 (c) "Limited long-term care insurance" does not include an insurance policy that is
2464 offered primarily to provide:
2465 (i) basic Medicare supplement [
2466 (ii) basic hospital expense coverage;
2467 (iii) basic medical-surgical expense coverage;
2468 (iv) hospital confinement indemnity coverage;
2469 (v) major medical expense coverage;
2470 (vi) disability income or related asset-protection coverage;
2471 (vii) accidental only coverage;
2472 (viii) specified disease or specified accident coverage; or
2473 (ix) limited benefit health coverage.
2474 (5) "Preexisting condition" means a condition for which medical advice or treatment is
2475 recommended:
2476 (a) by, or received from, a provider of health care services; and
2477 (b) within six months before the day on which the coverage of an insured person
2478 becomes effective.
2479 (6) "Waiting period" means the time an insured waits before some or all of the
2480 insured's coverage becomes effective.
2481 Section 19. Section 31A-23a-105 is amended to read:
2482 31A-23a-105. General requirements for individual and agency license issuance
2483 and renewal.
2484 (1) (a) The commissioner shall issue or renew a license to a person described in
2485 Subsection (1)(b) to act as:
2486 (i) a producer;
2487 (ii) a surplus lines producer;
2488 (iii) a limited line producer;
2489 (iv) a consultant;
2490 (v) a managing general agent; or
2491 (vi) a reinsurance intermediary.
2492 (b) The commissioner shall issue or renew a license under Subsection (1)(a) to a
2493 person who, as to the license type and line of authority classification applied for under Section
2494 31A-23a-106:
2495 (i) satisfies the application requirements under Section 31A-23a-104;
2496 (ii) satisfies the character requirements under Section 31A-23a-107;
2497 (iii) satisfies applicable continuing education requirements under Section
2498 31A-23a-202;
2499 (iv) satisfies applicable examination requirements under Section 31A-23a-108;
2500 (v) satisfies applicable training period requirements under Section 31A-23a-203;
2501 (vi) if an applicant for a resident individual producer license, certifies that, to the extent
2502 applicable, the applicant:
2503 (A) is in compliance with Section 31A-23a-203.5; and
2504 (B) will maintain compliance with Section 31A-23a-203.5 during the period for which
2505 the license is issued or renewed;
2506 (vii) has not committed an act that is a ground for denial, suspension, or revocation as
2507 provided in Section 31A-23a-111;
2508 (viii) if a nonresident:
2509 (A) complies with Section 31A-23a-109; and
2510 (B) holds an active similar license in that person's home state;
2511 (ix) if an applicant for an individual title insurance producer or agency title insurance
2512 producer license, satisfies the requirements of Section 31A-23a-204;
2513 (x) if an applicant for a license to act as a life settlement provider or life settlement
2514 producer, satisfies the requirements of Section 31A-23a-117; and
2515 (xi) pays the applicable fees under Section 31A-3-103.
2516 (2) (a) This Subsection (2) applies to the following persons:
2517 (i) an applicant for a pending:
2518 (A) individual or agency producer license;
2519 (B) surplus lines producer license;
2520 (C) limited line producer license;
2521 (D) consultant license;
2522 (E) managing general agent license; or
2523 (F) reinsurance intermediary license; or
2524 (ii) a licensed:
2525 (A) individual or agency producer;
2526 (B) surplus lines producer;
2527 (C) limited line producer;
2528 (D) consultant;
2529 (E) managing general agent; or
2530 (F) reinsurance intermediary.
2531 (b) A person described in Subsection (2)(a) shall report to the commissioner:
2532 (i) an administrative action taken against the person, including a denial of a new or
2533 renewal license application:
2534 (A) in another jurisdiction; or
2535 (B) by another regulatory agency in this state; [
2536 (ii) a criminal prosecution taken against the person in any jurisdiction[
2537 (iii) a civil action filed against the person in any jurisdiction if the action involves
2538 conduct related to a professional or occupational license, certification, authorization, or
2539 registration, regardless of whether the person held the license, certification, authorization, or
2540 registration.
