Rep. Norm Thurston — Voting Record

Bill

Number

H.B. 31 Second Substitute (2022GS)

Sponsor

Rep. Dunnigan, J.

Final action

Governor Signed 3/23/2022

Outcome

Became law — signed by Gov. Spencer J. Cox

Summary

What it does

• This bill:
• amends definitions;
• defines terms;
• amends provisions related to the Insurance Department's participation in certain national organizations;
• modifies provisions regarding Title and Escrow Commission meetings;
• modifies provisions regarding an insurer's withdrawal from writing certain lines of insurance;
• amends required disclosures for a service contract and vehicle protection product warranty;
• enacts provisions related to mutual insurance holding companies;
• amends provisions related to the registration of insurers;
• requires a large insurance holding company to submit to the Insurance Department a group capital calculation and liquidity stress test results;
• amends provisions regarding the standards and management of an insurer within a holding company system;
• amends provisions related to the confidentiality of certain information obtained by the Utah Insurance Commissioner (commissioner);
• allows an unearned premium reserve fund to be released in accordance with the standards of the National Association of Insurance Commissioners;
• amends insurance form requirements;

Every vote on this bill

Bill text

INSURANCE AMENDMENTS
GENERAL SESSION
STATE OF UTAH
Chief Sponsor: James A. Dunnigan
Senate Sponsor: 
Curtis S. Bramble
LONG TITLE
General Description:
This bill amends the Insurance Code.
Highlighted Provisions:
This bill:
▸ amends definitions;
▸ defines terms;
▸ amends provisions related to the Insurance Department's participation in certain
national organizations;
▸ modifies provisions regarding Title and Escrow Commission meetings;
▸ modifies provisions regarding an insurer's withdrawal from writing certain lines of
insurance;
▸ amends required disclosures for a service contract and vehicle protection product
warranty;
▸ enacts provisions related to mutual insurance holding companies;
▸ amends provisions related to the registration of insurers;
▸ requires a large insurance holding company to submit to the Insurance Department a
group capital calculation and liquidity stress test results;
▸ amends provisions regarding the standards and management of an insurer within a
holding company system;
▸ amends provisions related to the confidentiality of certain information obtained by
the Utah Insurance Commissioner (commissioner);
▸ allows an unearned premium reserve fund to be released in accordance with the
standards of the National Association of Insurance Commissioners;
▸ amends insurance form requirements;
▸ amends provisions regarding insurance policy renewal notification requirements;
▸ amends provisions related to an arbitration decision's resolution of a claim under an
underinsured motorist policy;
▸ amends provisions related to accident and health insurance;
▸ clarifies provisions related to the discontinuance, nonrenewal, or modification of
health benefit plans;
▸ clarifies provisions related to standardized health insurance identification cards;
▸ enacts provisions related to health insurance mandates;
▸ enacts provisions related to the renewal, cancellation, and modification of a group
accident and health insurance plan;
▸ allows the commissioner to take action against a license of an insurance producer
who fails to pay a final judgment rendered against the insurance producer by a court
outside of this state;
▸ makes an affiliate of an insolvent insurer subject to Title 31A, Chapter 27a, Insurer
Receivership Act;
▸ amends provisions related to a defense to a claim by a receiver;
▸ amends provisions related to a bail bond agency's required financial statements;
▸ amends provisions related to a drug manufacturer's required reports;
▸ modifies the Prescription Drug Price Transparency Act;
▸ amends the criminal offense of fraudulent insurance act; and
▸ makes technical and conforming changes.
Money Appropriated in this Bill:
None
Other Special Clauses:
None
Utah Code Sections Affected:
AMENDS:
26-61a-201
, as last amended by Laws of Utah 2021, Chapters 17 and further amended
by Revisor Instructions, Laws of Utah 2021, Chapters 337, 337, and 350
26-61a-204
, as last amended by Laws of Utah 2021, Chapter 350
31A-1-301
, as last amended by Laws of Utah 2021, Second Special Session, Chapter 4
31A-2-210
, as enacted by Laws of Utah 1985, Chapter 242
31A-2-403
, as last amended by Laws of Utah 2020, Chapters 32, 352, and 373
31A-4-115
, as last amended by Laws of Utah 2017, Chapter 292
31A-5-506
, as last amended by Laws of Utah 2007, Chapter 309
31A-6a-104
, as last amended by Laws of Utah 2020, Chapter 32
31A-16-105
, as last amended by Laws of Utah 2017, Chapter 168
31A-16-106
, as last amended by Laws of Utah 2015, Chapter 244
31A-16-109
, as last amended by Laws of Utah 2019, Chapter 193
31A-17-408
, as last amended by Laws of Utah 2001, Chapter 116
31A-17-601
, as last amended by Laws of Utah 2020, Chapter 32
31A-21-201
, as last amended by Laws of Utah 2021, Chapter 252
31A-21-303
, as last amended by Laws of Utah 2020, Chapter 292
31A-22-305.3
, as last amended by Laws of Utah 2020, Chapter 145
31A-22-602
, as last amended by Laws of Utah 2021, Chapter 252
31A-22-618.6
, as last amended by Laws of Utah 2021, Chapter 252
31A-22-618.7
, as last amended by Laws of Utah 2021, Chapter 252
31A-22-618.8
, as last amended by Laws of Utah 2021, Chapter 252
31A-22-627
, as last amended by Laws of Utah 2021, Chapter 252
31A-22-636
, as last amended by Laws of Utah 2011, Chapter 297
31A-23a-111
, as last amended by Laws of Utah 2020, Chapter 32
31A-27a-104
, as last amended by Laws of Utah 2013, Chapter 319
31A-27a-111
, as last amended by Laws of Utah 2018, Chapter 319
31A-30-103
, as last amended by Laws of Utah 2019, Chapter 193
31A-35-404
, as last amended by Laws of Utah 2021, Chapter 252
31A-48-102
, as enacted by Laws of Utah 2020, Chapter 198
31A-48-103
, as last amended by Laws of Utah 2020, Sixth Special Session, Chapter 8
58-13-2.5
, as enacted by Laws of Utah 2009, Chapter 14
63G-2-305
, as last amended by Laws of Utah 2021, Chapters 148, 179, 231, 353, 373,
and 382
76-6-521
, as last amended by Laws of Utah 2019, Chapter 193
ENACTS:
31A-16-102.6
, Utah Code Annotated 1953
31A-22-657
, Utah Code Annotated 1953
31A-22-727
, Utah Code Annotated 1953
REPEALS:
31A-17-519
, as last amended by Laws of Utah 2019, Chapter 193
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 
26-61a-201
 is amended to read:
26-61a-201.
Medical cannabis patient card -- Medical cannabis guardian card --
Conditional medical cannabis card -- Application -- Fees -- Studies.
(1) (a) The department shall, within 15 days after the day on which an individual who
satisfies the eligibility criteria in this section or Section 
26-61a-202
 submits an application in
accordance with this section or Section 
26-61a-202
:
(i) issue a medical cannabis patient card to an individual described in Subsection
(2)(a);
(ii) issue a medical cannabis guardian card to an individual described in Subsection
(2)(b);
(iii) issue a provisional patient card to a minor described in Subsection (2)(c); and
(iv) issue a medical cannabis caregiver card to an individual described in Subsection
26-61a-202
(4).
(b) (i) Beginning on the earlier of September 1, 2021, or the date on which the
electronic verification system is functionally capable of facilitating a conditional medical
cannabis card under this Subsection (1)(b), upon the entry of a recommending medical
provider's medical cannabis recommendation for a patient in the state electronic verification
system, either by the provider or the provider's employee or by a medical cannabis pharmacy
medical provider or medical cannabis pharmacy in accordance with Subsection
26-61a-501
(11)(a), the department shall issue to the patient an electronic conditional medical
cannabis card, in accordance with this Subsection (1)(b).
(ii) A conditional medical cannabis card is valid for the lesser of:
(A) 60 days; or
(B) the day on which the department completes the department's review and issues a
medical cannabis card under Subsection (1)(a), denies the patient's medical cannabis card
application, or revokes the conditional medical cannabis card under Subsection (8).
(iii) The department may issue a conditional medical cannabis card to an individual
applying for a medical cannabis patient card for which approval of the Compassionate Use
Board is not required.
(iv) An individual described in Subsection (1)(b)(iii) has the rights, restrictions, and
obligations under law applicable to a holder of the medical cannabis card for which the
individual applies and for which the department issues the conditional medical cannabis card.
(2) (a) An individual is eligible for a medical cannabis patient card if:
(i) (A) the individual is at least 21 years old; or
(B) the individual is 18, 19, or 20 years old, the individual petitions the Compassionate
Use Board under Section 
26-61a-105
, and the Compassionate Use Board recommends
department approval of the petition;
(ii) the individual is a Utah resident;
(iii) the individual's recommending medical provider recommends treatment with
medical cannabis in accordance with Subsection (4);
(iv) the individual signs an acknowledgment stating that the individual received the
information described in Subsection (8); and
(v) the individual pays to the department a fee in an amount that, subject to Subsection
26-61a-109
(5), the department sets in accordance with Section 
63J-1-504
.
(b) (i) An individual is eligible for a medical cannabis guardian card if the individual:
(A) is at least 18 years old;
(B) is a Utah resident;
(C) is the parent or legal guardian of a minor for whom the minor's qualified medical
provider recommends a medical cannabis treatment, the individual petitions the Compassionate
Use Board under Section 
26-61a-105
, and the Compassionate Use Board recommends
department approval of the petition;
(D) the individual signs an acknowledgment stating that the individual received the
information described in Subsection (9);
(E) pays to the department a fee in an amount that, subject to Subsection
26-61a-109
(5), the department sets in accordance with Section 
63J-1-504
, plus the cost of the
criminal background check described in Section 
26-61a-203
; and
(F) the individual has not been convicted of a misdemeanor or felony drug distribution
offense under either state or federal law, unless the individual completed any imposed sentence
six months or more before the day on which the individual applies for a medical cannabis
guardian card.
(ii) The department shall notify the Department of Public Safety of each individual that
the department registers for a medical cannabis guardian card.
(c) (i) A minor is eligible for a provisional patient card if:
(A) the minor has a qualifying condition;
(B) the minor's qualified medical provider recommends a medical cannabis treatment
to address the minor's qualifying condition;
(C) one of the minor's parents or legal guardians petitions the Compassionate Use
Board under Section 
26-61a-105
, and the Compassionate Use Board recommends department
approval of the petition; and
(D) the minor's parent or legal guardian is eligible for a medical cannabis guardian card
under Subsection (2)(b) or designates a caregiver under Subsection (2)(d) who is eligible for a
medical cannabis caregiver card under Section 
26-61a-202
.
(ii) The department shall automatically issue a provisional patient card to the minor
described in Subsection (2)(c)(i) at the same time the department issues a medical cannabis
guardian card to the minor's parent or legal guardian.
(d) Beginning on the earlier of September 1, 2021, or the date on which the electronic
verification system is functionally capable of servicing the designation, if the parent or legal
guardian of a minor described in Subsections (2)(c)(i)(A) through (C) does not qualify for a
medical cannabis guardian card under Subsection (2)(b), the parent or legal guardian may
designate up to two caregivers in accordance with Subsection 
26-61a-202
(1)(c) to ensure that
the minor has adequate and safe access to the recommended medical cannabis treatment.
(3) (a) An individual who is eligible for a medical cannabis card described in
Subsection (2)(a) or (b) shall submit an application for a medical cannabis card to the
department:
(i) through an electronic application connected to the state electronic verification
system;
(ii) with the recommending medical provider; and
(iii) with information including:
(A) the applicant's name, gender, age, and address;
(B) the number of the applicant's valid form of photo identification;
(C) for a medical cannabis guardian card, the name, gender, and age of the minor
receiving a medical cannabis treatment under the cardholder's medical cannabis guardian card;
and
(D) for a provisional patient card, the name of the minor's parent or legal guardian who
holds the associated medical cannabis guardian card.
(b) The department shall ensure that a medical cannabis card the department issues
under this section contains the information described in Subsection (3)(a)(iii).
(c) (i) If a recommending medical provider determines that, because of age, illness, or
disability, a medical cannabis patient cardholder requires assistance in administering the
medical cannabis treatment that the recommending medical provider recommends, the
recommending medical provider may indicate the cardholder's need in the state electronic
verification system, either directly or, for a limited medical provider, through the order
described in Subsections 
26-61a-106
(1)(c) and (d).
(ii) If a recommending medical provider makes the indication described in Subsection
(3)(c)(i):
(A) the department shall add a label to the relevant medical cannabis patient card
indicating the cardholder's need for assistance;
(B) any adult who is 18 years old or older and who is physically present with the
cardholder at the time the cardholder needs to use the recommended medical cannabis
treatment may handle the medical cannabis treatment and any associated medical cannabis
device as needed to assist the cardholder in administering the recommended medical cannabis
treatment; and
(C) an individual of any age who is physically present with the cardholder in the event
of an emergency medical condition, as that term is defined in Section [
31A-22-627
]
31A-1-301
, may handle the medical cannabis treatment and any associated medical cannabis
device as needed to assist the cardholder in administering the recommended medical cannabis
treatment.
(iii) A non-cardholding individual acting under Subsection (3)(c)(ii)(B) or (C) may not:
(A) ingest or inhale medical cannabis;
(B) possess, transport, or handle medical cannabis or a medical cannabis device outside
of the immediate area where the cardholder is present or with an intent other than to provide
assistance to the cardholder; or
(C) possess, transport, or handle medical cannabis or a medical cannabis device when
the cardholder is not in the process of being dosed with medical cannabis.
(4) To recommend a medical cannabis treatment to a patient or to renew a
recommendation, a recommending medical provider shall:
(a) before recommending or renewing a recommendation for medical cannabis in a
medicinal dosage form or a cannabis product in a medicinal dosage form:
(i) verify the patient's and, for a minor patient, the minor patient's parent or legal
guardian's valid form of identification described in Subsection (3)(a);
(ii) review any record related to the patient and, for a minor patient, the patient's parent
or legal guardian in:
(A) for a qualified medical provider, the state electronic verification system; and
(B) the controlled substance database created in Section 
58-37f-201
; and
(iii) consider the recommendation in light of the patient's qualifying condition and
history of medical cannabis and controlled substance use during an initial face-to-face visit
with the patient; and
(b) state in the recommending medical provider's recommendation that the patient:
(i) suffers from a qualifying condition, including the type of qualifying condition; and
(ii) may benefit from treatment with cannabis in a medicinal dosage form or a cannabis
product in a medicinal dosage form.
(5) (a) Except as provided in Subsection (5)(b), a medical cannabis card that the
department issues under this section is valid for the lesser of:
(i) an amount of time that the recommending medical provider determines; or
(ii) (A) six months for the first issuance, and, except as provided in Subsection
(5)(a)(ii)(B), for a renewal; or
(B) for a renewal, one year if, after at least one year following the issuance of the
original medical cannabis card, the recommending medical provider determines that the patient
has been stabilized on the medical cannabis treatment and a one-year renewal period is
justified.
(b) (i) A medical cannabis card that the department issues in relation to a terminal
illness described in Section 
26-61a-104
 does not expire.
(ii) The recommending medical provider may revoke a recommendation that the
provider made in relation to a terminal illness described in Section 
26-61a-104
 if the medical
cannabis cardholder no longer has the terminal illness.
(6) (a) A medical cannabis patient card or a medical cannabis guardian card is
renewable if:
(i) at the time of renewal, the cardholder meets the requirements of Subsection (2)(a) or
(b); or
(ii) the cardholder received the medical cannabis card through the recommendation of
the Compassionate Use Board under Section 
26-61a-105
.
(b) A cardholder described in Subsection (6)(a) may renew the cardholder's card:
(i) using the application process described in Subsection (3); or
(ii) through phone or video conference with the recommending medical provider who
made the recommendation underlying the card, at the qualifying medical provider's discretion.
(c) A cardholder under Subsection (2)(a) or (b) who renews the cardholder's card shall
pay to the department a renewal fee in an amount that:
(i) subject to Subsection 
26-61a-109
(5), the department sets in accordance with Section
63J-1-504
; and
(ii) may not exceed the cost of the relatively lower administrative burden of renewal in
comparison to the original application process.
(d) If a minor meets the requirements of Subsection (2)(c), the minor's provisional
patient card renews automatically at the time the minor's parent or legal guardian renews the
parent or legal guardian's associated medical cannabis guardian card.
(7) (a) A cardholder under this section shall carry the cardholder's valid medical
cannabis card with the patient's name.
(b) (i) A medical cannabis patient cardholder or a provisional patient cardholder may
purchase, in accordance with this chapter and the recommendation underlying the card,
cannabis in a medicinal dosage form, a cannabis product in a medicinal dosage form, or a
medical cannabis device.
(ii) A cardholder under this section may possess or transport, in accordance with this
chapter and the recommendation underlying the card, cannabis in a medicinal dosage form, a
cannabis product in a medicinal dosage form, or a medical cannabis device.
(iii) To address the qualifying condition underlying the medical cannabis treatment
recommendation:
(A) a medical cannabis patient cardholder or a provisional patient cardholder may use
cannabis in a medicinal dosage form, a medical cannabis product in a medicinal dosage form,
or a medical cannabis device; and
(B) a medical cannabis guardian cardholder may assist the associated provisional
patient cardholder with the use of cannabis in a medicinal dosage form, a medical cannabis
product in a medicinal dosage form, or a medical cannabis device.
(c) If a licensed medical cannabis pharmacy is not operating within the state after
January 1, 2021, a cardholder under this section:
(i) may possess:
(A) up to the legal dosage limit of unprocessed cannabis in a medicinal dosage form;
(B) up to the legal dosage limit of a cannabis product in a medicinal dosage form; and
(C) marijuana drug paraphernalia; and
(ii) is not subject to prosecution for the possession described in Subsection (7)(c)(i).
(8) The department may revoke a medical cannabis card that the department issues
under this section if the cardholder:
(a) violates this chapter; or
(b) is convicted under state or federal law of:
(i) a felony; or
(ii) after March 17, 2021, a misdemeanor for drug distribution.
(9) The department shall establish by rule, in accordance with Title 63G, Chapter 3,
Utah Administrative Rulemaking Act, a process to provide information regarding the following
to an individual receiving a medical cannabis card:
(a) risks associated with medical cannabis treatment;
(b) the fact that a condition's listing as a qualifying condition does not suggest that
medical cannabis treatment is an effective treatment or cure for that condition, as described in
Subsection 
26-61a-104
(1); and
(c) other relevant warnings and safety information that the department determines.
(10) The department may establish procedures by rule, in accordance with Title 63G,
Chapter 3, Utah Administrative Rulemaking Act, to implement the application and issuance
provisions of this section.
(11) (a) On or before September 1, 2021, the department shall establish by rule, in
accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, a process to allow
an individual from another state to register with the department in order to purchase medical
cannabis or a medical cannabis device from a medical cannabis pharmacy while the individual
is visiting the state.
(b) The department may only provide the registration process described in Subsection
(11)(a):
(i) to a nonresident patient; and
(ii) for no more than two visitation periods per calendar year of up to 21 calendar days
per visitation period.
(12) (a) A person may submit to the department a request to conduct a research study
using medical cannabis cardholder data that the state electronic verification system contains.
(b) The department shall review a request described in Subsection (12)(a) to determine
whether an institutional review board, as that term is defined in Section 
26-61-102
, could
approve the research study.
(c) At the time an individual applies for a medical cannabis card, the department shall
notify the individual:
(i) of how the individual's information will be used as a cardholder;
(ii) that by applying for a medical cannabis card, unless the individual withdraws
consent under Subsection (12)(d), the individual consents to the use of the individual's
information for external research; and
(iii) that the individual may withdraw consent for the use of the individual's
information for external research at any time, including at the time of application.
(d) An applicant may, through the medical cannabis card application, and a medical
cannabis cardholder may, through the state central patient portal, withdraw the applicant's or
cardholder's consent to participate in external research at any time.
(e) The department may release, for the purposes of a study described in this
Subsection (12), information about a cardholder under this section who consents to participate
under Subsection (12)(c).
(f) If an individual withdraws consent under Subsection (12)(d), the withdrawal of
consent:
(i) applies to external research that is initiated after the withdrawal of consent; and
(ii) does not apply to research that was initiated before the withdrawal of consent.
(g) The department may establish standards for a medical research study's validity, by
rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
(13) The department shall record the issuance or revocation of a medical cannabis card
under this section in the controlled substance database.
Section 2. Section 
26-61a-204
 is amended to read:
26-61a-204.
Medical cannabis card -- Patient and designated caregiver
requirements -- Rebuttable presumption.
(1) (a) A medical cannabis cardholder who possesses medical cannabis that the
cardholder purchased under this chapter:
(i) shall carry:
(A) at all times the cardholder's medical cannabis card; and
(B) after the earlier of January 1, 2021, or the day on which the individual purchases
any medical cannabis from a medical cannabis pharmacy, with the medical cannabis, a label
that identifies that the medical cannabis was sold from a licensed medical cannabis pharmacy
and includes an identification number that links the medical cannabis to the inventory control
system; [
and
]
(ii) may possess up to the legal dosage limit of:
(A) unprocessed cannabis in medicinal dosage form; and
(B) a cannabis product in medicinal dosage form;
(iii) may not possess more medical cannabis than described in Subsection (1)(a)(ii);
(iv) may only possess the medical cannabis in the container in which the cardholder
received the medical cannabis from the medical cannabis pharmacy; and
(v) may not alter or remove any label described in Section 
4-41a-602
 from the
container described in Subsection (1)(a)(iv).
(b) Except as provided in Subsection (1)(c) or (e), a medical cannabis cardholder who
possesses medical cannabis in violation of Subsection (1)(a) is:
(i) guilty of an infraction; and
(ii) subject to a $100 fine.
(c) A medical cannabis cardholder or a nonresident patient who possesses medical
cannabis in an amount that is greater than the legal dosage limit and equal to or less than twice
the legal dosage limit is:
(i) for a first offense:
(A) guilty of an infraction; and
(B) subject to a fine of up to $100; and
(ii) for a second or subsequent offense:
(A) guilty of a class B misdemeanor; and
(B) subject to a fine of $1,000.
(d) An individual who is guilty of a violation described in Subsection (1)(b) or (c) is
not guilty of a violation of Title 58, Chapter 37, Utah Controlled Substances Act, for the
conduct underlying the penalty described in Subsection (1)(b) or (c).
(e) A nonresident patient who possesses medical cannabis that is not in a medicinal
dosage form is:
(i) for a first offense:
(A) guilty of an infraction; and
(B) subject to a fine of up to $100; and
(ii) for a second or subsequent offense, is subject to the penalties described in Title 58,
Chapter 37, Utah Controlled Substances Act.
(f) A medical cannabis cardholder or a nonresident patient who possesses medical
cannabis in an amount that is greater than twice the legal dosage limit is subject to the penalties
described in Title 58, Chapter 37, Utah Controlled Substances Act.
(2) (a) As used in this Subsection (2), "emergency medical condition" means the same
as that term is defined in Section [
31A-22-627
] 
31A-1-301
.
(b) Except as described in Subsection (2)(c), a medical cannabis patient cardholder, a
provisional patient cardholder, or a nonresident patient may not use, in public view, medical
cannabis or a cannabis product.
(c) In the event of an emergency medical condition, an individual described in
Subsection (2)(b) may use, and the holder of a medical cannabis guardian card or a medical
cannabis caregiver card may administer to the cardholder's charge, in public view, cannabis in a
medicinal dosage form or a cannabis product in a medicinal dosage form.
(d) An individual described in Subsection (2)(b) who violates Subsection (2)(b) is:
(i) for a first offense:
(A) guilty of an infraction; and
(B) subject to a fine of up to $100; and
(ii) for a second or subsequent offense:
(A) guilty of a class B misdemeanor; and
(B) subject to a fine of $1,000.
(3) If a medical cannabis cardholder carrying the cardholder's card possesses cannabis
in a medicinal dosage form or a cannabis product in compliance with Subsection (1), or a
medical cannabis device that corresponds with the cannabis or cannabis product:
(a) there is a rebuttable presumption that the cardholder possesses the cannabis,
cannabis product, or medical cannabis device legally; and
(b) there is no probable cause, based solely on the cardholder's possession of the
cannabis in medicinal dosage form, cannabis product in medicinal dosage form, or medical
cannabis device, to believe that the cardholder is engaging in illegal activity.
(4) (a) If a law enforcement officer stops an individual who possesses cannabis in a
medicinal dosage form, a cannabis product in a medicinal dosage form, or a medical cannabis
device, and the individual represents to the law enforcement officer that the individual holds a
valid medical cannabis card, but the individual does not have the medical cannabis card in the
individual's possession at the time of the stop by the law enforcement officer, the law
enforcement officer shall attempt to access the state electronic verification system to determine
whether the individual holds a valid medical cannabis card.
(b) If the law enforcement officer is able to verify that the individual described in
Subsection (4)(a) is a valid medical cannabis cardholder, the law enforcement officer:
(i) may not arrest or take the individual into custody for the sole reason that the
individual is in possession of cannabis in a medicinal dosage form, a cannabis product in a
medicinal dosage form, or a medical cannabis device; and
(ii) may not seize the cannabis, cannabis product, or medical cannabis device.
Section 3. Section 
31A-1-301
 is amended to read:
31A-1-301.
Definitions.
As used in this title, unless otherwise specified:
(1) (a) "Accident and health insurance" means insurance to provide protection against
economic losses resulting from:
(i) a medical condition including:
(A) a medical care expense; or
(B) the risk of disability;
(ii) accident; or
(iii) sickness.
(b) "Accident and health insurance":
(i) includes a contract with disability contingencies including:
(A) an income replacement contract;
(B) a health care contract;
(C) [
an expense reimbursement
] 
a fixed indemnity
 contract;
(D) a credit accident and health contract;
(E) a continuing care contract; and
(F) a long-term care contract; and
(ii) may provide:
(A) hospital coverage;
(B) surgical coverage;
(C) medical coverage;
(D) loss of income coverage;
(E) prescription drug coverage;
(F) dental coverage; or
(G) vision coverage.
(c) "Accident and health insurance" does not include workers' compensation insurance.
(d) For purposes of a national licensing registry, "accident and health insurance" is the
same as "accident and health or sickness insurance."
(2) "Actuary" is as defined by the commissioner by rule, made in accordance with Title
63G, Chapter 3, Utah Administrative Rulemaking Act.
(3) "Administrator" means the same as that term is defined in Subsection [
(178)
] 
(182)
.
(4) "Adult" means an individual who [
has attained the age of at least 18 years
] 
is 18
years old or older
.
(5) "Affiliate" means a person who controls, is controlled by, or is under common
control with, another person. A corporation is an affiliate of another corporation, regardless of
ownership, if substantially the same group of individuals manage the corporations.
(6) "Agency" means:
(a) a person other than an individual, including a sole proprietorship by which an
individual does business under an assumed name; and
(b) an insurance organization licensed or required to be licensed under Section
31A-23a-301
, 
31A-25-207
, or 
31A-26-209
.
(7) "Alien insurer" means an insurer domiciled outside the United States.
(8) "Amendment" means an endorsement to an insurance policy or certificate.
(9) "Annuity" means an agreement to make periodical payments for a period certain or
over the lifetime of one or more individuals if the making or continuance of all or some of the
series of the payments, or the amount of the payment, is dependent upon the continuance of
human life.
(10) "Application" means a document:
(a) (i) completed by an applicant to provide information about the risk to be insured;
and
(ii) that contains information that is used by the insurer to evaluate risk and decide
whether to:
(A) insure the risk under:
(I) the coverage as originally offered; or
(II) a modification of the coverage as originally offered; or
(B) decline to insure the risk; or
(b) used by the insurer to gather information from the applicant before issuance of an
annuity contract.
(11) "Articles" or "articles of incorporation" means:
(a) the original articles;
(b) a special law;
(c) a charter;
(d) an amendment;
(e) restated articles;
(f) articles of merger or consolidation;
(g) a trust instrument;
(h) another constitutive document for a trust or other entity that is not a corporation;
and
(i) an amendment to an item listed in Subsections (11)(a) through (h).
(12) "Bail bond insurance" means a guarantee that a person will attend court when
required, up to and including surrender of the person in execution of a sentence imposed under
Subsection 
77-20-501
(1), as a condition to the release of that person from confinement.
(13) "Binder" means the same as that term is defined in Section 
31A-21-102
.
(14) "Blanket insurance policy" or "blanket contract" means a group insurance policy
covering a defined class of persons:
(a) without individual underwriting or application; and
(b) that is determined by definition without designating each person covered.
(15) "Board," "board of trustees," or "board of directors" means the group of persons
with responsibility over, or management of, a corporation, however designated.
(16) "Bona fide office" means a physical office in this state:
(a) that is open to the public;
(b) that is staffed during regular business hours on regular business days; and
(c) at which the public may appear in person to obtain services.
(17) "Business entity" means:
(a) a corporation;
(b) an association;
(c) a partnership;
(d) a limited liability company;
(e) a limited liability partnership; or
(f) another legal entity.
(18) "Business of insurance" means the same as that term is defined in Subsection
[
(94)
] 
(95)
.
(19) "Business plan" means the information required to be supplied to the
commissioner under Subsections 
31A-5-204
(2)(i) and (j), including the information required
when these subsections apply by reference under:
(a) Section 
31A-8-205
; or
(b) Subsection 
31A-9-205
(2).
(20) (a) "Bylaws" means the rules adopted for the regulation or management of a
corporation's affairs, however designated.
(b) "Bylaws" includes comparable rules for a trust or other entity that is not a
corporation.
(21) "Captive insurance company" means:
(a) an insurer:
(i) owned by a parent organization; and
(ii) whose purpose is to insure risks of the parent organization and other risks as
authorized under:
(A) Chapter 37, Captive Insurance Companies Act; and
(B) Chapter 37a, Special Purpose Financial Captive Insurance Company Act; or
(b) in the case of a group or association, an insurer:
(i) owned by the insureds; and
(ii) whose purpose is to insure risks of:
(A) a member organization;
(B) a group member; or
(C) an affiliate of:
(I) a member organization; or
(II) a group member.
(22) "Casualty insurance" means liability insurance.
(23) "Certificate" means evidence of insurance given to:
(a) an insured under a group insurance policy; or
(b) a third party.
(24) "Certificate of authority" is included within the term "license."
(25) "Claim," unless the context otherwise requires, means a request or demand on an
insurer for payment of a benefit according to the terms of an insurance policy.
(26) "Claims-made coverage" means an insurance contract or provision limiting
coverage under a policy insuring against legal liability to claims that are first made against the
insured while the policy is in force.
(27) (a) "Commissioner" or "commissioner of insurance" means Utah's insurance
commissioner.
(b) When appropriate, the terms listed in Subsection (27)(a) apply to the equivalent
supervisory official of another jurisdiction.
(28) (a) "Continuing care insurance" means insurance that:
(i) provides board and lodging;
(ii) provides one or more of the following:
(A) a personal service;
(B) a nursing service;
(C) a medical service; or
(D) any other health-related service; and
(iii) provides the coverage described in this Subsection (28)(a) under an agreement
effective:
(A) for the life of the insured; or
(B) for a period in excess of one year.
(b) Insurance is continuing care insurance regardless of whether or not the board and
lodging are provided at the same location as a service described in Subsection (28)(a)(ii).
(29) (a) "Control," "controlling," "controlled," or "under common control" means the
direct or indirect possession of the power to direct or cause the direction of the management
and policies of a person. This control may be:
(i) by contract;
(ii) by common management;
(iii) through the ownership of voting securities; or
(iv) by a means other than those described in Subsections (29)(a)(i) through (iii).
(b) There is no presumption that an individual holding an official position with another
person controls that person solely by reason of the position.
(c) A person having a contract or arrangement giving control is considered to have
control despite the illegality or invalidity of the contract or arrangement.
(d) There is a rebuttable presumption of control in a person who directly or indirectly
owns, controls, holds with the power to vote, or holds proxies to vote 10% or more of the
voting securities of another person.
(30) "Controlled insurer" means a licensed insurer that is either directly or indirectly
controlled by a producer.
(31) "Controlling person" means a person that directly or indirectly has the power to
direct or cause to be directed, the management, control, or activities of a reinsurance
intermediary.
(32) "Controlling producer" means a producer who directly or indirectly controls an
insurer.
(33) "Corporate governance annual disclosure" means a report an insurer or insurance
group files in accordance with the requirements of Chapter 16b, Corporate Governance Annual
Disclosure Act.
(34) (a) "Corporation" means an insurance corporation, except when referring to:
(i) a corporation doing business:
(A) as:
(I) an insurance producer;
(II) a surplus lines producer;
(III) a limited line producer;
(IV) a consultant;
(V) a managing general agent;
(VI) a reinsurance intermediary;
(VII) a third party administrator; or
(VIII) an adjuster; and
(B) under:
(I) Chapter 23a, Insurance Marketing - Licensing Producers, Consultants, and
Reinsurance Intermediaries;
(II) Chapter 25, Third Party Administrators; or
(III) Chapter 26, Insurance Adjusters; or
(ii) a noninsurer that is part of a holding company system under Chapter 16, Insurance
Holding Companies.
(b) "Mutual" or "mutual corporation" means a mutual insurance corporation.
(c) "Stock corporation" means a stock insurance corporation.
(35) (a) "Creditable coverage" has the same meaning as provided in federal regulations
adopted pursuant to the Health Insurance Portability and Accountability Act.
(b) "Creditable coverage" includes coverage that is offered through a public health plan
such as:
(i) the Primary Care Network Program under a Medicaid primary care network
demonstration waiver obtained subject to Section 
26-18-3
;
(ii) the Children's Health Insurance Program under Section 
26-40-106
; or
(iii) the Ryan White Program Comprehensive AIDS Resources Emergency Act, Pub. L.
No. 101-381, and Ryan White HIV/AIDS Treatment Modernization Act of 2006, Pub. L. No.
109-415.
(36) "Credit accident and health insurance" means insurance on a debtor to provide
indemnity for payments coming due on a specific loan or other credit transaction while the
debtor has a disability.
(37) (a) "Credit insurance" means insurance offered in connection with an extension of
credit that is limited to partially or wholly extinguishing that credit obligation.
(b) "Credit insurance" includes:
(i) credit accident and health insurance;
(ii) credit life insurance;
(iii) credit property insurance;
(iv) credit unemployment insurance;
(v) guaranteed automobile protection insurance;
(vi) involuntary unemployment insurance;
(vii) mortgage accident and health insurance;
(viii) mortgage guaranty insurance; and
(ix) mortgage life insurance.
(38) "Credit life insurance" means insurance on the life of a debtor in connection with
an extension of credit that pays a person if the debtor dies.
(39) "Creditor" means a person, including an insured, having a claim, whether:
(a) matured;
(b) unmatured;
(c) liquidated;
(d) unliquidated;
(e) secured;
(f) unsecured;
(g) absolute;
(h) fixed; or
(i) contingent.
(40) "Credit property insurance" means insurance:
(a) offered in connection with an extension of credit; and
(b) that protects the property until the debt is paid.
(41) "Credit unemployment insurance" means insurance:
(a) offered in connection with an extension of credit; and
(b) that provides indemnity if the debtor is unemployed for payments coming due on a:
(i) specific loan; or
(ii) credit transaction.
(42) (a) "Crop insurance" means insurance providing protection against damage to
crops from unfavorable weather conditions, fire or lightning, flood, hail, insect infestation,
disease, or other yield-reducing conditions or perils that is:
(i) provided by the private insurance market; or
(ii) subsidized by the Federal Crop Insurance Corporation.
(b) "Crop insurance" includes multiperil crop insurance.
(43) (a) "Customer service representative" means a person that provides an insurance
service and insurance product information:
(i) for the customer service representative's:
(A) producer;
(B) surplus lines producer; or
(C) consultant employer; and
(ii) to the customer service representative's employer's:
(A) customer;
(B) client; or
(C) organization.
(b) A customer service representative may only operate within the scope of authority of
the customer service representative's producer, surplus lines producer, or consultant employer.
(44) "Deadline" means a final date or time:
(a) imposed by:
(i) statute;
(ii) rule; or
(iii) order; and
(b) by which a required filing or payment must be received by the department.
(45) "Deemer clause" means a provision under this title under which upon the
occurrence of a condition precedent, the commissioner is considered to have taken a specific
action. If the statute so provides, a condition precedent may be the commissioner's failure to
take a specific action.
(46) "Degree of relationship" means the number of steps between two persons
determined by counting the generations separating one person from a common ancestor and
then counting the generations to the other person.
(47) "Department" means the Insurance Department.
(48) "Director" means a member of the board of directors of a corporation.
(49) "Disability" means a physiological or psychological condition that partially or
totally limits an individual's ability to:
(a) perform the duties of:
(i) that individual's occupation; or
(ii) an occupation for which the individual is reasonably suited by education, training,
or experience; or
(b) perform two or more of the following basic activities of daily living:
(i) eating;
(ii) toileting;
(iii) transferring;
(iv) bathing; or
(v) dressing.
(50) "Disability income insurance" means the same as that term is defined in
Subsection [
(85)
] 
(86)
.
(51) "Domestic insurer" means an insurer organized under the laws of this state.
(52) "Domiciliary state" means the state in which an insurer:
(a) is incorporated;
(b) is organized; or
(c) in the case of an alien insurer, enters into the United States.