2541 (c) The report required by Subsection (2)(b) shall:
2542 (i) be filed:
2543 (A) at the time the person files the application for an individual or agency license; and
2544 (B) for an action or prosecution that occurs on or after the day on which the person
2545 files the application:
2546 (I) for an administrative action, within 30 days of the final disposition of the
2547 administrative action; or
2548 (II) for a criminal prosecution or civil action, within 30 days of the initial appearance
2549 before a court; and
2550 (ii) include a copy of the complaint or other relevant legal documents related to the
2551 action or prosecution described in Subsection (2)(b).
2552 (3) (a) The department may require a person applying for a license or for consent to
2553 engage in the business of insurance to submit to a criminal background check as a condition of
2554 receiving a license or consent.
2555 (b) A person, if required to submit to a criminal background check under Subsection
2556 (3)(a), shall:
2557 (i) submit a fingerprint card in a form acceptable to the department; and
2558 (ii) consent to a fingerprint background check by:
2559 (A) the Utah Bureau of Criminal Identification; and
2560 (B) the Federal Bureau of Investigation.
2561 (c) For a person who submits a fingerprint card and consents to a fingerprint
2562 background check under Subsection (3)(b), the department may request:
2563 (i) criminal background information maintained pursuant to Title 53, Chapter 10, Part
2564 2, Bureau of Criminal Identification, from the Bureau of Criminal Identification; and
2565 (ii) complete Federal Bureau of Investigation criminal background checks through the
2566 national criminal history system.
2567 (d) Information obtained by the department from the review of criminal history records
2568 received under this Subsection (3) shall be used by the department for the purposes of:
2569 (i) determining if a person satisfies the character requirements under Section
2570 31A-23a-107 for issuance or renewal of a license;
2571 (ii) determining if a person has failed to maintain the character requirements under
2572 Section 31A-23a-107; and
2573 (iii) preventing a person who violates the federal Violent Crime Control and Law
2574 Enforcement Act of 1994, 18 U.S.C. Sec. 1033, from engaging in the business of insurance in
2575 the state.
2576 (e) If the department requests the criminal background information, the department
2577 shall:
2578 (i) pay to the Department of Public Safety the costs incurred by the Department of
2579 Public Safety in providing the department criminal background information under Subsection
2580 (3)(c)(i);
2581 (ii) pay to the Federal Bureau of Investigation the costs incurred by the Federal Bureau
2582 of Investigation in providing the department criminal background information under
2583 Subsection (3)(c)(ii); and
2584 (iii) charge the person applying for a license or for consent to engage in the business of
2585 insurance a fee equal to the aggregate of Subsections (3)(e)(i) and (ii).
2586 (4) To become a resident licensee in accordance with Section 31A-23a-104 and this
2587 section, a person licensed as one of the following in another state who moves to this state shall
2588 apply within 90 days of establishing legal residence in this state:
2589 (a) insurance producer;
2590 (b) surplus lines producer;
2591 (c) limited line producer;
2592 (d) consultant;
2593 (e) managing general agent; or
2594 (f) reinsurance intermediary.
2595 (5) (a) The commissioner may deny a license application for a license listed in
2596 Subsection (5)(b) if the person applying for the license, as to the license type and line of
2597 authority classification applied for under Section 31A-23a-106:
2598 (i) fails to satisfy the requirements as set forth in this section; or
2599 (ii) commits an act that is grounds for denial, suspension, or revocation as set forth in
2600 Section 31A-23a-111.
2601 (b) This Subsection (5) applies to the following licenses:
2602 (i) producer;
2603 (ii) surplus lines producer;
2604 (iii) limited line producer;
2605 (iv) consultant;
2606 (v) managing general agent; or
2607 (vi) reinsurance intermediary.
2608 (6) Notwithstanding the other provisions of this section, the commissioner may:
2609 (a) issue a license to an applicant for a license for a title insurance line of authority only
2610 with the concurrence of the Title and Escrow Commission; and
2611 (b) renew a license for a title insurance line of authority only with the concurrence of
2612 the Title and Escrow Commission.
2613 Section 20. Section 31A-23a-119 is enacted to read:
2614 31A-23a-119. Special requirements for agency title insurance producers.