(53) (a) "Eligible employee" means:
(i) an employee who:
(A) works on a full-time basis; and
(B) has a normal work week of 30 or more hours; or
(ii) a person described in Subsection (53)(b).
(b) "Eligible employee" includes:
[
(i) an owner who:
]
[
(A) works on a full-time basis;
]
[
(B) has a normal work week of 30 or more hours; and
]
[
(C) employs at least one common employee; and
]
[
(ii) if the individual is included under a health benefit plan of a small employer:
]
[
(A) a sole proprietor;
]
[
(B) a partner in a partnership; or
]
[
(C) an independent contractor.
]
(i) an owner, sole proprietor, or partner who:
(A) works on a full-time basis;
(B) has a normal work week of 30 or more hours; and
(C) employs at least one common employee; and
(ii) an independent contractor if the individual is included under a health benefit plan
of a small employer.
(c) "Eligible employee" does not include, unless eligible under Subsection (53)(b):
(i) an individual who works on a temporary or substitute basis for a small employer;
(ii) an employer's spouse who does not meet the requirements of Subsection (53)(a)(i);
or
(iii) a dependent of an employer who does not meet the requirements of Subsection
(53)(a)(i).
(54) "Emergency medical condition" means a medical condition that:
(a) manifests itself by acute symptoms, including severe pain; and
(b) would cause a prudent layperson possessing an average knowledge of medicine and
health to reasonably expect the absence of immediate medical attention through a hospital
emergency department to result in:
(i) placing the layperson's health or the layperson's unborn child's health in serious
jeopardy;
(ii) serious impairment to bodily functions; or
(iii) serious dysfunction of any bodily organ or part.
[
(54)
] 
(55)
 "Employee" means:
(a) an individual employed by an employer; [
and
] 
or
(b) an [
owner
] 
individual
 who meets the requirements of Subsection (53)(b)[
(i)
].
[
(55)
] 
(56)
 "Employee benefits" means one or more benefits or services provided to:
(a) an employee; or
(b) a dependent of an employee.
[
(56)
] 
(57)
 (a) "Employee welfare fund" means a fund:
(i) established or maintained, whether directly or through a trustee, by:
(A) one or more employers;
(B) one or more labor organizations; or
(C) a combination of employers and labor organizations; and
(ii) that provides employee benefits paid or contracted to be paid, other than income
from investments of the fund:
(A) by or on behalf of an employer doing business in this state; or
(B) for the benefit of a person employed in this state.
(b) "Employee welfare fund" includes a plan funded or subsidized by a user fee or tax
revenues.
[
(57)
] 
(58)
 "Endorsement" means a written agreement attached to a policy or certificate
to modify the policy or certificate coverage.
[
(58)
] 
(59)
 (a) "Enrollee" means:
(i) a policyholder;
(ii) a certificate holder;
(iii) a subscriber; or
(iv) a covered individual:
(A) who has entered into a contract with an organization for health care; or
(B) on whose behalf an arrangement for health care has been made.
(b) "Enrollee" includes an insured.
[
(59)
] 
(60)
 "Enrollment date," with respect to a health benefit plan, means:
(a) the first day of coverage; or
(b) if there is a waiting period, the first day of the waiting period.
[
(60)
] 
(61)
 "Enterprise risk" means an activity, circumstance, event, or series of events
involving one or more affiliates of an insurer that, if not remedied promptly, is likely to have a
material adverse effect upon the financial condition or liquidity of the insurer or its insurance
holding company system as a whole, including anything that would cause:
(a) the insurer's risk-based capital to fall into an action or control level as set forth in
Sections 
31A-17-601
 through 
31A-17-613
; or
(b) the insurer to be in hazardous financial condition set forth in Section 
31A-27a-101
.
[
(61)
] 
(62)
 (a) "Escrow" means:
(i) a transaction that effects the sale, transfer, encumbering, or leasing of real property,
when a person not a party to the transaction, and neither having nor acquiring an interest in the
title, performs, in accordance with the written instructions or terms of the written agreement
between the parties to the transaction, any of the following actions:
(A) the explanation, holding, or creation of a document; or
(B) the receipt, deposit, and disbursement of money;
(ii) a settlement or closing involving:
(A) a mobile home;
(B) a grazing right;
(C) a water right; or
(D) other personal property authorized by the commissioner.
(b) "Escrow" does not include:
(i) the following notarial acts performed by a notary within the state:
(A) an acknowledgment;
(B) a copy certification;
(C) jurat; and
(D) an oath or affirmation;
(ii) the receipt or delivery of a document; or
(iii) the receipt of money for delivery to the escrow agent.
[
(62)
] 
(63)
 "Escrow agent" means an agency title insurance producer meeting the
requirements of Sections 
31A-4-107
, 
31A-14-211
, and 
31A-23a-204
, who is acting through an
individual title insurance producer licensed with an escrow subline of authority.
[
(63)
] 
(64)
 (a) "Excludes" is not exhaustive and does not mean that another thing is not
also excluded.
(b) The items listed in a list using the term "excludes" are representative examples for
use in interpretation of this title.
[
(64)
] 
(65)
 "Exclusion" means for the purposes of accident and health insurance that an
insurer does not provide insurance coverage, for whatever reason, for one of the following:
(a) a specific physical condition;
(b) a specific medical procedure;
(c) a specific disease or disorder; or
(d) a specific prescription drug or class of prescription drugs.
[
(65) "Expense reimbursement insurance" means insurance:
]
[
(a) written to provide a payment for an expense relating to hospital confinement
resulting from illness or injury; and
]
[
(b) written:
]
[
(i) as a daily limit for a specific number of days in a hospital; and
]
[
(ii) to have a one or two day waiting period following a hospitalization.
]
(66) "Fidelity insurance" means insurance guaranteeing the fidelity of a person holding
a position of public or private trust.
(67) (a) "Filed" means that a filing is:
(i) submitted to the department as required by and in accordance with applicable
statute, rule, or filing order;
(ii) received by the department within the time period provided in applicable statute,
rule, or filing order; and
(iii) accompanied by the appropriate fee in accordance with:
(A) Section 
31A-3-103
; or
(B) rule.
(b) "Filed" does not include a filing that is rejected by the department because it is not
submitted in accordance with Subsection (67)(a).
(68) "Filing," when used as a noun, means an item required to be filed with the
department including:
(a) a policy;
(b) a rate;
(c) a form;
(d) a document;
(e) a plan;
(f) a manual;
(g) an application;
(h) a report;
(i) a certificate;
(j) an endorsement;
(k) an actuarial certification;
(l) a licensee annual statement;
(m) a licensee renewal application;
(n) an advertisement;
(o) a binder; or
(p) an outline of coverage.
(69) "First party insurance" means an insurance policy or contract in which the insurer
agrees to pay a claim submitted to it by the insured for the insured's losses.
(70) (a) "Fixed indemnity insurance" means accident and health insurance written to
provide a fixed amount for a specified event relating to or resulting from an illness or injury.
(b) "Fixed indemnity insurance" includes hospital confinement indemnity insurance.
[
(70)
] 
(71)
 "Foreign insurer" means an insurer domiciled outside of this state, including
an alien insurer.
[
(71)
] 
(72)
 (a) "Form" means one of the following prepared for general use:
(i) a policy;
(ii) a certificate;
(iii) an application;
(iv) an outline of coverage; or
(v) an endorsement.
(b) "Form" does not include a document specially prepared for use in an individual
case.
[
(72)
] 
(73)
 "Franchise insurance" means an individual insurance policy provided
through a mass marketing arrangement involving a defined class of persons related in some
way other than through the purchase of insurance.
[
(73)
] 
(74)
 "General lines of authority" include:
(a) the general lines of insurance in Subsection [
(74)
] 
(75)
;
(b) title insurance under one of the following sublines of authority:
(i) title examination, including authority to act as a title marketing representative;
(ii) escrow, including authority to act as a title marketing representative; and
(iii) title marketing representative only;
(c) surplus lines;
(d) workers' compensation; and
(e) another line of insurance that the commissioner considers necessary to recognize in
the public interest.
[
(74)
] 
(75)
 "General lines of insurance" include:
(a) accident and health;
(b) casualty;
(c) life;
(d) personal lines;
(e) property; and
(f) variable contracts, including variable life and annuity.
[
(75)
] 
(76)
 "Group health plan" means an employee welfare benefit plan to the extent
that the plan provides medical care:
(a) (i) to an employee; or
(ii) to a dependent of an employee; and
(b) (i) directly;
(ii) through insurance reimbursement; or
(iii) through another method.
[
(76)
] 
(77)
 (a) "Group insurance policy" means a policy covering a group of persons
that is issued:
(i) to a policyholder on behalf of the group; and
(ii) for the benefit of a member of the group who is selected under a procedure defined
in:
(A) the policy; or
(B) an agreement that is collateral to the policy.
(b) A group insurance policy may include a member of the policyholder's family or a
dependent.
[
(77)
] 
(78)
 "Group-wide supervisor" means the commissioner or other regulatory
official designated as the group-wide supervisor for an internationally active insurance group
under Section 
31A-16-108.6
.
[
(78)
] 
(79)
 "Guaranteed automobile protection insurance" means insurance offered in
connection with an extension of credit that pays the difference in amount between the
insurance settlement and the balance of the loan if the insured automobile is a total loss.
[
(79)
] 
(80)
 (a) "Health benefit plan" means[
, except as provided in Subsection (79)(b),
]
a policy, contract, certificate, or agreement offered or issued by [
a health carrier
] 
an insurer
 to
provide, deliver, arrange for, pay for, or reimburse any of the costs of health care
, including
major medical expense coverage
.
(b) "Health benefit plan" does not include:
(i) coverage only for accident or disability income insurance, or any combination
thereof;
(ii) coverage issued as a supplement to liability insurance;
(iii) liability insurance, including general liability insurance and automobile liability
insurance;
(iv) workers' compensation or similar insurance;
(v) automobile medical payment insurance;
(vi) credit-only insurance;
(vii) coverage for on-site medical clinics;
(viii) other similar insurance coverage, specified in federal regulations issued pursuant
to Pub. L. No. 104-191, under which benefits for health care services are secondary or
incidental to other insurance benefits;
(ix) the following benefits if they are provided under a separate policy, certificate, or
contract of insurance or are otherwise not an integral part of the plan:
(A) limited scope dental or vision benefits;
(B) benefits for long-term care, nursing home care, home health care,
community-based care, or any combination thereof; or
(C) other similar limited benefits, specified in federal regulations issued pursuant to
Pub. L. No. 104-191;
(x) the following benefits if the benefits are provided under a separate policy,
certificate, or contract of insurance, there is no coordination between the provision of benefits
and any exclusion of benefits under any health plan, and the benefits are paid with respect to an
event without regard to whether benefits are provided under any health plan:
(A) coverage only for specified disease or illness; or
(B) [
hospital indemnity or other
] fixed indemnity insurance;
(xi) the following if offered as a separate policy, certificate, or contract of insurance:
(A) Medicare supplemental health insurance as defined under the Social Security Act,
42 U.S.C. Sec. 1395ss(g)(1);
(B) coverage supplemental to the coverage provided under United States Code, Title
10, Chapter 55, Civilian Health and Medical Program of the Uniformed Services
(CHAMPUS); or
(C) similar supplemental coverage provided to coverage under a group health insurance
plan;
(xii) short-term limited duration health insurance; and
(xiii) student health insurance, except as required under 45 C.F.R. Sec. 147.145.
[
(80)
] 
(81)
 "Health care" means any of the following intended for use in the diagnosis,
treatment, mitigation, or prevention of a human ailment or impairment:
(a) a professional service;
(b) a personal service;
(c) a facility;
(d) equipment;
(e) a device;
(f) supplies; or
(g) medicine.
[
(81)
] 
(82)
 (a) "Health care insurance" or "health insurance" means insurance
providing:
(i) a health care benefit; or
(ii) payment of an incurred health care expense.
(b) "Health care insurance" or "health insurance" does not include accident and health
insurance providing a benefit for:
(i) replacement of income;
(ii) short-term accident;
(iii) fixed indemnity;
(iv) credit accident and health;
(v) supplements to liability;
(vi) workers' compensation;
(vii) automobile medical payment;
(viii) no-fault automobile;
(ix) equivalent self-insurance; or
(x) a type of accident and health insurance coverage that is a part of or attached to
another type of policy.
[
(82)
] 
(83)
 "Health care provider" means the same as that term is defined in Section
78B-3-403
.
[
(83)
] 
(84)
 "Health insurance exchange" means an exchange as defined in 45 C.F.R.
Sec. 155.20.
[
(84)
] 
(85)
 "Health Insurance Portability and Accountability Act" means the Health
Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191, 110 Stat. 1936, as
amended.
[
(85)
] 
(86)
 "Income replacement insurance" or "disability income insurance" means
insurance written to provide payments to replace income lost from accident or sickness.
[
(86)
] 
(87)
 "Indemnity" means the payment of an amount to offset all or part of an
insured loss.
[
(87)
] 
(88)
 "Independent adjuster" means an insurance adjuster required to be licensed
under Section 
31A-26-201
 who engages in insurance adjusting as a representative of an insurer.
[
(88)
] 
(89)
 "Independently procured insurance" means insurance procured under
Section 
31A-15-104
.
[
(89)
] 
(90)
 "Individual" means a natural person.
[
(90)
] 
(91)
 "Inland marine insurance" includes insurance covering:
(a) property in transit on or over land;
(b) property in transit over water by means other than boat or ship;
(c) bailee liability;
(d) fixed transportation property such as bridges, electric transmission systems, radio
and television transmission towers and tunnels; and
(e) personal and commercial property floaters.
[
(91)
] 
(92)
 "Insolvency" or "insolvent" means that:
(a) an insurer is unable to pay the insurer's obligations as the obligations are due;
(b) an insurer's total adjusted capital is less than the insurer's mandatory control level
RBC under Subsection 
31A-17-601
(8)(c); or
(c) an insurer's admitted assets are less than the insurer's liabilities.
[
(92)
] 
(93)
 (a) "Insurance" means:
(i) an arrangement, contract, or plan for the transfer of a risk or risks from one or more
persons to one or more other persons; or
(ii) an arrangement, contract, or plan for the distribution of a risk or risks among a
group of persons that includes the person seeking to distribute that person's risk.
(b) "Insurance" includes:
(i) a risk distributing arrangement providing for compensation or replacement for
damages or loss through the provision of a service or a benefit in kind;
(ii) a contract of guaranty or suretyship entered into by the guarantor or surety as a
business and not as merely incidental to a business transaction; and
(iii) a plan in which the risk does not rest upon the person who makes an arrangement,
but with a class of persons who have agreed to share the risk.
[
(93)
] 
(94)
 "Insurance adjuster" means a person who directs or conducts the
investigation, negotiation, or settlement of a claim under an insurance policy other than life
insurance or an annuity, on behalf of an insurer, policyholder, or a claimant under an insurance
policy.
[
(94)
] 
(95)
 "Insurance business" or "business of insurance" includes:
(a) providing health care insurance by an organization that is or is required to be
licensed under this title;
(b) providing a benefit to an employee in the event of a contingency not within the
control of the employee, in which the employee is entitled to the benefit as a right, which
benefit may be provided either:
(i) by a single employer or by multiple employer groups; or
(ii) through one or more trusts, associations, or other entities;
(c) providing an annuity:
(i) including an annuity issued in return for a gift; and
(ii) except an annuity provided by a person specified in Subsections 
31A-22-1305
(2)
and (3);
(d) providing the characteristic services of a motor club [
as outlined in Subsection
(125)
];
(e) providing another person with insurance;
(f) making as insurer, guarantor, or surety, or proposing to make as insurer, guarantor,
or surety, a contract or policy offering title insurance;
(g) transacting or proposing to transact any phase of title insurance, including:
(i) solicitation;
(ii) negotiation preliminary to execution;
(iii) execution of a contract of title insurance;
(iv) insuring; and
(v) transacting matters subsequent to the execution of the contract and arising out of
the contract, including reinsurance;
(h) transacting or proposing a life settlement; and
(i) doing, or proposing to do, any business in substance equivalent to Subsections
[
(94)
] 
(95)
(a) through (h) in a manner designed to evade this title.
[
(95)
] 
(96)
 "Insurance consultant" or "consultant" means a person who:
(a) advises another person about insurance needs and coverages;
(b) is compensated by the person advised on a basis not directly related to the insurance
placed; and
(c) except as provided in Section 
31A-23a-501
, is not compensated directly or
indirectly by an insurer or producer for advice given.
[
(96)
] 
(97)
 "Insurance group" means the persons that comprise an insurance holding
company system.
[
(97)
] 
(98)
 "Insurance holding company system" means a group of two or more
affiliated persons, at least one of whom is an insurer.
[
(98)
] 
(99)
 (a) "Insurance producer" or "producer" means a person licensed or required
to be licensed under the laws of this state to sell, solicit, or negotiate insurance.
(b) (i) "Producer for the insurer" means a producer who is compensated directly or
indirectly by an insurer for selling, soliciting, or negotiating an insurance product of that
insurer.
(ii) "Producer for the insurer" may be referred to as an "agent."
(c) (i) "Producer for the insured" means a producer who:
(A) is compensated directly and only by an insurance customer or an insured; and
(B) receives no compensation directly or indirectly from an insurer for selling,
soliciting, or negotiating an insurance product of that insurer to an insurance customer or
insured.
(ii) "Producer for the insured" may be referred to as a "broker."
[
(99)
] 
(100)
 (a) "Insured" means a person to whom or for whose benefit an insurer
makes a promise in an insurance policy and includes:
(i) a policyholder;
(ii) a subscriber;
(iii) a member; and
(iv) a beneficiary.
(b) The definition in Subsection [
(99)
] 
(100)
(a):
(i) applies only to this title;
(ii) does not define the meaning of "insured" as used in an insurance policy or
certificate; and
(iii) includes an enrollee.
[
(100)
] 
(101)
 (a) "Insurer
,
" 
"carrier," "insurance carrier," or "insurance company"
means a person doing an insurance business as a principal including:
(i) a fraternal benefit society;
(ii) an issuer of a gift annuity other than an annuity specified in Subsections
31A-22-1305
(2) and (3);
(iii) a motor club;
(iv) an employee welfare plan;
(v) a person purporting or intending to do an insurance business as a principal on that
person's own account; and
(vi) a health maintenance organization.
(b) "Insurer
,
" 
"carrier," "insurance carrier," or "insurance company"
 does not include a
governmental entity.
[
(101)
] 
(102)
 "Interinsurance exchange" means the same as that term is defined in
Subsection [
(160)
] 
(163)
.
[
(102)
] 
(103)
 "Internationally active insurance group" means an insurance holding
company system:
(a) that includes an insurer registered under Section 
31A-16-105
;
(b) that has premiums written in at least three countries;
(c) whose percentage of gross premiums written outside the United States is at least
10% of its total gross written premiums; and
(d) that, based on a three-year rolling average, has:
(i) total assets of at least $50,000,000,000; or
(ii) total gross written premiums of at least $10,000,000,000.
[
(103)
] 
(104)
 "Involuntary unemployment insurance" means insurance:
(a) offered in connection with an extension of credit; and
(b) that provides indemnity if the debtor is involuntarily unemployed for payments
coming due on a:
(i) specific loan; or
(ii) credit transaction.
[
(104)
] 
(105)
 "Large employer," in connection with a health benefit plan, means an
employer who, with respect to a calendar year and to a plan year:
(a) employed an average of at least 51 employees on business days during the
preceding calendar year; and
(b) employs at least one employee on the first day of the plan year.
[
(105)
] 
(106)
 "Late enrollee," with respect to an employer health benefit plan, means
an individual whose enrollment is a late enrollment.