2615 (1) As used in this section:
2616 (a) "Applicable percentage" means:
2617 (i) on February 1, 2024, through January 31, 2025, 2.5%;
2618 (ii) on February 1, 2025, through January 31, 2026, 3%;
2619 (iii) on February 1, 2026, through January 31, 2027, 3.5%;
2620 (iv) on February 1, 2027, through January 31, 2028, 4%; and
2621 (v) on February 1, 2028, through January 31, 2029, 4.5%.
2622 (b) "Sufficient capital and net worth" means:
2623 (i) for a new title entity:
2624 (A) $100,000 for the first five years after becoming a new agency title insurance
2625 producer; or
2626 (B) after the first five years after becoming a new agency title insurance producer, the
2627 greater of $50,000, or on February 1 of each year, an amount equal to 5% of the title entity's
2628 average annual gross revenue over the preceding two calendar years, up to $150,000; or
2629 (ii) for a title entity licensed before May 14, 2019:
2630 (A) for the time period beginning on February 1, 2020, and ending on January 31,
2631 2029, the lesser of an amount equal to the applicable percentage of the title entity's average
2632 annual gross revenue over the two calendar years immediately preceding the February 1 on
2633 which the applicable percentage applies or $150,000; and
2634 (B) beginning on February 1, 2029, the greater of $50,000 or an amount equal to 5% of
2635 the title entity's average annual gross revenue over the preceding two calendar years, up to
2636 $150,000.
2637 (2) Before May 1 of each year, each agency title insurance producer shall submit a
2638 report to the commissioner containing proof satisfactory to the commissioner that the agency
2639 title insurance producer had sufficient capital and net worth for the preceding calendar year.
2640 Section 21. Section 31A-23a-406 is amended to read:
2641 31A-23a-406. Title insurance producer's business.
2642 (1) As used in this section:
2643 (a) "Automated clearing house network" or "ACH network" means a national
2644 electronic funds transfer system regulated by the Federal Reserve and the Office of the
2645 Comptroller of the Currency.
2646 (b) "Depository institution" means the same as that term is defined in Section 7-1-103.
2647 (c) "Funds transfer system" means the same as that term is defined in Section
2648 [
2649 (2) An individual title insurance producer or agency title insurance producer may do
2650 escrow involving real property transactions if all of the following exist:
2651 (a) the individual title insurance producer or agency title insurance producer is licensed
2652 with:
2653 (i) the title line of authority; and
2654 (ii) the escrow subline of authority;
2655 (b) the individual title insurance producer or agency title insurance producer is
2656 appointed by a title insurer authorized to do business in the state;
2657 (c) except as provided in Subsection (4), the individual title insurance producer or
2658 agency title insurance producer issues one or more of the following as part of the transaction:
2659 (i) an owner's policy offering title insurance;
2660 (ii) a lender's policy offering title insurance; or
2661 (iii) if the transaction does not involve a transfer of ownership, an endorsement to an
2662 owner's or a lender's policy offering title insurance;
2663 (d) money deposited with the individual title insurance producer or agency title
2664 insurance producer in connection with any escrow is deposited:
2665 (i) in a federally insured depository institution, as defined in Section 7-1-103, that:
2666 (A) has a branch in this state, if the individual title insurance producer or agency title
2667 insurance producer depositing the money is a resident licensee; and
2668 (B) is authorized by the depository institution's primary regulator to engage in trust
2669 business, as defined in Section 7-5-1, in this state; and
2670 (ii) in a trust account that is separate from all other trust account money that is not
2671 related to real estate transactions;
2672 (e) money deposited with the individual title insurance producer or agency title
2673 insurance producer in connection with any escrow is the property of the one or more persons
2674 entitled to the money under the provisions of the escrow;
2675 (f) money deposited with the individual title insurance producer or agency title
2676 insurance producer in connection with an escrow is segregated escrow by escrow in the records
2677 of the individual title insurance producer or agency title insurance producer;
2678 (g) earnings on money held in escrow may be paid out of the [
2679 any person in accordance with the conditions of the escrow;
2680 (h) the escrow does not require the individual title insurance producer or agency title
2681 insurance producer to hold:
2682 (i) construction money; or
2683 (ii) money held for exchange under Section 1031, Internal Revenue Code; and
2684 (i) the individual title insurance producer or agency title insurance producer shall
2685 maintain a physical office in Utah staffed by a person with an escrow subline of authority who
2686 processes the escrow.