[
(106)
] 
(107)
 "Late enrollment," with respect to an employer health benefit plan, means
enrollment of an individual other than:
(a) on the earliest date on which coverage can become effective for the individual
under the terms of the plan; or
(b) through special enrollment.
[
(107)
] 
(108)
 (a) Except for a retainer contract or legal assistance described in Section
31A-1-103
, "legal expense insurance" means insurance written to indemnify or pay for a
specified legal expense.
(b) "Legal expense insurance" includes an arrangement that creates a reasonable
expectation of an enforceable right.
(c) "Legal expense insurance" does not include the provision of, or reimbursement for,
legal services incidental to other insurance coverage.
[
(108)
] 
(109)
 (a) "Liability insurance" means insurance against liability:
(i) for death, injury, or disability of a human being, or for damage to property,
exclusive of the coverages under:
(A) medical malpractice insurance;
(B) professional liability insurance; and
(C) workers' compensation insurance;
(ii) for a medical, hospital, surgical, and funeral benefit to a person other than the
insured who is injured, irrespective of legal liability of the insured, when issued with or
supplemental to insurance against legal liability for the death, injury, or disability of a human
being, exclusive of the coverages under:
(A) medical malpractice insurance;
(B) professional liability insurance; and
(C) workers' compensation insurance;
(iii) for loss or damage to property resulting from an accident to or explosion of a
boiler, pipe, pressure container, machinery, or apparatus;
(iv) for loss or damage to property caused by:
(A) the breakage or leakage of a sprinkler, water pipe, or water container; or
(B) water entering through a leak or opening in a building; or
(v) for other loss or damage properly the subject of insurance not within another kind
of insurance as defined in this chapter, if the insurance is not contrary to law or public policy.
(b) "Liability insurance" includes:
(i) vehicle liability insurance;
(ii) residential dwelling liability insurance; and
(iii) making inspection of, and issuing a certificate of inspection upon, an elevator,
boiler, machinery, or apparatus of any kind when done in connection with insurance on the
elevator, boiler, machinery, or apparatus.
[
(109)
] 
(110)
 (a) "License" means authorization issued by the commissioner to engage
in an activity that is part of or related to the insurance business.
(b) "License" includes a certificate of authority issued to an insurer.
[
(110)
] 
(111)
 (a) "Life insurance" means:
(i) insurance on a human life; and
(ii) insurance pertaining to or connected with human life.
(b) The business of life insurance includes:
(i) granting a death benefit;
(ii) granting an annuity benefit;
(iii) granting an endowment benefit;
(iv) granting an additional benefit in the event of death by accident;
(v) granting an additional benefit to safeguard the policy against lapse; and
(vi) providing an optional method of settlement of proceeds.
[
(111)
] 
(112)
 "Limited license" means a license that:
(a) is issued for a specific product of insurance; and
(b) limits an individual or agency to transact only for that product or insurance.
[
(112)
] 
(113)
 "Limited line credit insurance" includes the following forms of
insurance:
(a) credit life;
(b) credit accident and health;
(c) credit property;
(d) credit unemployment;
(e) involuntary unemployment;
(f) mortgage life;
(g) mortgage guaranty;
(h) mortgage accident and health;
(i) guaranteed automobile protection; and
(j) another form of insurance offered in connection with an extension of credit that:
(i) is limited to partially or wholly extinguishing the credit obligation; and
(ii) the commissioner determines by rule should be designated as a form of limited line
credit insurance.
[
(113)
] 
(114)
 "Limited line credit insurance producer" means a person who sells,
solicits, or negotiates one or more forms of limited line credit insurance coverage to an
individual through a master, corporate, group, or individual policy.
[
(114)
] 
(115)
 "Limited line insurance" includes:
(a) bail bond;
(b) limited line credit insurance;
(c) legal expense insurance;
(d) motor club insurance;
(e) car rental related insurance;
(f) travel insurance;
(g) crop insurance;
(h) self-service storage insurance;
(i) guaranteed asset protection waiver;
(j) portable electronics insurance; and
(k) another form of limited insurance that the commissioner determines by rule should
be designated a form of limited line insurance.
[
(115)
] 
(116)
 "Limited lines authority" includes the lines of insurance listed in
Subsection [
(114)
] 
(115)
.
[
(116)
] 
(117)
 "Limited lines producer" means a person who sells, solicits, or negotiates
limited lines insurance.
[
(117)
] 
(118)
 (a) "Long-term care insurance" means an insurance policy or rider
advertised, marketed, offered, or designated to provide coverage:
(i) in a setting other than an acute care unit of a hospital;
(ii) for not less than 12 consecutive months for a covered person on the basis of:
(A) expenses incurred;
(B) indemnity;
(C) prepayment; or
(D) another method;
(iii) for one or more necessary or medically necessary services that are:
(A) diagnostic;
(B) preventative;
(C) therapeutic;
(D) rehabilitative;
(E) maintenance; or
(F) personal care; and
(iv) that may be issued by:
(A) an insurer;
(B) a fraternal benefit society;
(C) (I) a nonprofit health hospital; and
(II) a medical service corporation;
(D) a prepaid health plan;
(E) a health maintenance organization; or
(F) an entity similar to the entities described in Subsections [
(117)
] 
(118)
(a)(iv)(A)
through (E) to the extent that the entity is otherwise authorized to issue life or health care
insurance.
(b) "Long-term care insurance" includes:
(i) any of the following that provide directly or supplement long-term care insurance:
(A) a group or individual annuity or rider; or
(B) a life insurance policy or rider;
(ii) a policy or rider that provides for payment of benefits on the basis of:
(A) cognitive impairment; or
(B) functional capacity; or
(iii) a qualified long-term care insurance contract.
(c) "Long-term care insurance" does not include:
(i) a policy that is offered primarily to provide basic Medicare supplement coverage;
(ii) basic hospital expense coverage;
(iii) basic medical/surgical expense coverage;
(iv) hospital confinement indemnity coverage;
(v) major medical expense coverage;
(vi) income replacement or related asset-protection coverage;
(vii) accident only coverage;
(viii) coverage for a specified:
(A) disease; or
(B) accident;
(ix) limited benefit health coverage; [
or
]
(x) a life insurance policy that accelerates the death benefit to provide the option of a
lump sum payment:
(A) if the following are not conditioned on the receipt of long-term care:
(I) benefits; or
(II) eligibility; and
(B) the coverage is for one or more the following qualifying events:
(I) terminal illness;
(II) medical conditions requiring extraordinary medical intervention; or
(III) permanent institutional confinement[
.
]
; or
(xi) limited long-term care as defined in Section 
31A-22-2002
.
[
(118)
] 
(119)
 "Managed care organization" means a person:
(a) licensed as a health maintenance organization under Chapter 8, Health Maintenance
Organizations and Limited Health Plans; or
(b) (i) licensed under:
(A) Chapter 5, Domestic Stock and Mutual Insurance Corporations;
(B) Chapter 7, Nonprofit Health Service Insurance Corporations; or
(C) Chapter 14, Foreign Insurers; and
(ii) that requires an enrollee to use, or offers incentives, including financial incentives,
for an enrollee to use, network providers.
[
(119)
] 
(120)
 "Medical malpractice insurance" means insurance against legal liability
incident to the practice and provision of a medical service other than the practice and provision
of a dental service.
[
(120)
] 
(121)
 "Member" means a person having membership rights in an insurance
corporation.
[
(121)
] 
(122)
 "Minimum capital" or "minimum required capital" means the capital that
must be constantly maintained by a stock insurance corporation as required by statute.
[
(122)
] 
(123)
 "Mortgage accident and health insurance" means insurance offered in
connection with an extension of credit that provides indemnity for payments coming due on a
mortgage while the debtor has a disability.
[
(123)
] 
(124)
 "Mortgage guaranty insurance" means surety insurance under which a
mortgagee or other creditor is indemnified against losses caused by the default of a debtor.
[
(124)
] 
(125)
 "Mortgage life insurance" means insurance on the life of a debtor in
connection with an extension of credit that pays if the debtor dies.
[
(125)
] 
(126)
 "Motor club" means a person:
(a) licensed under:
(i) Chapter 5, Domestic Stock and Mutual Insurance Corporations;
(ii) Chapter 11, Motor Clubs; or
(iii) Chapter 14, Foreign Insurers; and
(b) that promises for an advance consideration to provide for a stated period of time
one or more:
(i) legal services under Subsection 
31A-11-102
(1)(b);
(ii) bail services under Subsection 
31A-11-102
(1)(c); or
(iii) (A) trip reimbursement;
(B) towing services;
(C) emergency road services;
(D) stolen automobile services;
(E) a combination of the services listed in Subsections [
(125)
] 
(126)
(b)(iii)(A) through
(D); or
(F) other services given in Subsections 
31A-11-102
(1)(b) through (f).
[
(126)
] 
(127)
 "Mutual" means a mutual insurance corporation.
(128) "NAIC" means the National Association of Insurance Commissioners.
(129) "NAIC liquidity stress test framework" means a NAIC publication that includes:
(a) a history of the NAIC's development of regulatory liquidity stress testing;
(b) the scope criteria applicable for a specific data year; and
(c) the liquidity stress test instructions and reporting templates for a specific data year,
as adopted by the NAIC and as amended by the NAIC in accordance with NAIC procedures.
[
(127)
] 
(130)
 "Network plan" means health care insurance:
(a) that is issued by an insurer; and
(b) under which the financing and delivery of medical care is provided, in whole or in
part, through a defined set of providers under contract with the insurer, including the financing
and delivery of an item paid for as medical care.
[
(128)
] 
(131)
 "Network provider" means a health care provider who has an agreement
with a managed care organization to provide health care services to an enrollee with an
expectation of receiving payment, other than coinsurance, copayments, or deductibles, directly
from the managed care organization.
[
(129)
] 
(132)
 "Nonparticipating" means a plan of insurance under which the insured is
not entitled to receive a dividend representing a share of the surplus of the insurer.
[
(130)
] 
(133)
 "Ocean marine insurance" means insurance against loss of or damage to:
(a) ships or hulls of ships;
(b) goods, freight, cargoes, merchandise, effects, disbursements, profits, money,
securities, choses in action, evidences of debt, valuable papers, bottomry, respondentia
interests, or other cargoes in or awaiting transit over the oceans or inland waterways;
(c) earnings such as freight, passage money, commissions, or profits derived from
transporting goods or people upon or across the oceans or inland waterways; or
(d) a vessel owner or operator as a result of liability to employees, passengers, bailors,
owners of other vessels, owners of fixed objects, customs or other authorities, or other persons
in connection with maritime activity.
[
(131)
] 
(134)
 "Order" means an order of the commissioner.
[
(132)
] 
(135)
 "ORSA guidance manual" means the current version of the Own Risk
and Solvency Assessment Guidance Manual developed and adopted by the National
Association of Insurance Commissioners and as amended from time to time.
[
(133)
] 
(136)
 "ORSA summary report" means a confidential high-level summary of an
insurer or insurance group's own risk and solvency assessment.
[
(134)
] 
(137)
 "Outline of coverage" means a summary that explains an accident and
health insurance policy.
[
(135)
] 
(138)
 "Own risk and solvency assessment" means an insurer or insurance
group's confidential internal assessment:
(a) (i) of each material and relevant risk associated with the insurer or insurance group;
(ii) of the insurer or insurance group's current business plan to support each risk
described in Subsection [
(135)
] 
(138)
(a)(i); and
(iii) of the sufficiency of capital resources to support each risk described in Subsection
[
(135)
] 
(138)
(a)(i); and
(b) that is appropriate to the nature, scale, and complexity of an insurer or insurance
group.
[
(136)
] 
(139)
 "Participating" means a plan of insurance under which the insured is
entitled to receive a dividend representing a share of the surplus of the insurer.
[
(137)
] 
(140)
 "Participation," as used in a health benefit plan, means a requirement
relating to the minimum percentage of eligible employees that must be enrolled in relation to
the total number of eligible employees of an employer reduced by each eligible employee who
voluntarily declines coverage under the plan because the employee:
(a) has other group health care insurance coverage; or
(b) receives:
(i) Medicare, under the Health Insurance for the Aged Act, Title XVIII of the Social
Security Amendments of 1965; or
(ii) another government health benefit.
[
(138)
] 
(141)
 "Person" includes:
(a) an individual;
(b) a partnership;
(c) a corporation;
(d) an incorporated or unincorporated association;
(e) a joint stock company;
(f) a trust;
(g) a limited liability company;
(h) a reciprocal;
(i) a syndicate; or
(j) another similar entity or combination of entities acting in concert.
[
(139)
] 
(142)
 "Personal lines insurance" means property and casualty insurance
coverage sold for primarily noncommercial purposes to:
(a) an individual; or
(b) a family.
[
(140)
] 
(143)
 "Plan sponsor" means the same as that term is defined in 29 U.S.C. Sec.
1002(16)(B).
[
(141)
] 
(144)
 "Plan year" means:
(a) the year that is designated as the plan year in:
(i) the plan document of a group health plan; or
(ii) a summary plan description of a group health plan;
(b) if the plan document or summary plan description does not designate a plan year or
there is no plan document or summary plan description:
(i) the year used to determine deductibles or limits;
(ii) the policy year, if the plan does not impose deductibles or limits on a yearly basis;
or
(iii) the employer's taxable year if:
(A) the plan does not impose deductibles or limits on a yearly basis; and
(B) (I) the plan is not insured; or
(II) the insurance policy is not renewed on an annual basis; or
(c) in a case not described in Subsection [
(141)
] 
(144)
(a) or (b), the calendar year.
[
(142)
] 
(145)
 (a) "Policy" means a document, including an attached endorsement or
application that:
(i) purports to be an enforceable contract; and
(ii) memorializes in writing some or all of the terms of an insurance contract.
(b) "Policy" includes a service contract issued by:
(i) a motor club under Chapter 11, Motor Clubs;
(ii) a service contract provided under Chapter 6a, Service Contracts; and
(iii) a corporation licensed under:
(A) Chapter 7, Nonprofit Health Service Insurance Corporations; or
(B) Chapter 8, Health Maintenance Organizations and Limited Health Plans.
(c) "Policy" does not include:
(i) a certificate under a group insurance contract; or
(ii) a document that does not purport to have legal effect.
[
(143)
] 
(146)
 "Policyholder" means a person who controls a policy, binder, or oral
contract by ownership, premium payment, or otherwise.
[
(144)
] 
(147)
 "Policy illustration" means a presentation or depiction that includes
nonguaranteed elements of a policy offering life insurance over a period of years.
[
(145)
] 
(148)
 "Policy summary" means a synopsis describing the elements of a life
insurance policy.
[
(146)
] 
(149)
 "PPACA" means the Patient Protection and Affordable Care Act, Pub. L.
No. 111-148 and the Health Care Education Reconciliation Act of 2010, Pub. L. No. 111-152,
and related federal regulations and guidance.
[
(147)
] 
(150)
 "Preexisting condition," with respect to health care insurance:
(a) means a condition that was present before the effective date of coverage, whether or
not medical advice, diagnosis, care, or treatment was recommended or received before that day;
and
(b) does not include a condition indicated by genetic information unless an actual
diagnosis of the condition by a physician has been made.
[
(148)
] 
(151)
 (a) "Premium" means the monetary consideration for an insurance policy.
(b) "Premium" includes, however designated:
(i) an assessment;
(ii) a membership fee;
(iii) a required contribution; or
(iv) monetary consideration.
(c) (i) "Premium" does not include consideration paid to a third party administrator for
the third party administrator's services.
(ii) "Premium" includes an amount paid by a third party administrator to an insurer for
insurance on the risks administered by the third party administrator.
[
(149)
] 
(152)
 "Principal officers" for a corporation means the officers designated under
Subsection 
31A-5-203
(3).
[
(150)
] 
(153)
 "Proceeding" includes an action or special statutory proceeding.
[
(151)
] 
(154)
 "Professional liability insurance" means insurance against legal liability
incident to the practice of a profession and provision of a professional service.
[
(152)
] 
(155)
 (a) [
Except as provided in Subsection (152)(b), "property
] 
"Property
insurance" means insurance against loss or damage to real or personal property of every kind
and any interest in that property:
(i) from all hazards or causes; and
(ii) against loss consequential upon the loss or damage including vehicle
comprehensive and vehicle physical damage coverages.
(b) "Property insurance" does not include:
(i) inland marine insurance; and
(ii) ocean marine insurance.
[
(153)
] 
(156)
 "Qualified long-term care insurance contract" or "federally tax qualified
long-term care insurance contract" means:
(a) an individual or group insurance contract that meets the requirements of Section
7702B(b), Internal Revenue Code; or
(b) the portion of a life insurance contract that provides long-term care insurance:
(i) (A) by rider; or
(B) as a part of the contract; and
(ii) that satisfies the requirements of Sections 7702B(b) and (e), Internal Revenue
Code.
[
(154)
] 
(157)
 "Qualified United States financial institution" means an institution that:
(a) is:
(i) organized under the laws of the United States or any state; or
(ii) in the case of a United States office of a foreign banking organization, licensed
under the laws of the United States or any state;
(b) is regulated, supervised, and examined by a United States federal or state authority
having regulatory authority over a bank or trust company; and
(c) meets the standards of financial condition and standing that are considered
necessary and appropriate to regulate the quality of a financial institution whose letters of credit
will be acceptable to the commissioner as determined by:
(i) the commissioner by rule; or
(ii) the Securities Valuation Office of the National Association of Insurance
Commissioners.
[
(155)
] 
(158)
 (a) "Rate" means:
(i) the cost of a given unit of insurance; or
(ii) for property or casualty insurance, that cost of insurance per exposure unit either
expressed as:
(A) a single number; or
(B) a pure premium rate, adjusted before the application of individual risk variations
based on loss or expense considerations to account for the treatment of:
(I) expenses;
(II) profit; and
(III) individual insurer variation in loss experience.
(b) "Rate" does not include a minimum premium.
[
(156)
] 
(159)
 (a) [
Except as provided in Subsection (156)(b), "rate
] 
"Rate
 service
organization" means a person who assists an insurer in rate making or filing by:
(i) collecting, compiling, and furnishing loss or expense statistics;
(ii) recommending, making, or filing rates or supplementary rate information; or
(iii) advising about rate questions, except as an attorney giving legal advice.
(b) "Rate service organization" does not [
mean
] 
include
:
(i) an employee of an insurer;
(ii) a single insurer or group of insurers under common control;
(iii) a joint underwriting group; or
(iv) an individual serving as an actuarial or legal consultant.
[
(157)
] 
(160)
 "Rating manual" means any of the following used to determine initial and
renewal policy premiums:
(a) a manual of rates;
(b) a classification;
(c) a rate-related underwriting rule; and
(d) a rating formula that describes steps, policies, and procedures for determining
initial and renewal policy premiums.
[
(158)
] 
(161)
 (a) "Rebate" means a licensee paying, allowing, giving, or offering to
pay, allow, or give, directly or indirectly:
(i) a refund of premium or portion of premium;
(ii) a refund of commission or portion of commission;
(iii) a refund of all or a portion of a consultant fee; or
(iv) providing services or other benefits not specified in an insurance or annuity
contract.
(b) "Rebate" does not include:
(i) a refund due to termination or changes in coverage;
(ii) a refund due to overcharges made in error by the licensee; or
(iii) savings or wellness benefits as provided in the contract by the licensee.
[
(159)
] 
(162)
 "Received by the department" means:
(a) the date delivered to and stamped received by the department, if delivered in
person;
(b) the post mark date, if delivered by mail;
(c) the delivery service's post mark or pickup date, if delivered by a delivery service;
(d) the received date recorded on an item delivered, if delivered by:
(i) facsimile;