2687 (3) Notwithstanding Subsection (2), an individual title insurance producer or agency
2688 title insurance producer may engage in the escrow business if:
2689 (a) the escrow involves:
2690 (i) a mobile home;
2691 (ii) a grazing right;
2692 (iii) a water right; or
2693 (iv) other personal property authorized by the commissioner; and
2694 (b) the individual title insurance producer or agency title insurance producer complies
2695 with this section except for Subsection (2)(c).
2696 (4) (a) Subsection (2)(c) does not apply if the transaction is for the transfer of real
2697 property from the School and Institutional Trust Lands Administration.
2698 (b) This subsection does not prohibit an individual title insurance producer or agency
2699 title insurance producer from issuing a policy described in Subsection (2)(c) as part of a
2700 transaction described in Subsection (4)(a).
2701 (5) Money held in escrow:
2702 (a) is not subject to any debts of the individual title insurance producer or agency title
2703 insurance producer;
2704 (b) may only be used to fulfill the terms of the individual escrow under which the
2705 money is accepted; and
2706 (c) may not be used until the conditions of the escrow are met.
2707 (6) Assets or property other than escrow money received by an individual title
2708 insurance producer or agency title insurance producer in accordance with an escrow shall be
2709 maintained in a manner that will:
2710 (a) reasonably preserve and protect the asset or property from loss, theft, or damages;
2711 and
2712 (b) otherwise comply with the general duties and responsibilities of a fiduciary or
2713 bailee.
2714 (7) (a) A check from the trust account described in Subsection (2)(d) may not be
2715 drawn, executed, or dated, or money otherwise disbursed unless the segregated [
2716 account from which money is to be disbursed contains a sufficient credit balance consisting of
2717 collected and cleared money at the time the check is drawn, executed, or dated, or money is
2718 otherwise disbursed.
2719 (b) As used in this Subsection (7), money is considered to be "collected and cleared,"
2720 and may be disbursed as follows:
2721 (i) cash may be disbursed on the same day the cash is deposited;
2722 (ii) a wire transfer may be disbursed on the same day the wire transfer is deposited;
2723 (iii) the proceeds of one or more of the following financial instruments may be
2724 disbursed on the same day the financial instruments are deposited if received from a single
2725 party to the real estate transaction and if the aggregate of the financial instruments for the real
2726 estate transaction is less than $10,000:
2727 (A) a cashier's check, certified check, or official check that is drawn on an existing
2728 account at a federally insured financial institution;
2729 (B) a check drawn on the trust account of a principal broker or associate broker
2730 licensed under Title 61, Chapter 2f, Real Estate Licensing and Practices Act, if the individual
2731 title insurance producer or agency title insurance producer has reasonable and prudent grounds
2732 to believe sufficient money will be available from the trust account on which the check is
2733 drawn at the time of disbursement of proceeds from the individual title insurance producer or
2734 agency title insurance producer's [
2735 (C) a personal check not to exceed $500 per closing; or
2736 (D) a check drawn on the [
2737 producer or agency title insurance producer, if the individual title insurance producer or agency
2738 title insurance producer in the escrow transaction has reasonable and prudent grounds to
2739 believe that sufficient money will be available for withdrawal from the account upon which the
2740 check is drawn at the time of disbursement of money from the [
2741 individual title insurance producer or agency title insurance producer in the escrow transaction;
2742 (iv) deposits made through the ACH network may be disbursed on the same day the
2743 deposit is made if:
2744 (A) the transferred funds remain uniquely designated and traceable throughout the
2745 entire ACH network transfer process;
2746 (B) except as a function of the ACH network process, the transferred funds are not
2747 subject to comingling or third party access during the transfer process;
2748 (C) the transferred funds are deposited into the title insurance producer's [
2749 account and are available for disbursement; and
2750 (D) either the ACH network payment type or the title insurance producer's systems
2751 prevent the transaction from being unilaterally canceled or reversed by the consumer once the
2752 transferred funds are deposited to the individual title insurance producer or agency title
2753 producer; or
2754 (v) deposits may be disbursed on the same day the deposit is made if the deposit is
2755 made via:
2756 (A) the Federal Reserve Bank through the Federal Reserve's Fedwire funds transfer
2757 system; or
2758 (B) a funds transfer system provided by an association of [
2759 depository institutions.
2760 (c) A check or deposit not described in Subsection (7)(b) may be disbursed:
2761 (i) within the time limits provided under the Expedited Funds Availability Act, 12
2762 U.S.C. Sec. 4001 et seq., as amended, and related regulations of the Federal Reserve System; or
2763 (ii) upon notification from the financial institution to which the money has been
2764 deposited that final settlement has occurred on the deposited financial instrument.
2765 (8) An individual title insurance producer or agency title insurance producer shall
2766 maintain a record of a receipt or disbursement of escrow money.
2767 (9) An individual title insurance producer or agency title insurance producer shall
2768 comply with:
2769 (a) Section 31A-23a-409;
2770 (b) Title 46, Chapter 1, Notaries Public Reform Act; and
2771 (c) any rules adopted by the Title and Escrow Commission, subject to Section
2772 31A-2-404, that govern escrows.
2773 (10) If an individual title insurance producer or agency title insurance producer
2774 conducts a search for real estate located in the state, the individual title insurance producer or
2775 agency title insurance producer shall conduct a reasonable search of the public records.
2776 Section 22. Section 31A-23a-413 is amended to read:
2777 31A-23a-413. Title insurance producer's annual report.
2778 An agency title insurance producer [
2779
2780
2781 specifies by rule, a verified statement of the agency title insurance producer's [
2782
2783 preceding calendar year.
2784 Section 23. Section 31A-27a-108.1 is enacted to read:
2785 31A-27a-108.1. Injunctions and orders applicable to a federal home loan bank.
2786 (1) As used in this section:
2787 (a) "Federal home loan bank" means the same as that term is defined in 12 U.S.C. Sec.
2788 1422.
2789 (b) "Insurer-member" means an insurer that is a member as defined in 12 U.S.C. Sec.
2790 1422.
2791 (2) (a) Notwithstanding any other provision of this chapter, after the seventh day
2792 following the filing of a delinquency proceeding, a state court may not stay or prohibit a federal
2793 home loan bank from exercising its rights regarding collateral pledged by an insurer-member.
2794 (b) A federal home loan bank may repurchase any outstanding capital stock that is in
2795 excess of the amount of federal home loan bank stock that the federal loan bank requires the
2796 insurer-member to hold as a minimum investment if:
2797 (i) the insurer-member is subject to a delinquency proceeding;
2798 (ii) the federal home loan bank exercises the federal home loan bank's rights regarding
2799 collateral pledged by the insurer-member;
2800 (iii) the federal home loan bank, in good faith, determines the repurchase is permissible
2801 under applicable laws, regulations, regulatory obligations, and the federal home loan bank's
2802 capital plan; and
2803 (iv) the repurchase is consistent with the federal home loan bank's current capital stock
2804 practices that apply to the federal home loan bank's entire membership.
2805 (c) Subject to Subsection (2)(c)(ii), after a court appoints a receiver for an
2806 insurer-member, a federal home loan bank shall provide the receiver a process, and establish a
2807 timeline, for the following:
2808 (i) the release of collateral that exceeds the amount required to support secured
2809 obligations remaining after any repayment of loans as determined in accordance with the
2810 applicable agreements between the federal home loan bank and the insurer-member;
2811 (ii) the release of any of the insurer-member's collateral remaining in the federal home
2812 loan bank's possession following full repayment of all outstanding secured obligations of the
2813 insurer-member;
2814 (iii) the payment of fees owed by the insurer-member and the operation of deposits and
2815 other accounts of the insurer-member with the federal home loan bank; and
2816 (iv) the possible redemption or repurchase of federal home loan bank stock or excess
2817 stock of any class that an insurer-member is required to own.