(ii) email; or
(iii) another electronic method; or
(e) a date specified in:
(i) a statute;
(ii) a rule; or
(iii) an order.
[
(160)
] 
(163)
 "Reciprocal" or "interinsurance exchange" means an unincorporated
association of persons:
(a) operating through an attorney-in-fact common to all of the persons; and
(b) exchanging insurance contracts with one another that provide insurance coverage
on each other.
[
(161)
] 
(164)
 "Reinsurance" means an insurance transaction where an insurer, for
consideration, transfers any portion of the risk it has assumed to another insurer. In referring to
reinsurance transactions, this title sometimes refers to:
(a) the insurer transferring the risk as the "ceding insurer"; and
(b) the insurer assuming the risk as the:
(i) "assuming insurer"; or
(ii) "assuming reinsurer."
[
(162)
] 
(165)
 "Reinsurer" means a person licensed in this state as an insurer with the
authority to assume reinsurance.
[
(163)
] 
(166)
 "Residential dwelling liability insurance" means insurance against
liability resulting from or incident to the ownership, maintenance, or use of a residential
dwelling that is a detached single family residence or multifamily residence up to four units.
[
(164)
] 
(167)
 (a) "Retrocession" means reinsurance with another insurer of a liability
assumed under a reinsurance contract.
(b) A reinsurer "retrocedes" when the reinsurer reinsures with another insurer part of a
liability assumed under a reinsurance contract.
[
(165)
] 
(168)
 "Rider" means an endorsement to:
(a) an insurance policy; or
(b) an insurance certificate.
(169) "Scope criteria" means the designated exposure bases and minimum magnitudes
for a specified data year that are used to establish a preliminary list of insurers considered
scoped into the NAIC liquidity stress test framework for that data year.
[
(166)
] 
(170)
 "Secondary medical condition" means a complication related to an
exclusion from coverage in accident and health insurance.
[
(167)
] 
(171)
 (a) "Security" means a:
(i) note;
(ii) stock;
(iii) bond;
(iv) debenture;
(v) evidence of indebtedness;
(vi) certificate of interest or participation in a profit-sharing agreement;
(vii) collateral-trust certificate;
(viii) preorganization certificate or subscription;
(ix) transferable share;
(x) investment contract;
(xi) voting trust certificate;
(xii) certificate of deposit for a security;
(xiii) certificate of interest of participation in an oil, gas, or mining title or lease or in
payments out of production under such a title or lease;
(xiv) commodity contract or commodity option;
(xv) certificate of interest or participation in, temporary or interim certificate for,
receipt for, guarantee of, or warrant or right to subscribe to or purchase any of the items listed
in Subsections [
(167)
] 
(171)
(a)(i) through (xiv); or
(xvi) another interest or instrument commonly known as a security.
(b) "Security" does not include:
(i) any of the following under which an insurance company promises to pay money in a
specific lump sum or periodically for life or some other specified period:
(A) insurance;
(B) an endowment policy; or
(C) an annuity contract; or
(ii) a burial certificate or burial contract.
[
(168)
] 
(172)
 "Securityholder" means a specified person who owns a security of a
person, including:
(a) common stock;
(b) preferred stock;
(c) debt obligations; and
(d) any other security convertible into or evidencing the right of any of the items listed
in this Subsection [
(168)
] 
(172)
.
[
(169)
] 
(173)
 (a) "Self-insurance" means an arrangement under which a person
provides for spreading [
its own
] 
the person's own
 risks by a systematic plan.
(b) "Self-insurance" includes:
(i) an arrangement under which a governmental entity undertakes to indemnify an
employee for liability arising out of the employee's employment; and
(ii) an arrangement under which a person with a managed program of self-insurance
and risk management undertakes to indemnify the person's affiliate, subsidiary, director,
officer, or employee for liability or risk that arises out of the person's relationship with the
affiliate, subsidiary, director, officer, or employee.
[
(b) Except as provided in this Subsection (169), "self-insurance"
] 
(c) "Self-insurance"
does not include
:
(i)
 an arrangement under which a number of persons spread their risks among
themselves[
.
]
; or
(ii) an arrangement with an independent contractor.
[
(c) "Self-insurance" includes:
]
[
(i) an arrangement by which a governmental entity undertakes to indemnify an
employee for liability arising out of the employee's employment; and
]
[
(ii) an arrangement by which a person with a managed program of self-insurance and
risk management undertakes to indemnify its affiliates, subsidiaries, directors, officers, or
employees for liability or risk that is related to the relationship or employment.
]
[
(d) "Self-insurance" does not include an arrangement with an independent contractor.
]
[
(170)
] 
(174)
 "Sell" means to exchange a contract of insurance:
(a) by any means;
(b) for money or its equivalent; and
(c) on behalf of an insurance company.
[
(171)
] 
(175)
 "Short-term limited duration health insurance" means a health benefit
product that:
(a) after taking into account any renewals or extensions, has a total duration of no more
than 36 months; and
(b) has an expiration date specified in the contract that is less than 12 months after the
original effective date of coverage under the health benefit product.
[
(172)
] 
(176)
 "Significant break in coverage" means a period of 63 consecutive days
during each of which an individual does not have creditable coverage.
[
(173)
] 
(177)
 (a) "Small employer" means, in connection with a health benefit plan and
with respect to a calendar year and to a plan year, an employer who:
(i) (A) employed at least one but not more than 50 eligible employees on business days
during the preceding calendar year; or
(B) if the employer did not exist for the entirety of the preceding calendar year,
reasonably expects to employ an average of at least one but not more than 50 eligible
employees on business days during the current calendar year;
(ii) employs at least one employee on the first day of the plan year; and
(iii) for an employer who has common ownership with one or more other employers, is
treated as a single employer under 26 U.S.C. Sec. 414(b), (c), (m), or (o).
(b) "Small employer" does not include 
an owner or
 a sole proprietor that does not
employ at least one employee.
[
(174)
] 
(178)
 "Special enrollment period," in connection with a health benefit plan, has
the same meaning as provided in federal regulations adopted pursuant to the Health Insurance
Portability and Accountability Act.
[
(175)
] 
(179)
 (a) "Subsidiary" of a person means an affiliate controlled by that person
either directly or indirectly through one or more affiliates or intermediaries.
(b) "Wholly owned subsidiary" of a person is a subsidiary of which all of the voting
shares are owned by that person either alone or with its affiliates, except for the minimum
number of shares the law of the subsidiary's domicile requires to be owned by directors or
others.
[
(176)
] 
(180)
 Subject to Subsection [
(91)
] 
(92)
(b), "surety insurance" includes:
(a) a guarantee against loss or damage resulting from the failure of a principal to pay or
perform the principal's obligations to a creditor or other obligee;
(b) bail bond insurance; and
(c) fidelity insurance.
[
(177)
] 
(181)
 (a) "Surplus" means the excess of assets over the sum of paid-in capital
and liabilities.
(b) (i) "Permanent surplus" means the surplus of an insurer or organization that is
designated by the insurer or organization as permanent.
(ii) Sections 
31A-5-211
, 
31A-7-201
, 
31A-8-209
, 
31A-9-209
, and 
31A-14-205
 require
that insurers or organizations doing business in this state maintain specified minimum levels of
permanent surplus.
(iii) Except for assessable mutuals, the minimum permanent surplus requirement is the
same as the minimum required capital requirement that applies to stock insurers.
(c) "Excess surplus" means:
(i) for a life insurer, accident and health insurer, health organization, or property and
casualty insurer as defined in Section 
31A-17-601
, the lesser of:
(A) that amount of an insurer's or health organization's total adjusted capital that
exceeds the product of:
(I) 2.5; and
(II) the sum of the insurer's or health organization's minimum capital or permanent
surplus required under Section 
31A-5-211
, 
31A-9-209
, or 
31A-14-205
; or
(B) that amount of an insurer's or health organization's total adjusted capital that
exceeds the product of:
(I) 3.0; and
(II) the authorized control level RBC as defined in Subsection 
31A-17-601
(8)(a); and
(ii) for a monoline mortgage guaranty insurer, financial guaranty insurer, or title insurer
that amount of an insurer's paid-in-capital and surplus that exceeds the product of:
(A) 1.5; and
(B) the insurer's total adjusted capital required by Subsection 
31A-17-609
(1).
[
(178)
] 
(182)
 "Third party administrator" or "administrator" means a person who
collects charges or premiums from, or who, for consideration, adjusts or settles claims of
residents of the state in connection with insurance coverage, annuities, or service insurance
coverage, except:
(a) a union on behalf of its members;
(b) a person administering a:
(i) pension plan subject to the federal Employee Retirement Income Security Act of
1974;
(ii) governmental plan as defined in Section 414(d), Internal Revenue Code; or
(iii) nonelecting church plan as described in Section 410(d), Internal Revenue Code;
(c) an employer on behalf of the employer's employees or the employees of one or
more of the subsidiary or affiliated corporations of the employer;
(d) an insurer licensed under the following, but only for a line of insurance for which
the insurer holds a license in this state:
(i) Chapter 5, Domestic Stock and Mutual Insurance Corporations;
(ii) Chapter 7, Nonprofit Health Service Insurance Corporations;
(iii) Chapter 8, Health Maintenance Organizations and Limited Health Plans;
(iv) Chapter 9, Insurance Fraternals; or
(v) Chapter 14, Foreign Insurers;
(e) a person:
(i) licensed or exempt from licensing under:
(A) Chapter 23a, Insurance Marketing - Licensing Producers, Consultants, and
Reinsurance Intermediaries; or
(B) Chapter 26, Insurance Adjusters; and
(ii) whose activities are limited to those authorized under the license the person holds
or for which the person is exempt; or
(f) an institution, bank, or financial institution:
(i) that is:
(A) an institution whose deposits and accounts are to any extent insured by a federal
deposit insurance agency, including the Federal Deposit Insurance Corporation or National
Credit Union Administration; or
(B) a bank or other financial institution that is subject to supervision or examination by
a federal or state banking authority; and
(ii) that does not adjust claims without a third party administrator license.
[
(179)
] 
(183)
 "Title insurance" means the insuring, guaranteeing, or indemnifying of an
owner of real or personal property or the holder of liens or encumbrances on that property, or
others interested in the property against loss or damage suffered by reason of liens or
encumbrances upon, defects in, or the unmarketability of the title to the property, or invalidity
or unenforceability of any liens or encumbrances on the property.
[
(180)
] 
(184)
 "Total adjusted capital" means the sum of an insurer's or health
organization's statutory capital and surplus as determined in accordance with:
(a) the statutory accounting applicable to the annual financial statements required to be
filed under Section 
31A-4-113
; and
(b) another item provided by the RBC instructions, as RBC instructions is defined in
Section 
31A-17-601
.
[
(181)
] 
(185)
 (a) "Trustee" means "director" when referring to the board of directors of
a corporation.
(b) "Trustee," when used in reference to an employee welfare fund, means an
individual, firm, association, organization, joint stock company, or corporation, whether acting
individually or jointly and whether designated by that name or any other, that is charged with
or has the overall management of an employee welfare fund.
[
(182)
] 
(186)
 (a) "Unauthorized insurer," "unadmitted insurer," or "nonadmitted
insurer" means an insurer:
(i) not holding a valid certificate of authority to do an insurance business in this state;
or
(ii) transacting business not authorized by a valid certificate.
(b) "Admitted insurer" or "authorized insurer" means an insurer:
(i) holding a valid certificate of authority to do an insurance business in this state; and
(ii) transacting business as authorized by a valid certificate.
[
(183)
] 
(187)
 "Underwrite" means the authority to accept or reject risk on behalf of the
insurer.
[
(184)
] 
(188)
 "Vehicle liability insurance" means insurance against liability resulting
from or incident to ownership, maintenance, or use of a land vehicle or aircraft, exclusive of a
vehicle comprehensive or vehicle physical damage coverage [
under
] 
described in
 Subsection
[
(152)
] 
(155)
.
[
(185)
] 
(189)
 "Voting security" means a security with voting rights, and includes a
security convertible into a security with a voting right associated with the security.
[
(186)
] 
(190)
 "Waiting period" for a health benefit plan means the period that must
pass before coverage for an individual, who is otherwise eligible to enroll under the terms of
the health benefit plan, can become effective.
[
(187)
] 
(191)
 "Workers' compensation insurance" means:
(a) insurance for indemnification of an employer against liability for compensation
based on:
(i) a compensable accidental injury; and
(ii) occupational disease disability;
(b) employer's liability insurance incidental to workers' compensation insurance and
written in connection with workers' compensation insurance; and
(c) insurance assuring to a person entitled to workers' compensation benefits the
compensation provided by law.
Section 4. Section 
31A-2-210
 is amended to read:
31A-2-210.
Participation in organizations.
(1)
 The commissioner and the Insurance Department shall maintain close relations with
the commissioners of other states and shall participate in the activities and affairs of the
[
National Association of Insurance Commissioners
] 
NAIC
 and other organizations to the
extent, in the commissioner's judgment, these activities will promote the purposes of the
Insurance Code. The actual and necessary expenses incurred by this participation shall be paid
out of the Insurance Department appropriation. The commissioner may not make any
commitments that are not terminable on reasonable notice by the commissioner.
(2) The commissioner shall participate in or provide support for participation in a
professional organization that represents states or legislatures for the purpose of preserving
state jurisdiction over the business of insurance.
Section 5. Section 
31A-2-403
 is amended to read:
31A-2-403.
Title and Escrow Commission created.
(1) (a) Subject to Subsection (1)(b), there is created within the department the Title and
Escrow Commission that is comprised of five members who shall be, in accordance with Title
63G, Chapter 24, Part 2, Vacancies, appointed by the governor with the advice and consent of
the Senate as follows:
(i) except as provided in Subsection (1)(d), two members shall be employees of a title
insurer;
(ii) two members shall:
(A) be employees of a Utah agency title insurance producer;
(B) be or have been licensed under the title insurance line of authority;
(C) as of the day on which the member is appointed, be or have been licensed with the
title examination or escrow subline of authority for at least five years; and
(D) as of the day on which the member is appointed, not be from the same county as
another member appointed under this Subsection (1)(a)(ii); and
(iii) one member shall be a member of the general public from any county in the state.
(b) No more than one commission member may be appointed from a single company
or an affiliate or subsidiary of the company.
(c) No more than two commission members may be employees of an entity operating
under an affiliated business arrangement, as defined in Section 
31A-23a-1001
.
(d) If the governor is unable to identify more than one individual who is an employee
of a title insurer and willing to serve as a member of the commission, the commission shall
include the following members in lieu of the members described in Subsection (1)(a)(i):
(i) one member who is an employee of a title insurer; and
(ii) one member who is an employee of a Utah agency title insurance producer.
(2) (a) Subject to Subsection (2)(c), a commission member shall comply with the
conflict of interest provisions described in Title 63G, Chapter 24, Part 3, Conflicts of Interest,
and file with the commissioner a disclosure of any position of employment or ownership
interest that the commission member has with respect to a person that is subject to the
jurisdiction of the commissioner.
(b) The disclosure statement required by this Subsection (2) shall be:
(i) filed by no later than the day on which the person begins that person's appointment;
and
(ii) amended when a significant change occurs in any matter required to be disclosed
under this Subsection (2).
(c) A commission member is not required to disclose an ownership interest that the
commission member has if the ownership interest is in a publicly traded company or held as
part of a mutual fund, trust, or similar investment.
(3) (a) Except as required by Subsection (3)(b), as terms of current commission
members expire, the governor shall appoint each new commission member to a four-year term
ending on June 30.
(b) Notwithstanding the requirements of Subsection (3)(a), the governor shall, at the
time of appointment, adjust the length of terms to ensure that the terms of the commission
members are staggered so that approximately half of the members appointed under Subsection
(1)(a)(i) and half of the members appointed under Subsection (1)(a)(ii) are appointed every two
years.
(c) A commission member may not serve more than one consecutive term.
(d) When a vacancy occurs in the membership for any reason, the governor, with the
advice and consent of the Senate, shall appoint a replacement for the unexpired term.
(e) Notwithstanding the other provisions of this Subsection (3), a commission member
serves until a successor is appointed by the governor with the advice and consent of the Senate.
(4) A commission member may not receive compensation or benefits for the
commission member's service, but may receive per diem and travel expenses in accordance
with:
(a) Section 
63A-3-106
;
(b) Section 
63A-3-107
; and
(c) rules made by the Division of Finance pursuant to Sections 
63A-3-106
 and
63A-3-107
.
(5) Members of the commission shall annually select one commission member to serve
as chair.
(6) (a) (i) Except as provided in Subsection (6)(b), the commission shall meet at least
monthly.
(ii) (A) The commissioner shall, with the concurrence of the chair of the commission,
designate [
at least
] one monthly meeting per [
quarter
] 
calendar year
 as an in-person meeting.
[
(B) Notwithstanding Section 
52-4-207
, a commission member shall physically attend
a meeting designated as an in-person meeting under Subsection (6)(a)(ii)(A) and may not
attend through electronic means. A commission member may attend any other commission
meeting, subcommittee meeting, or emergency meeting by electronic means in accordance with
Section 
52-4-207
.
]
(B) A commission member may, after providing advance notice to the commissioner,
attend an in-person meeting through electronic means.
(b) (i) Except as provided in Subsection (6)(b)(ii), the commissioner may, with the
concurrence of the chair of the commission, cancel a monthly meeting of the commission if,
due to the number or nature of pending title insurance matters, the monthly meeting is not
necessary.
(ii) The commissioner may not cancel a monthly meeting designated as an in-person
meeting under Subsection (6)(a)(ii)(A).
(c) The commissioner may call additional meetings:
(i) at the commissioner's discretion;
(ii) upon the request of the chair of the commission; or
(iii) upon the written request of three or more commission members.
(d) (i) Three commission members constitute a quorum for the transaction of business.
(ii) The action of a majority of the commission members when a quorum is present is
the action of the commission.
(7) The commissioner shall staff the commission.
Section 6. Section 
31A-4-115
 is amended to read:
31A-4-115.
Plan of orderly withdrawal.
(1) As used in this section, a "line of insurance" means:
(a) a general line of authority;
(b) a general line of insurance;
(c) a limited line insurance;
(d) the small employer group health benefit plan market when there is a discontinuance
of all small employer health benefit plans under Subsection 
31A-22-618.6
(5)(e);
(e) the large employer group health benefit market when there is a discontinuance of all
large employer health benefit plans under Subsection 
31A-22-618.6
(5)(e); or
(f) the individual health benefit plan market when there is a discontinuance of all
individual health benefit plans under Subsection 
31A-22-618.7
(3)(e).
[
(1) (a)
] 
(2)
 When an insurer intends to withdraw from writing a line of insurance in
this state or to reduce its total annual premium volume by 75% or more, the insurer shall file
with the commissioner a plan of orderly withdrawal.
[
(b) For purposes of this section, a discontinuance of a health benefit plan is a
withdrawal from a line of insurance under Subsections 
31A-22-618.6
(5) or 
31A-22-618.7
(3).
]
[
(2)
] 
(3)
 An insurer's plan of orderly withdrawal shall:
(a) indicate the date the insurer intends to
:
(i)
 begin 
the withdrawal plan;
 and
(ii)
 complete [
its
] 
the
 withdrawal plan; and
(b) include provisions for:
(i) meeting the insurer's contractual obligations;
(ii) providing services to [
its
] 
the insurer's
 Utah policyholders and claimants;
(iii) meeting applicable statutory obligations; and
(iv) the payment of a withdrawal fee of $50,000 to the department if the insurer's line
of [
business
] 
insurance
 is not assumed or placed with another insurer approved by the
commissioner.
[
(3)
] 
(4)
 The commissioner shall approve a plan of orderly withdrawal if the plan of
orderly withdrawal adequately demonstrates that the insurer will:
(a) protect the interests of the people of the state;
(b) meet the insurer's contractual obligations;
(c) provide service to the insurer's Utah policyholders and claimants; and
(d) meet applicable statutory obligations.
[
(4)
] 
(5)
 Section 
31A-2-302
 governs the commissioner's approval or disapproval of a
plan for orderly withdrawal.
[
(5)
] 
(6)
 The commissioner may require an insurer to increase the deposit maintained
in accordance with Section 
31A-4-105
 or Section 
31A-4-105.5
 and place the deposit in trust in
the name of the commissioner upon finding, after an adjudicative proceeding that:
(a) there is reasonable cause to conclude that the interests of the people of the state are
best served by such action; and
(b) the insurer:
(i) has filed a plan of orderly withdrawal; or
(ii) intends to:
(A) withdraw from writing a line of insurance in this state; or
(B) reduce the insurer's total annual premium volume by 75% or more.
[
(6)
] 
(7)
 An insurer is subject to the civil penalties under Section 
31A-2-308
, if the
insurer:
(a) withdraws from writing 
a line of
 insurance in this state without receiving the
commissioner's approval of a plan of orderly withdrawal; or
(b) reduces [
its
] 
the insurer's
 total annual premium volume by 75% or more in any year
without receiving the commissioner's approval of a plan of orderly withdrawal.
[
(7)
] 
(8)
 An insurer that withdraws from writing [
all lines
] 
a line
 of insurance in this
state may not resume writing 
the line of
 insurance in this state for five years unless the
commissioner finds that the prohibition should be waived because the waiver is:
(a) in the public interest to promote competition; or
(b) to resolve inequity in the marketplace.
[
(8)
] 
(9)
 The commissioner shall adopt rules necessary to implement this section.
(10) This section does not apply to an insurer that places coverage with an affiliate of
the insurer with the same or similar coverage.
Section 7. Section 
31A-5-506
 is amended to read:
31A-5-506.
Conversion of a domestic mutual into a stock corporation.
(1) (a) Except as provided in Subsection (1)(b), a domestic mutual may be converted
into a domestic stock corporation under Subsections (2) through (11).
(b) A domestic mutual that is affiliated with other mutuals may not be converted into a
stock corporation, unless all the affiliated mutuals are converted at the same time, or the
commissioner finds that the interests of the policyholders of the remaining mutuals can be
permanently protected by limitations on the corporate powers of the new stock corporation or
on its authority to do business, or otherwise.
(2) The board shall pass a resolution stating that the conversion is in the best interests
of the policyholders. The resolution shall specify the reasons for and the purposes of the
proposed conversion, and how the conversion is expected to benefit policyholders.
(3) (a) Chapter 16, Insurance Holding Companies, applies to the conversion of a
domestic mutual into a stock corporation. In addition, the commissioner shall order the
examination and appraisal of the corporation, unless the commissioner finds that:
(i) the resolution is defective upon its face; or
(ii) the basis or the purposes of the proposed conversion are contrary to law, to the
interests of the policyholders, or to the public.
(b) The commissioner shall examine the company and all of its controlled affiliates
under Section 
31A-2-203
 to determine their financial condition and whether they are operating
in accordance with law.
(c) The commissioner shall appoint an appraisal committee, consisting of at least three
qualified and disinterested persons with differing expertise, to determine the value of the
corporation on the date of the resolution required by Subsection (2). Members of the appraisal
committee shall receive reasonable compensation and shall be reimbursed for reasonable
expenses in discharging their duties. They may employ consultants to advise them on technical
problems of the appraisal, if necessary. The appraisal committee shall consider the assets and
liabilities of the corporation, adjusting liabilities to take account of:
(i) the amounts of any reserves in excess of or below realistic estimates;
(ii) the value of the marketing organization;
(iii) the value of goodwill;
(iv) the going-concern value; and
(v) any other factor having an influence on the value of the corporation.
(4) When the examination and appraisal reports have been made to the commissioner,
the commissioner shall make copies available to the board. The board shall then prepare and
adopt by resolution a plan of conversion. The plan shall be consistent with Subsections (4)(a)
through (e) and shall state how the requirements of those subsections are satisfied.
(a) The plan of conversion shall state the number of shares proposed to be authorized
for the new stock corporation, their par value, if any, and the price per share at which they will
be offered to policyholders. The price per share may not exceed 1/2 of the median equitable
share of all policyholders under Subsection (4)(b).
(b) (i) When an insurer has the type of policies with no investment value to the
policyholders, each person who has been a policyholder and has paid premiums within five
years prior to the resolution under Subsection (2) is entitled, without additional payment, to as
much common stock of the new stock corporation as that person's equitable share of the value
of the converting corporation will purchase. The equitable share is determined by the ratio
which the net premium that person has paid to the corporation during the five years
immediately preceding the resolution required by Subsection (2) bears to the total net
premiums received by the corporation during the same period. The net premium is the gross
premium less the return premium and dividends paid. If the equitable share would only
purchase a fraction of a share of stock, the policyholder has the option of either receiving the
value of the fractional share in cash or purchasing a full share by paying the balance in cash.
(ii) When an insurer has the type of policies with specifically attributable investment
value to the policyholders, each policyholder is entitled, without additional payment, to as
much common stock of the new stock corporation as the policyholder's investment value in the
converting corporation will purchase, determined by the proportion of the policyholder's
investment value to the aggregate investment values of all policyholders. If the policyholder's
share would only purchase a fraction of a share of stock, the policyholder has the option of
either receiving the value of the fractional share in cash or purchasing a full share by paying the
balance in cash.
(c) A written offer shall be sent to each policyholder indicating the policyholder's
individual equitable share and the terms upon which the policyholder may subscribe for stock.
(d) Common shares may not be subscribed by or issued to persons other than
policyholders, until all subscriptions by the policyholders have been filled. After those
subscriptions have been filled, any new issue of stock for five years after the conversion shall
first be offered to the persons who have become shareholders under Subsection (4)(b) in
proportion to their interests under Subsection (4)(b).
(e) A policyholder in a nonlife mutual may not receive a distribution of shares valued
under Subsection (4)(b)(i), which distribution is greater than the amount the policyholder is
entitled to under Section 
31A-27a-701
. Any excess over the policyholder's entitlement under
Section 
31A-27a-701
 shall be distributed in accordance with Section 
31A-27a-705
.
(5) The plan of conversion shall be submitted to the commissioner for approval,
together with:
(a) the proposed articles and bylaws of the new stock corporation which comply with
Section 
31A-5-203
;
(b) any information specified under Subsection 
31A-5-204
(2), which the commissioner
reasonably requires; and
(c) a projection of the planned or anticipated financial situation of the new corporation
for five years after the conversion.
(6) The commissioner shall then hold a hearing. The notice of the hearing shall be
mailed to each person who was a policyholder of the corporation on the date of the resolution
required by Subsection (2). This notice shall include a copy of the plan of conversion and any
comments the commissioner considers necessary to adequately inform the policyholders.
(7) The commissioner shall approve the plan of conversion unless the commissioner
finds that the plan violates the law or is contrary to the interests of policyholders or the public.
(8) After approval under Subsection (7), the conversion plan shall be submitted to a
vote of:
(a) for mutuals subject to Subsection (4)(b)(i), those persons who were policyholders
of the mutual on the date of the resolution required by Subsection (2); or
(b) for mutuals subject to Subsection (4)(b)(ii), those persons who had investment
values in their policies as of the date of the resolution required by Subsection (2).
(9) If the policyholders approve the conversion under Subsection (8), the commissioner
shall issue a new certificate of authority. The issuance of the certificate is the conversion of the
mutual to a stock corporation. This stock corporation is considered as being organized at the
time the converted mutual was organized. Subject to the plan of conversion, the directors,
officers, agents, and employees of the mutual shall continue in their same positions with the
stock corporation.
(10) In the proposed conversion, the corporation may not pay any person compensation
other than regular salaries to existing personnel and compensation for clerical and mailing
expenses. With the commissioner's approval, the corporation may pay, at reasonable rates, for
printing costs and for legal and other professional fees for services actually rendered. All
expenses of the conversion, including the expenses incurred by the commissioner and the
prorated salaries of any department staff members involved, shall be paid by the corporation
being converted.
(11) The commissioner's approval of the plan of conversion satisfies the registration
requirement of Section 
31A-5-302
.
(12) This section does not apply to a mutual reorganization or merger under Section
31A-16-102.6
.
Section 8. Section 
31A-6a-104
 is amended to read:
31A-6a-104.
Required disclosures.
(1) A reimbursement insurance policy insuring a service contract or a vehicle
protection product warranty that is issued, sold, or offered for sale in this state shall
conspicuously state that, upon failure of the service contract provider or warrantor to perform
under the contract, the issuer of the policy shall:
(a) pay on behalf of the service contract provider or warrantor any sums the service
contract provider or warrantor is legally obligated to pay according to the service contract
provider's or warrantor's contractual obligations under the service contract or a vehicle
protection product warranty issued or sold by the service contract provider or warrantor; or
(b) provide the service which the service contract provider is legally obligated to
perform, according to the service contract provider's contractual obligations under the service
contract issued or sold by the service contract provider.
(2) (a) A service contract may not be issued, sold, or offered for sale in this state unless
the service contract contains the following statements in substantially the following form:
(i) "Obligations of the provider under this service contract are guaranteed under a
service contract reimbursement insurance policy. Should the provider fail to pay or provide
service on any claim within 60 days after proof of loss has been filed, the contract holder is
entitled to make a claim directly against the Insurance Company.";
(ii) "This service contract or warranty is subject to limited regulation by the Utah
Insurance Department. To file a complaint, contact the Utah Insurance Department."; and
(iii) A service contract or reimbursement insurance policy may not be issued, sold, or
offered for sale in this state unless the contract contains a statement in substantially the
following form, "Coverage afforded under this contract is not guaranteed by the Property and
Casualty Guaranty Association."
(b) A vehicle protection product warranty may not be issued, sold, or offered for sale in
this state unless the vehicle protection product warranty contains the following statements in
substantially the following form:
(i) "Obligations of the warrantor under this vehicle protection product warranty are
guaranteed under a reimbursement insurance policy. Should the warrantor fail to pay on any
claim within 60 days after proof of loss has been filed, the warranty holder is entitled to make a
claim directly against the Insurance Company.";
(ii) "This vehicle protection product warranty is subject to limited regulation by the
Utah Insurance Department. To file a complaint, contact the Utah Insurance Department."; and
(iii) as applicable:
(A) "The warrantor under this vehicle protection product warranty will reimburse the
warranty holder as specified in the warranty upon the theft of the vehicle."; or
(B) "The warrantor under this vehicle protection product warranty will reimburse the
warranty holder as specified in the warranty and at the end of the time period specified in the
warranty if, following the theft of the vehicle, the stolen vehicle is not recovered within a time
period specified in the warranty, not to exceed 30 days after the day on which the vehicle is
reported stolen."
(c) A vehicle protection product warranty, or reimbursement insurance policy, may not
be issued, sold, or offered for sale in this state unless the warranty contains a statement in
substantially the following form, "Coverage afforded under this warranty is not guaranteed by
the Property and Casualty Guaranty Association."
(3) (a) A service contract and a vehicle protection product warranty shall:
(i) conspicuously state the name, address, and a toll free claims service telephone
number of the reimbursement insurer;
(ii) (A) identify the service contract provider, the seller, and the service contract holder;
or
(B) identify the warrantor, the seller, and the warranty holder;
(iii) conspicuously state the total purchase price and the terms under which the service
contract or warranty is to be paid;
(iv) conspicuously state the existence of any deductible amount 
or service fee
;
(v) specify the merchandise, service to be provided, and any limitation, exception, or
exclusion;
(vi) state a term, restriction, or condition governing the transferability of the service
contract or warranty; and
(vii) state a term, restriction, or condition that governs cancellation of the service
contract as provided in Sections 
31A-21-303
 through 
31A-21-305
 by either the contract holder
or service contract provider.
(b) Beginning January 1, 2021, a service contract shall contain a conspicuous statement
in substantially the following form: "Purchase of this product is optional and is not required in
order to finance, lease, or purchase a motor vehicle."
(4) If prior approval of repair work is required under a home protection service contract
or a vehicle service contract, the contract shall conspicuously state the procedure for obtaining
prior approval and for making a claim, including:
(a) a toll free telephone number for claim service; and
(b) a procedure for obtaining reimbursement for emergency repairs performed outside
of normal business hours.
(5) A preexisting condition clause in a service contract shall specifically state which
preexisting condition is excluded from coverage.
(6) (a) Except as provided in Subsection (6)(c), a service contract shall state the
conditions upon which the use of a nonmanufacturers' part is allowed.
(b) A condition described in Subsection (6)(a) shall comply with applicable state and
federal laws.
(c) This Subsection (6) does not apply to:
(i) a home warranty service contract; or
(ii) a service contract that does not impose an obligation to provide parts.
(7) This section applies to a vehicle protection product warranty, except for the
requirements of Subsections (3)(a)(iv) and (vii), (4), (5), and (6). The department may make
rules in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, to
implement the application of this section to a vehicle protection product warranty.
(8) (a) As used in this Subsection (8), "conspicuous statement" means a disclosure that:
(i) appears in all-caps, bold, and 14-point font; and
(ii) provides a space to be initialed by the consumer:
(A) immediately below the printed disclosure; and
(B) at or before the time the consumer purchases the vehicle protection product.
(b) A vehicle protection product warranty shall contain a conspicuous statement in
substantially the following form: "Purchase of this product is optional and is not required in
order to finance, lease, or purchase a motor vehicle."
(9) If a vehicle protection product warranty states that the warrantor will reimburse the
warranty holder for incidental costs, the vehicle protection product warranty shall state how
incidental costs paid under the warranty are calculated.
(10) If a vehicle protection product warranty states that the warrantor will reimburse
the warranty holder in a fixed amount, the vehicle protection product warranty shall state the
fixed amount.
Section 9. Section 
31A-16-102.6
 is enacted to read:
 31A-16-102.6.
Mutual insurance holding companies.
(1) As used in this section:
(a) "Intermediate holding company" means a holding company that:
(i) is a subsidiary of a mutual insurance holding company;
(ii) directly or through a subsidiary of the holding company, holds one or more
subsidiary insurers, including a reorganized mutual insurer; and
(iii) if the subsidiary insurers were not held by the holding company, a majority of the
voting shares of the subsidy insurers' capital stock would be required under this section to be
owned by the mutual insurance holding company.
(b) "Majority of the voting shares" means the shares of a reorganized mutual insurer's
capital stock that carry the right to cast a majority of the votes entitled to be cast by all of the
outstanding shares of the reorganized mutual insurer's capital stock for the election of directors
and other matters submitted to a vote of the reorganized mutual insurer's shareholders.
(2) (a) With the commissioner's approval, a domestic mutual insurer may reorganize by
forming a mutual insurance holding company in which:
(i) in accordance with the mutual insurance holding company's articles of incorporation
and bylaws, the membership interests of the domestic mutual insurer's policyholders become
membership interests in the mutual insurance holding company; and
(ii) the domestic mutual insurer is reorganized as a domestic stock insurance company.
(b) The commissioner may approve a domestic mutual insurer's reorganization if:
(i) the domestic mutual insurer's reorganization plan:
(A) properly protects the interests of the domestic mutual insurer's policyholders;
(B) is fair and equitable to the domestic mutual insurer's policyholders; and
(C) satisfies the requirements of Subsections 
31A-16-103
(8) through (10);
(ii) the initial shares of the reorganized domestic mutual insurer's capital stock are
issued to the mutual insurance holding company or intermediate holding company; and
(iii) at all times, the mutual insurance holding company or intermediate holding
company owns a majority of the voting shares of the reorganized domestic mutual insurer's
capital stock.
(3) (a) With the commissioner's approval, a foreign mutual insurer that would qualify
to become a domestic insurer organized under the laws of this state may reorganize by forming
a mutual insurance holding company system in which:
(i) in accordance with the mutual insurance holding company's articles of incorporation
and bylaws, the membership interests of the foreign mutual insurer's policyholders become
membership interests in the mutual insurance holding company; and
(ii) the foreign mutual insurer is reorganized as a foreign stock insurance company.
(b) The commissioner may approve a foreign mutual insurer's reorganization if:
(i) the foreign mutual insurer's reorganization plan:
(A) complies with any other law or rule applicable to the foreign mutual insurer;
(B) properly protects the interests of the foreign mutual insurer's policyholders;
(C) is fair and equitable to the foreign mutual insurer's policyholders; and
(D) satisfies the requirements of Subsections 
31A-16-103
(8) through (10);
(ii) the initial shares of the reorganized foreign mutual insurer's capital stock are issued
to the mutual insurance holding company or intermediate holding company; and
(iii) at all times, the mutual insurance holding company or intermediate holding