2818 (d) An insurer-member shall provide the information described in Subsection (2)(c)(i)
2819 within 10 business days after the day on which the receiver requests the information.
2820 (e) Upon request from a receiver, a federal home loan bank shall provide any available
2821 options for an insurer-member subject to a delinquency proceeding to renew or restructure a
2822 loan to defer associated prepayment fees, subject to:
2823 (i) market conditions;
2824 (ii) the terms of any loan outstanding to the insurer-member;
2825 (iii) the applicable policies of the federal home loan bank; and
2826 (iv) the federal home loan bank's compliance with federal laws and regulations.
2827 (3) (a) Notwithstanding any other provision of this chapter, the receiver for an
2828 insurer-member may not void any transfer of, or any obligation to transfer, money or any other
2829 property arising under or in connection with:
2830 (i) any federal home loan bank security agreement;
2831 (ii) any pledge, security, collateral, or guarantee agreement; or
2832 (iii) any other similar arrangement or credit enhancement relating to a federal home
2833 loan bank security agreement made in the ordinary course of business and in compliance with
2834 the applicable federal home loan bank agreement.
2835 (b) Notwithstanding Subsection (3)(a), an insurer-member may avoid a transfer if a
2836 party to the transfer made the transfer with intent to hinder, delay, or defraud the
2837 insurer-member, the receiver for the insurer-member, or an existing or future creditor.
2838 (c) This subsection shall not affect a receiver's rights regarding advances to an
2839 insurer-member in a delinquency proceeding pursuant to 12 C.F.R. Sec. 1266.4.
2840 Section 24. Section 31A-28-113 is amended to read:
2841 31A-28-113. Credit for assessments paid.
2842 (1) (a) A member insurer may offset against its premium tax, income tax, or franchise
2843 tax liability to this state an assessment described in Subsection 31A-28-109(2)(b) to the extent
2844 of 20% of the amount of the assessment for each of the five calendar years following the year
2845 in which the assessment was paid.
2846 (b) To the extent that the offsets described in Subsection (1)(a) exceed [
2847 liability, the offsets may be carried forward and used to offset [
2848 years.
2849 (c) If a member insurer ceases doing business, all uncredited assessments may be
2850 credited against its [
2851 (2) (a) A member insurer that is exempt from taxes described in Subsection (1) may
2852 recoup the member insurer's assessment by a surcharge on premiums in a sum reasonably
2853 calculated to recoup the assessments over a reasonable period of time, as approved by the
2854 commissioner.
2855 (b) Amounts recouped shall not be considered premiums for any other purpose,
2856 including the computation of gross premium tax, income tax, franchise tax, producer
2857 commission, or, to the extent allowed under federal law, medical loss ratio.
2858 (c) If a member insurer collects excess surcharges, the member insurer shall remit the
2859 excess amount to the association, and the excess amount shall be applied to reduce future
2860 assessments in the appropriate account.
2861 (3) (a) Money shall be paid by the member insurers to the state in a manner required by
2862 the State Tax Commission if the money:
2863 (i) is acquired by refund in accordance with Subsection 31A-28-109(6) from the
2864 association by member insurers; and
2865 (ii) has been offset against [
2866 (b) The association shall notify the commissioner that the refunds described in
2867 Subsection (3)(a) have been made.
2868 Section 25. Section 31A-31-108 is amended to read:
2869 31A-31-108. Assessment of insurers.
2870 (1) For purposes of this section:
2871 (a) The commissioner shall by rule made in accordance with Title 63G, Chapter 3,
2872 Utah Administrative Rulemaking Act, define:
2873 (i) "annuity consideration";
2874 (ii) "membership fees";
2875 (iii) "other fees";
2876 (iv) "deposit-type contract funds"; and
2877 (v) "other considerations in Utah."
2878 (b) "Insurance fraud provisions" means:
2879 (i) this chapter;
2880 (ii) Section 34A-2-110; and
2881 (iii) Section 76-6-521.