company owns a majority of the voting shares of the reorganized foreign mutual insurer's
capital stock.
(c) After a merger, the reorganized foreign mutual insurer may:
(i) remain a foreign corporation; and
(ii) with the commissioner's approval, be admitted to conduct business in this state.
(d) A foreign mutual insurer that is a party to a reorganization plan may redomesticate
in this state by complying with the applicable requirements of this state and the foreign mutual
insurer's state of domicile.
(4) (a) As a condition of approval, the commissioner may require a mutual insurer to
modify the mutual insurer's reorganization plan to protect the interests of the mutual insurer's
policyholders.
(b) If the commissioner determines reasonably necessary, at the reorganizing mutual
insurer's expense, the commissioner may retain a third-party consultant to assist the
commissioner in reviewing the mutual insurer's reorganization plan.
(c) The commissioner has jurisdiction over a mutual insurance holding company or
intermediate holding company organized in accordance with this section.
(d) Subject to the commissioner's approval, a reorganized mutual insurer or a stock
insurance subsidiary within a mutual insurance company may issue a dividend or distribution
to the mutual insurance holding company or intermediate holding company.
(5) (a) Subject to the provisions of this section, a mutual insurance holding company
resulting from the reorganization of a domestic mutual insurer shall be incorporated in
accordance with Chapter 5, Domestic Stock and Mutual Insurance Corporations.
(b) A mutual insurance holding company's articles of incorporation and bylaws are
subject to commissioner's approval in the same manner as an insurance company's articles of
incorporation and bylaws.
(6) (a) A mutual insurance holding company is:
(i) subject to Chapter 27a, Insurer Receivership Act; and
(ii) a party to any proceeding under Chapter 27a, Insurer Receivership Act, involving
an insurer that is a subsidiary of the mutual insurance holding company as a result of a
reorganization in accordance with this section.
(b) In a proceeding under Chapter 27a, Insurer Receivership Act, involving a
reorganized mutual insurer, the assets of the mutual insurance holding company are assets of
the estate of the reorganized mutual insurer for the purpose of satisfying the claims of the
reorganized mutual insurer's policyholders.
(c) A mutual insurance holding company may be dissolved or liquidated only by:
(i) prior approval of the commissioner; or
(ii) court order in accordance with Chapter 27a, Insurer Receivership Act.
(7) (a) Section 
31A-5-506
 does not apply to a mutual insurer's reorganization or merger
under this section.
(b) Section 
31A-5-506
 applies to demutualization of a mutual insurance holding
company.
(8) A membership interest in a domestic mutual insurance holding company is not a
security under Utah law.
(9) (a) The ownership of a majority of the voting shares of a reorganized mutual
insurer's capital stock includes indirect ownership through one or more intermediate holding
companies in a corporate structure approved by the commissioner.
(b) The indirect ownership described in Subsection (9)(a) may not result in the mutual
insurance holding company owning less than the equivalent of the majority of the voting shares
of the reorganized mutual insurer's capital stock.
(10) (a) A mutual insurance holding company or intermediate holding company may
not sell, transfer, assign, pledge, encumber, hypothecate, alienate, or subject to a security
interest or lien the majority of the voting shares of the reorganized mutual insurer's capital
stock.
(b) An act that violates Subsection (10)(a) is void in reverse chronological order of the
date the act occurred.
(c) The majority of the voting shares of the reorganized mutual insurer's capital stock
are not subject to execution and levy under Utah law.
(d) The shares of the capital stock of the surviving or new company resulting from a
merger or consolidation of two or more reorganized mutual insurers, or two or more
intermediate holding companies that were subsidiaries of the same mutual insurance holding
company, are subject to the same requirements, restrictions, and limitations described in this
section that applied to the shares of the merging or consolidating reorganized mutual insurers
or intermediate holding companies before the merger or consolidation.
(11) In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act,
the commissioner may make rules to implement the provisions of this section.
Section 10. Section 
31A-16-105
 is amended to read:
31A-16-105.
Registration of insurers.
(1) (a) An insurer that is authorized to do business in this state and that is a member of
an insurance holding company system shall register with the commissioner, except a foreign
insurer subject to registration requirements and standards adopted by statute or regulation in the
jurisdiction of its domicile, if the requirements and standards are substantially similar to those
contained in this section, Subsections 
31A-16-106
(1)(a) and (2) and either Subsection
31A-16-106
(1)(b) or a statutory provision similar to the following: "Each registered insurer
shall keep current the information required to be disclosed in its registration statement by
reporting all material changes or additions within 15 days after the end of the month in which it
learns of each change or addition."
(b) An insurer that is subject to registration under this section shall register within 15
days after it becomes subject to registration, and annually thereafter by June 30 of each year for
the previous calendar year, unless the commissioner for good cause extends the time for
registration and then at the end of the extended time period. The commissioner may require
any insurer authorized to do business in the state, which is a member of a holding company
system, and which is not subject to registration under this section, to furnish a copy of the
registration statement, the summary specified in Subsection (3), or any other information filed
by the insurer with the insurance regulatory authority of domiciliary jurisdiction.
(2) An insurer subject to registration shall file the registration statement with the
commissioner on a form and in a format prescribed by the [
National Association of Insurance
Commissioners
] 
NAIC
, which shall contain the following current information:
(a) the capital structure, general financial condition, and ownership and management of
the insurer and any person controlling the insurer;
(b) the identity and relationship of every member of the insurance holding company
system;
(c) any of the following agreements in force, and transactions currently outstanding or
which have occurred during the last calendar year between the insurer and its affiliates:
(i) loans, other investments, or purchases, sales or exchanges of securities of the
affiliates by the insurer or of securities of the insurer by its affiliates;
(ii) purchases, sales, or exchanges of assets;
(iii) transactions not in the ordinary course of business;
(iv) guarantees or undertakings for the benefit of an affiliate which result in an actual
contingent exposure of the insurer's assets to liability, other than insurance contracts entered
into in the ordinary course of the insurer's business;
(v) all management agreements, service contracts, and all cost-sharing arrangements;
(vi) reinsurance agreements;
(vii) dividends and other distributions to shareholders; and
(viii) consolidated tax allocation agreements;
(d) any pledge of the insurer's stock, including stock of any subsidiary or controlling
affiliate, for a loan made to any member of the insurance holding company system;
(e) if requested by the commissioner, financial statements of or within an insurance
holding company system, including all affiliates:
(i) which may include annual audited financial statements filed with the United States
Securities and Exchange Commission pursuant to the Securities Act of 1933, as amended, or
the Securities Exchange Act of 1934, as amended; and
(ii) which request is satisfied by providing the commissioner with the most recently
filed parent corporation financial statements that have been filed with the United States
Securities and Exchange Commission;
(f) any other matters concerning transactions between registered insurers and any
affiliates as may be included in any subsequent registration forms adopted or approved by the
commissioner;
(g) statements that the insurer's board of directors oversees corporate governance and
internal controls and that the insurer's officers or senior management have approved,
implemented, and continue to maintain and monitor corporate governance and internal control
procedures; and
(h) any other information required by rule made by the commissioner in accordance
with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
(3) All registration statements shall contain a summary outlining all items in the
current registration statement representing changes from the prior registration statement.
(4) 
(a)
 No information need be disclosed on the registration statement filed pursuant to
Subsection (2) if the information is not material for the purposes of this section.
(b)
 Unless the commissioner by rule or order provides otherwise, sales, purchases,
exchanges, loans or extensions of credit, investments, or guarantees involving one-half of 1%,
or less, of an insurer's admitted assets as of the next preceding December 31 may not be
considered material for purposes of [
this section
] 
Subsection (2)
.
(5) Subject to Section 
31A-16-106
, each registered insurer shall report to the
commissioner a dividend or other distribution to shareholders within 15 business days
following the declaration of the dividend or distribution.
(6) Any person within an insurance holding company system subject to registration
shall provide complete and accurate information to an insurer if the information is reasonably
necessary to enable the insurer to comply with the provisions of this chapter.
(7) The commissioner shall terminate the registration of any insurer which
demonstrates that it no longer is a member of an insurance holding company system.
(8) The commissioner may require or allow two or more affiliated insurers subject to
registration under this section to file a consolidated registration statement.
(9) The commissioner may allow an insurer which is authorized to do business in this
state, and which is part of an insurance holding company system, to register on behalf of any
affiliated insurer which is required to register under Subsection (1) and to file all information
and material required to be filed under this section.
(10) This section does not apply to any insurer, information, or transaction if, and to
the extent that, the commissioner by rule or order exempts the insurer from this section.
(11) Any person may file with the commissioner a disclaimer of affiliation with any
authorized insurer, or a disclaimer of affiliation may be filed by any insurer or any member of
an insurance holding company system. The disclaimer shall fully disclose all material
relationships and bases for affiliation between the person and the insurer as well as the basis for
disclaiming the affiliation. A disclaimer of affiliation is considered to have been granted
unless the commissioner, within 30 days following receipt of a complete disclaimer, notifies
the filing party the disclaimer is disallowed. If disallowed, the disclaiming party may request
an administrative hearing, which shall be granted. The disclaiming party shall be relieved of its
duty to register under this section if approval of the disclaimer is granted by the commissioner,
or if the disclaimer is considered to have been approved.
(12) The ultimate controlling person of an insurer subject to registration shall also file
an annual enterprise risk report. The annual enterprise risk report shall, to the best of the
ultimate controlling person's knowledge and belief, identify the material risks within the
insurance holding company that could pose enterprise risk to the insurer. The annual enterprise
risk report shall be filed with the lead state commissioner of the insurance holding company
system as determined by the procedures within the Financial Analysis Handbook adopted by
the [
National Association of Insurance Commissioners
] 
NAIC
.
(13) (a) The ultimate controlling person of an insurer subject to registration shall
concurrently file with the registration an annual group capital calculation report as directed by
the lead state commissioner.
(b) The annual group capital calculation report described in Subsection (13)(a) shall be
filed with the lead state commissioner of the insurance holding company system as determined
by the commissioner in accordance with the procedures within the Financial Analysis
Handbook adopted by the NAIC.
(c) Subject to Subsections (13)(d) and (e), the following insurance holding company
systems are exempt from filing the annual group capital calculation report described in
Subsection (13)(a):
(i) an insurance holding company system that:
(A) has only one insurer within the insurance holding company's structure;
(B) writes business and is licensed only in the insurance holding company system's
domestic state; and
(C) assumes no business from any other insurer;
(ii) an insurance holding company system that is required to perform a group capital
calculation specified by the United States Federal Reserve Board unless:
(A) the lead state commissioner requests the calculation from the Federal Reserve
Board under the terms of information sharing agreements in effect; and
(B) the Federal Reserve Board cannot share the calculation with the lead state
commissioner;
(iii) an insurance holding company system whose non-United States group-wide
supervisor is located within a reciprocal jurisdiction as described in Subsection 
31A-17-404
(8)
that recognizes the United States' state regulatory approach to group supervision and group
capital; and
(iv) an insurance holding company system:
(A) that provides information to the lead state that meets the requirements for
accreditation under the NAIC financial standards and accreditation program, either directly or
indirectly through the group-wide supervisor, who has determined the information is
satisfactory to allow the lead state to comply with the NAIC group supervision approach, as
detailed in the NAIC Financial Analysis Handbook; and
(B) whose non-United States group-wide supervisor that is not located in a reciprocal
jurisdiction recognizes and accepts, as specified by the lead state commissioner in regulation,
the group capital calculation as the world-wide group capital assessment for United States
insurance groups that operate in that jurisdiction.
(d) If, after consultation with other supervisors or officials, the lead state commissioner
determines appropriate for prudential oversight and solvency monitoring purposes or for
ensuring the competitiveness of the insurance marketplace, the lead state commissioner shall
require the group capital calculation for United States operations of any non-United States
based insurance holding company system.
(e) The lead state commissioner may:
(i) exempt the ultimate controlling person from filing the annual group capital
calculation; or
(ii) accept a limited group capital filing or report in accordance with criteria as
specified by the lead state commissioner in regulation.
(f) If the lead state commissioner determines that an insurance holding company
system no longer meets one or more of the requirements for an exemption from filing the group
capital calculation under this section, the insurance holding company system shall file the
group capital calculation at the next annual filing date unless the lead state commissioner gives
an extension based on reasonable grounds.
(14) (a) The ultimate controlling person of every insurer subject to registration and also
scoped into the NAIC liquidity stress test framework shall file the results of a specific year's
liquidity stress test.
(b) The filing described in Subsection (14)(a) shall be made to the lead state insurance
commissioner of the insurance holding company system as determined by the procedures
within the Financial Analysis Handbook adopted by the NAIC.
(c) Any change to the NAIC liquidity stress test framework or to the data year for
which the scope criteria are to be measured shall be effective on January 1 of the year
following the calendar year in which the change is adopted.
(d) Insurers meeting at least one threshold of the NAIC liquidity stress test framework's
scope criteria are scoped into the NAIC liquidity stress test framework for the specified data
year unless the lead state insurance commissioner, in consultation with the NAIC Financial
Stability Task Force or the NAIC Financial Stability Task Force's successor, determines the
insurer should not be scoped into the NAIC liquidity stress test framework for that data year.
(e) Insurers that do not meet at least one threshold of the NAIC liquidity stress test
framework's scope criteria are scoped out of the NAIC liquidity stress test framework for the
specified data year, unless the lead state insurance commissioner, in consultation with the
NAIC Financial Stability Task Force or the NAIC Financial Stability Task Force's successor,
determines the insurer should be scoped into the NAIC liquidity stress test framework for that
data year.
(f) To avoid having insurers scoped in and out of the NAIC liquidity stress test
framework on a frequent basis, the lead state insurance commissioner, in consultation with the
Financial Stability Task Force or the NAIC Financial Stability Task Force's successor, shall
assess this concern as part of the lead state insurance commissioner's determination of whether
an insurer is scoped into the NAIC liquidity stress test framework for a specified data year.
(g) The performance of, and filing of the results from, a specific year's liquidity stress
test shall comply with:
(i) the NAIC liquidity stress test framework instructions and reporting templates for
that year; and
(ii) lead state insurance commissioner determinations made in conjunction with the
NAIC Financial Stability Task Force or the NAIC Financial Stability Task Force's successor,
provided within the NAIC liquidity stress test framework.
[
(13)
] 
(15)
 The failure to file a registration statement or any summary of the
registration statement or enterprise risk filing required by this section within the time specified
for the filing is a violation of this section.
Section 11. Section 
31A-16-106
 is amended to read:
31A-16-106.
Standards and management of an insurer within a holding company
system.
(1) (a) Transactions within an insurance holding company system to which an insurer
subject to registration is a party are subject to the following standards:
(i) the terms shall be fair and reasonable;
(ii) agreements for cost sharing services and management shall include the provisions
required by rule made by the commissioner in accordance with Title 63G, Chapter 3, Utah
Administrative Rulemaking Act;
(iii) charges or fees for services performed shall be reasonable;
(iv) expenses incurred and payment received shall be allocated to the insurer in
conformity with customary insurance accounting practices consistently applied;
(v) the books, accounts, and records of each party to all transactions shall be so
maintained as to clearly and accurately disclose the nature and details of the transactions,
including the accounting information necessary to support the reasonableness of the charges or
fees to the respective parties; [
and
]
(vi) the insurer's surplus held for policyholders, following any dividends or
distributions to shareholder affiliates, shall be reasonable in relation to the insurer's outstanding
liabilities and shall be adequate to its financial needs[
.
]
;
(vii) the commissioner may require the insurer to secure and maintain a deposit held by
the commissioner or a bond, as determined by the insurer at the insurer's discretion, in an
amount determined by the commissioner not to exceed the value of the agreement in any one
year, if the commissioner:
(A) determines that the insurer is in a hazardous financial condition under Title 31A,
Chapter 27a, Insurer Receivership Act, or a condition that would warrant a delinquency
proceeding under Title 31A, Chapter 27a, Insurer Receivership Act; and
(B) believes that the insurers' affiliate may be unable to fulfill an agreement with the
insurer if the insurer were put into liquidation;
(viii) all insurer records and data held by an affiliate:
(A) are the insurer's property;
(B) are subject to the insurer's control;
(C) are identifiable;
(D) are segregated or readily capable of segregation, at no additional cost to the insurer,
from all other records and data;
(E) shall be provided to a receiver, at the insurer's request, including any information,
software, licensing agreement, release, waiver, or any other thing required to access the records
and data; and
(F) may be restricted in use by the affiliate if the affiliate is not operating the insurer's
business; and
(ix) (A) all funds belonging to the insurer that an affiliate collects or holds are the
exclusive property of the insurer and subject to the control of the insurer; and
(B) if the insurer is placed into receivership, any right of offset against the funds is
subject to Title 31A, Chapter 27a, Insurance Receivership Act.
(b) The following transactions involving a domestic insurer and any person in its
insurance holding company system, including amendments or modifications of affiliate