2882 (c) "Utah consideration" means:
2883 (i) the total premiums written for Utah risks;
2884 (ii) annuity consideration;
2885 (iii) membership fees collected by the insurer;
2886 (iv) other fees collected by the insurer;
2887 (v) deposit-type contract funds; and
2888 (vi) other considerations in Utah.
2889 (d) "Utah risks" means insurance coverage on the lives, health, or against the liability
2890 of persons residing in Utah, or on property located in Utah, other than property temporarily in
2891 transit through Utah.
2892 (2) To implement insurance fraud provisions, the commissioner may assess an
2893 admitted insurer and a nonadmitted insurer transacting insurance under Chapter 15, Part 1,
2894 Unauthorized Insurers and Surplus Lines, and Chapter 15, Part 2, Risk Retention Groups Act,
2895 an annual fee as follows:
2896 (a) [
2897 or equal to $1,000,000;
2898 (b) [
2899 than $1,000,000 but is less than or equal to $2,500,000;
2900 (c) [
2901 than $2,500,000 but is less than or equal to $5,000,000;
2902 (d) [
2903 greater than $5,000,000 but less than or equal to $10,000,000;
2904 (e) [
2905 greater than $10,000,000 but less than $50,000,000; and
2906 (f) [
2907 or exceeds $50,000,000.
2908 (3) Money received by the state under this section shall be deposited into the Insurance
2909 Fraud Investigation Restricted Account created in Subsection (4).
2910 (4) (a) There is created in the General Fund a restricted account known as the
2911 "Insurance Fraud Investigation Restricted Account."
2912 (b) The Insurance Fraud Investigation Restricted Account shall consist of the money
2913 received by the commissioner under this section and Subsections 31A-31-109(1)(a)(ii), (1)(b),
2914 (2)(b)(i), (2)(c), and (3)(a). Money ordered paid under Subsections 31A-31-109(1)(a)(i) and
2915 (2)(a) shall be deposited in the Insurance Fraud Victim Restitution Fund pursuant to Section
2916 31A-31-108.5.
2917 (c) The commissioner shall administer the Insurance Fraud Investigation Restricted
2918 Account. Subject to appropriations by the Legislature, the commissioner shall use the money
2919 deposited into the Insurance Fraud Investigation Restricted Account to pay for a cost or
2920 expense incurred by the commissioner in the administration, investigation, and enforcement of
2921 insurance fraud provisions.
2922 Section 26. Section 31A-35-202 is amended to read:
2923 31A-35-202. Board responsibilities.
2924 (1) The board shall:
2925 (a) meet:
2926 (i) at least quarterly; and
2927 (ii) at the call of the chair;
2928 (b) make written recommendations to the commissioner for rules governing the
2929 following aspects of the bail bond insurance business:
2930 (i) qualifications, applications, and fees for obtaining:
2931 (A) a license required by this Section 31A-35-401; or
2932 (B) a certificate;
2933 (ii) limits on the aggregate amounts of bail bonds;
2934 (iii) unprofessional conduct;
2935 (iv) procedures for hearing and resolving allegations of unprofessional conduct; and
2936 (v) sanctions for unprofessional conduct;
2937 (c) screen:
2938 (i) bail bond agency license applications; and
2939 (ii) persons applying for a bail bond agency license; and
2940 (d) recommend to the commissioner action regarding the granting, [
2941 suspending, revoking, and reinstating of bail bond agency license.
2942 (2) Nothing in Subsection (1)(d) precludes the commissioner from suspending a license
2943 under Section 31A-35-504.
2944 [
2945 (a) conduct investigations of allegations of unprofessional conduct on the part of
2946 persons or bail bond agencies involved in the business of bail bond insurance; and
2947 (b) provide the results of the investigations described in Subsection [
2948 the commissioner with recommendations for:
2949 (i) action; and
2950 (ii) any appropriate sanctions.
2951 Section 27. Section 31A-35-406 is amended to read:
2952 31A-35-406. Initial licensing, license renewal, and license reinstatement.
2953 (1) An applicant for an initial bail bond agency license shall:
2954 (a) complete and submit to the department an application;
2955 (b) submit to the department, as applicable, a copy of the applicant's:
2956 (i) irrevocable letter of credit, as required under Subsection 31A-35-404(1);
2957 (ii) verified financial statement, as required under Subsection 31A-35-404(2); or
2958 (iii) qualifying power of attorney, as required under Subsection 31A-35-404(3); and
2959 (c) pay the department the applicable renewal fee established in accordance with
2960 Section 31A-3-103.
2961 (2) (a) A license under this chapter expires annually effective at midnight on August
2962 [
2963 (b) To renew a bail bond agency license issued under this chapter, on or before [
2964
2965 (i) complete and submit to the department a renewal application that includes
2966 certification that:
2967 (A) a principal of the agency attended or participated by telephone in at least one entire
2968 board meeting during the 12-month period before [
2969 (B) as of May 1, the agency complies with aggregate bond limits established by rule
2970 made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act;
2971 (ii) submit to the department, as applicable, a copy of the applicant's:
2972 (A) irrevocable letter of credit, as required under Subsection 31A-35-404(1);
2973 (B) verified financial statement, as required under Subsection 31A-35-404(2); or
2974 (C) qualifying power of attorney, as required under Subsection 31A-35-404(3); and
2975 (iii) pay the department the applicable renewal fee established in accordance with
2976 Section 31A-3-103.
2977 (c) A bail bond agency shall renew the bail bond agency's license under this chapter
2978 annually as established by department rule, regardless of when the license is issued.
2979 (3) (a) A bail bond agency may apply for reinstatement of an expired bail bond agency
2980 license within one year after the day on which the license expires by complying with the
2981 renewal requirements described in Subsection (2).
2982 (b) If a bail bond agency license has been expired for more than one year, the person
2983 applying for reinstatement of the bail bond agency license shall comply with the initial
2984 licensing requirements described in Subsection (1).
2985 (4) If a bail bond agency license is suspended, the applicant may not submit an
2986 application for a bail bond agency license until after the day on which the period of suspension
2987 ends.
2988 (5) The department shall deposit a fee collected under this section in the restricted
2989 account created in Section 31A-35-407.
2990 Section 28. Section 31A-37-202 is amended to read:
2991 31A-37-202. Permissive areas of insurance.
2992 (1) Except as provided in Subsections (2) and (3), a captive insurance company may
2993 not directly insure a risk other than the risk of the captive insurance company's parent or
2994 affiliated company.
2995 (2) In addition to the risks described in Subsection (1), an association captive insurance
2996 company may insure the risk of:
2997 (a) a member organization of the association captive insurance company's association;
2998 or
2999 (b) an affiliate of a member organization of the association captive insurance
3000 company's association.
3001 (3) The following may insure a risk of a controlled unaffiliated business:
3002 (a) an industrial insured captive insurance company;
3003 (b) a protected cell;
3004 (c) a pure captive insurance company; or
3005 (d) a sponsored captive insurance company.
3006 (4) To the extent allowed by a captive insurance company's organizational charter, a
3007 captive insurance company may provide any type of insurance described in this title, except:
3008 (a) workers' compensation insurance;
3009 (b) personal motor vehicle insurance;
3010 (c) homeowners' insurance; and
3011 (d) any component of the types of insurance described in Subsections (4)(a) through
3012 (c).
3013 (5) A captive insurance company may not provide coverage for:
3014 (a) a wager or gaming risk;
3015 (b) loss of an election; or
3016 (c) the penal consequences of a crime.
3017 (6) Unless the punitive damages award arises out of a criminal act of an insured, a
3018 captive insurance company may provide coverage for punitive damages awarded, including
3019 through adjudication or compromise, against the captive insurance company's:
3020 (a) parent; or
3021 (b) affiliated company.
3022 (7) Notwithstanding Subsection (4), if approved by the commissioner[
3023 (a) a captive insurance company may insure as a reimbursement a limited layer or
3024 deductible of workers' compensation coverage[
3025 (b) an association captive insurance company that satisfies the requirements of this
3026 chapter may provide homeowners' insurance.
3027 Section 29. Effective date.
3028 This bill takes effect on May 1, 2024.