agreements previously filed pursuant to this section, which are subject to any materiality
standards contained in Subsections (1)(a)(i) through (vi), may not be entered into unless the
insurer has notified the commissioner in writing of its intention to enter into the transaction at
least 30 days before entering into the transaction, or within any shorter period the
commissioner may permit, if the commissioner has not disapproved the transaction within the
period. The notice for an amendment or modification shall include the reasons for the change
and financial impact on the domestic insurer. Informal notice shall be reported, within 30 days
after a termination of a previously filed agreement, to the commissioner for determination of
the type of filing required, if any:
(i) sales, purchases, exchanges, loans or extensions of credit, guarantees, or
investments if the transactions are equal to, or exceed as of the next preceding December 31:
(A) for nonlife insurers, the lesser of 3% of the insurer's admitted assets or 25% of
surplus held for policyholders;
(B) for life insurers, 3% of the insurer's admitted assets;
(ii) loans or extensions of credit made to any person who is not an affiliate, if the
insurer makes the loans or extensions of credit with the agreement or understanding that the
proceeds of the transactions, in whole or in substantial part, are to be used to make loans or
extensions of credit to, to purchase assets of, or to make investments in, any affiliate of the
insurer making the loans or extensions of credit if the transactions are equal to, or exceed as of
the next preceding December 31:
(A) for nonlife insurers, the lesser of 3% of the insurer's admitted assets or 25% of
surplus held for policyholders;
(B) for life insurers, 3% of the insurer's admitted assets;
(iii) reinsurance agreements or modifications to reinsurance agreements, including an
agreement in which the reinsurance premium, a change in the insurer's liabilities, or the
projected reinsurance premium or a change in the insurer's liabilities in any of the current and
succeeding three years, equals or exceeds 5% of the insurer's surplus held for policyholders, as
of the next preceding December 31, including those agreements that may require as
consideration the transfer of assets from an insurer to a non-affiliate, if an agreement or
understanding exists between the insurer and the non-affiliate that any portion of the assets will
be transferred to one or more affiliates of the reinsurer;
(iv) all management agreements, service contracts, tax allocation agreements, and all
cost-sharing arrangements;
(v) guarantees when made by a domestic insurer, except that:
(A) a guarantee that is quantifiable as to amount is not subject to the notice
requirements of this Subsection (1) unless it exceeds the lesser of .5% of the insurer's admitted
assets or 10% of surplus held for policyholders, as of the next preceding December 31; and
(B) a guarantee that is not quantifiable as to amount is subject to the notice
requirements of this Subsection (1);
(vi) direct or indirect acquisitions or investments in a person that controls the insurer or
in an affiliate of the insurer in an amount that, together with its present holdings in the
investments, exceeds 2.5% of the insurer's surplus to policyholders, except that a direct or
indirect acquisition or investment in a subsidiary acquired pursuant to Section 
31A-16-102.5
,
or in a non-subsidiary insurance affiliate that is subject to this chapter, is exempt from this
Subsection (1)(b)(vi);
(vii) any material transactions, specified by rule, which the commissioner determines
may adversely affect the interests of the insurer's policyholders; and
(viii) this Subsection (1) may not be interpreted to authorize or permit any transactions
which would be otherwise contrary to law in the case of an insurer not a member of the same
holding company system.
(c) A domestic insurer may not enter into transactions which are part of a plan or series
of like transactions with persons within the holding company system if the purpose of the
separate transactions is to avoid the statutory threshold amount and thus to avoid the review by
the commissioner that would occur otherwise. If the commissioner determines that the
separate transactions were entered into over any 12 month period for such a purpose, the
commissioner may exercise the commissioner's authority under Section 
31A-16-110
.
(d) The commissioner, in reviewing transactions pursuant to Subsection (1)(b), shall
consider whether the transactions comply with the standards set forth in Subsection (1)(a) and
whether they may adversely affect the interests of policyholders.
(e) The commissioner shall be notified within 30 days of any investment of the
domestic insurer in any one corporation, if the total investment in the corporation by the
insurance holding company system exceeds 10% of the corporation's voting securities.
(2) (a) A domestic insurer may not pay any extraordinary dividend or make any other
extraordinary distribution to its shareholders until:
(i) 30 days after the commissioner has received notice of the declaration of the
dividend and has not within the 30-day period disapproved the payment; or
(ii) the commissioner has approved the payment within the 30-day period.
(b) For purposes of this Subsection (2), an extraordinary dividend or distribution
includes any dividend or distribution of cash or other property, fair market value of which,
together with that of other dividends or distributions made within the preceding 12 months,
exceeds the lesser of:
(i) 10% of the insurer's surplus held for policyholders as of the next preceding
December 31;
(ii) the net gain from operations of the insurer, if the insurer is a life insurer, or the net
income, if the insurer is not a life insurer, not including realized capital gains, for the 12-month
period ending the next preceding December 31; or
(iii) an extraordinary dividend does not include pro rata distributions of any class of the
insurer's own securities.
(c) In determining whether a dividend or distribution is extraordinary, an insurer other
than a life insurer may carry forward net income from the previous two calendar years that has
not already been paid out as dividends. This carry-forward shall be computed by taking the net
income from the second and third preceding calendar years, not including realized capital
gains, less dividends paid in the second and immediate preceding calendar years.
(d) Notwithstanding any other provision of law, an insurer may declare an
extraordinary dividend or distribution, which is conditioned upon the commissioner's approval
of the dividend or distribution, and the declaration shall confer no rights upon shareholders
until:
(i) the commissioner has approved the payment of the dividend or distribution; or
(ii) the commissioner has not disapproved the payment within the 30-day period
referred to in Subsection (2)(a).
(3) (a) Notwithstanding the control of a domestic insurer by any person, the officers
and directors of the insurer may not be relieved of any obligation or liability to which they
would otherwise be subject by law, and the insurer shall be managed so as to assure its separate
operating identity consistent with this chapter.
(b) Nothing in this section precludes a domestic insurer from having or sharing a
common management or cooperative or joint use of personnel, property, or services with one or
more other persons under arrangements meeting the standards of Subsection (1)(a).
(c) (i) Not less than one-third of the directors of a domestic insurer, and not less than
one-third of the members of each committee of the board of directors of a domestic insurer,
shall be persons who are not officers or employees of the insurer or of any entity controlling,
controlled by, or under common control with the insurer and who are not beneficial owners of a
controlling interest in the voting stock of the insurer or entity.
(ii) At least one person described in Subsection (3)(c)(i) shall be included in a quorum
for the transaction of business at a meeting of the board of directors or a committee of the
board of directors.
(d) Subsection (3)(c) does not apply to a domestic insurer if the person controlling the
insurer, such as an insurer, a mutual insurance holding company, or a publicly held corporation,
has a board of directors and committees of the board of directors that meet the requirements of
Subsection (3)(c) with respect to the controlling entity.
(e) An insurer may make application to the commissioner for a waiver from the
requirements of this Subsection (3) if the insurer's annual direct written and assumed premium,
excluding premiums reinsured with the Federal Crop Insurance Corporation and Federal Flood
Program, is less than $300,000,000. An insurer may also make application to the
commissioner for a waiver from the requirements of this Subsection (3) based upon unique
circumstances. The commissioner may consider various factors, including:
(i) the type of business entity;
(ii) the volume of business written;
(iii) the availability of qualified board members; or
(iv) the ownership or organizational structure of the entity.
(4) (a) For purposes of this chapter, in determining whether an insurer's surplus as
regards policyholders is reasonable in relation to the insurer's outstanding liabilities and
adequate to meet its financial needs, the following factors, among others, shall be considered:
(i) the size of the insurer as measured by its assets, capital and surplus, reserves,
premium writings, insurance in force, and other appropriate criteria;
(ii) the extent to which the insurer's business is diversified among several lines of
insurance;
(iii) the number and size of risks insured in each line of business;
(iv) the extent of the geographical dispersion of the insurer's insured risks;
(v) the nature and extent of the insurer's reinsurance program;
(vi) the quality, diversification, and liquidity of the insurer's investment portfolio;
(vii) the recent past and projected future trend in the size of the insurer's investment
portfolio;
(viii) the surplus as regards policyholders maintained by other comparable insurers;
(ix) the adequacy of the insurer's reserves; and
(x) the quality and liquidity of investments in affiliates.
(b) The commissioner may treat an investment described in Subsection (4)(a)(x) as a
disallowed asset for purposes of determining the adequacy of surplus as regards policyholders
whenever in the judgment of the commissioner the investment so warrants.
Section 12. Section 
31A-16-109
 is amended to read:
31A-16-109.
Confidentiality of information obtained by commissioner.
(1) (a) Documents, materials, or information obtained by or disclosed to the
commissioner or any other person in the course of an examination or investigation made under
Section 
31A-16-107.5
, and all information reported or provided to the department under
Section 
31A-16-105
 or 
31A-16-108.6
, is 
proprietary, contains trade secrets, and is
 confidential.
(b) Any confidential document, material, or information described in Subsection (1)(a)
is not subject to subpoena and may not be made public by the commissioner or any other
person without the permission of the insurer, except the confidential document, material, or
information may be provided to the insurance departments of other states, without the prior
written consent of the insurer to which the confidential document, material, or information
pertains.
(c) The commissioner shall maintain the confidentiality of the following received in
accordance with Section 
31A-16-105
 from an insurance holding company supervised by the
Federal Reserve Board or any United States group-wide supervisor:
(i) a group capital calculation;
(ii) a group capital ratio produced within the group capital calculation; or
(iii) group capital information.
(d) The commissioner shall maintain the confidentiality of the liquidity stress test
results, supporting disclosures, and any liquidity stress test information received in accordance
with Section 
31A-16-105
 from an insurance holding company supervised by the Federal
Reserve Board and non-United States group-wide supervisors.
(2) The commissioner and any person who receives documents, materials, or other
information while acting under the authority of the commissioner or with whom the
documents, materials, or other information are shared pursuant to this chapter shall keep
confidential any confidential documents, materials, or information subject to Subsection (1).
(3) [
(a)
] To assist in the performance of the commissioner's duties, the commissioner:
[
(i)
] 
(a)
 may share documents, materials, 
proprietary and trade secret documents,
 or
other information, including the confidential documents, materials, or information subject to
Subsection (1), with the following if the recipient agrees in writing to maintain the
confidentiality status of the document, material, or other information, and has verified in
writing the legal authority to maintain confidentiality:
[
(A)
] 
(i)
 a state, federal, or international regulatory agency;
[
(B)
] 
(ii)
 the [
National Association of Insurance Commissioners or an NAIC affiliate or
subsidiary; or
] 
NAIC;
(iii) a third-party consultant designated by the commissioner; or
[
(C)
] 
(iv)
 a state, federal, or international law enforcement authority, including a
member of a supervisory college described in Section 
31A-16-108.5
;
[
(ii)
] 
(b)
 notwithstanding Subsection (1), may only share confidential documents,
material, or information reported pursuant to Section 
31A-16-105
 or 
31A-16-108.6
 with a
commissioner of a state having statutes or regulations substantially similar to Subsection (1)
and who has agreed in writing not to disclose the documents, material, or information;
[
(iii)
] 
(c)
 may receive documents, materials, 
proprietary and trade secret information,
or 
other
 information, including otherwise confidential documents, materials, or information
from:
[
(A)
] 
(i)
 the [
National Association of Insurance Commissioners
] 
NAIC
 or an NAIC
affiliate or subsidiary; or
[
(B)
] 
(ii)
 a regulatory or law enforcement official of a foreign or domestic jurisdiction;
[
(iv)
] 
(d)
 shall maintain as confidential any document, material, or information
received under this section with notice or the understanding that it is confidential under the
laws of the jurisdiction that is the source of the document, material, or information; and
[
(v)
] 
(e)
 shall enter into written agreements with the [
National Association of Insurance
Commissioners
] 
NAIC or a third-party consultant designated by the commissioner
 governing
sharing and use of information provided pursuant to this chapter consistent with this
Subsection (3) that shall:
[
(A)
] 
(i)
 specify procedures and protocols regarding the confidentiality and security of
information shared with the [
National Association of Insurance Commissioners
] 
NAIC
 and
NAIC affiliates and subsidiaries pursuant to this chapter, including procedures and protocols
for sharing by the [
National Association of Insurance Commissioners
] 
NAIC
 with other state,
federal, or international regulators;
[
(B)
] 
(ii)
 specify that ownership of information shared with the [
National Association
of Insurance Commissioners
] 
NAIC
 and NAIC affiliates and subsidiaries pursuant to this
chapter remains with the commissioner and the [
National Association of Insurance
Commissioner's
] 
NAIC's
 use of the information is subject to the direction of the commissioner;
[
(C)
] 
(iii)
 require prompt notice to be given to an insurer whose confidential
information in the possession of the [
National Association of Insurance Commissioners
] 
NAIC
pursuant to this chapter is subject to a request or subpoena to the [
National Association of
Insurance Commissioners
] 
NAIC
 for disclosure or production; and
[
(D)
] 
(iv)
 require the [
National Association of Insurance Commissioners
] 
NAIC
 and
NAIC affiliates and subsidiaries to consent to intervention by an insurer in any judicial or
administrative action in which the [
National Association of Insurance Commissioners
] 
NAIC
and NAIC affiliates and subsidiaries may be required to disclose confidential information about
the insurer shared with the [
National Association of Insurance Commissioners
] 
NAIC
 and
NAIC affiliates and subsidiaries pursuant to this chapter.
(4) The sharing of information by the commissioner pursuant to this chapter does not
constitute a delegation of regulatory authority or rulemaking, and the commissioner is solely
responsible for the administration, execution, and enforcement of this chapter.
(5) A waiver of any applicable claim of confidentiality in the documents, materials, or
information does not occur as a result of disclosure to the commissioner under this section or
as a result of sharing as authorized in Subsection (3).
(6) Documents, materials, or other information in the possession or control of the
[
National Association of Insurance Commissioners
] 
NAIC
 pursuant to this chapter are:
(a) confidential, not public records, and not open to public inspection; and
(b) not subject to Title 63G, Chapter 2, Government Records Access and Management
Act.
(7) (a) The group capital calculation, including the resulting group capital ratio, and the
liquidity stress test, including the liquidity stress test results and supporting disclosures, are:
(i) regulatory tools for assessing risk and capital adequacy; and
(ii) not a method to rank insurers or insurance holding company systems generally.
(b) Except as provided in Subsection (7)(c), an insurer, broker, or other person engaged
in the business of insurance may not make, disseminate, or circulate to the public a materially
false or misleading statement relating to an insurer's or insurer group's, or a component of an
insurer's or insurer group's:
(i) group capital calculation;
(ii) group capital ratio;
(iii) liquidity stress test results; or
(iv) liquidity stress test supporting disclosures.
(c) If an insurer provides to the commissioner substantial proof that a statement
described in Subsection (7)(b) is materially false or misleading, the insurer may publish an
announcement in a written publication for the sole purpose of rebutting the materially false or
misleading statement.
Section 13. Section 
31A-17-408
 is amended to read:
31A-17-408.
Title insurance reserves.
(1) In addition to an adequate reserve for outstanding losses, a title insurance company
shall either:
(a) maintain and segregate an unearned premium reserve fund of not less than 10 cents
for each $1,000 face amount of retained liability under each title insurance contract or policy
on a single insurance risk issued; or
(b) have the commissioner review and approve a contract of reinsurance applicable to
the title insurance company's policies, which contract adequately covers the exposure or risk
which the unearned premium reserve would serve.
(2) The fund shall be maintained for the protection of policyholders and is not subject
to the claims of stockholders or creditors other than policyholders.
(3) The title insurance company may release the fund in accordance with the standards
of the NAIC Accounting Practices and Procedures Manual.
Section 14. Section 
31A-17-601
 is amended to read:
31A-17-601.
Definitions.
As used in this part:
(1) "Adjusted RBC report" means an RBC report that has been adjusted by the
commissioner in accordance with Subsection 
31A-17-602
(5).
(2) "Corrective order" means an order issued by the commissioner specifying
corrective action that the commissioner determines is required.
(3) "Health organization" means:
(a) an entity that is authorized under Chapter 7, Nonprofit Health Service Insurance
Corporations, or Chapter 8, Health Maintenance Organizations and Limited Health Plans; and
(b) that is:
(i) a health maintenance organization;
(ii) a limited health service organization;
(iii) a dental or vision plan;
(iv) a hospital, medical, and dental indemnity or service corporation; or
(v) other managed care organization.
(4) "Life or accident and health insurer" means:
(a) an insurance company licensed to write life insurance, [
disability
] 
accident and
health
 insurance, or both; or
(b) a licensed property casualty insurer writing only disability insurance.
(5) "Property and casualty insurer" means any insurance company licensed to write
lines of insurance other than life but does not include a monoline mortgage guaranty insurer,
financial guaranty insurer, or title insurer.
(6) "RBC" means risk-based capital.
(7) "RBC instructions" means the RBC report including the National Association of
Insurance Commissioner's risk-based capital instructions that govern the year for which an
RBC report is prepared.
(8) "RBC level" means an insurer's or health organization's authorized control level
RBC, company action level RBC, mandatory control level RBC, or regulatory action level
RBC.
(a) "Authorized control level RBC" means the number determined under the risk-based
capital formula in accordance with the RBC instructions;
(b) "Company action level RBC" means the product of 2.0 and its authorized control
level RBC;
(c) "Mandatory control level RBC" means the product of .70 and the authorized control
level RBC; and
(d) "Regulatory action level RBC" means the product of 1.5 and its authorized control
level RBC.
(9) (a) "RBC plan" means a comprehensive financial plan containing the elements
specified in Subsection 
31A-17-603
(2).
(b) Notwithstanding Subsection (9)(a), the plan is a "revised RBC plan" if:
(i) the commissioner rejects the RBC plan; and
(ii) the plan is revised by the insurer or health organization, with or without the
commissioner's recommendation.
(10) "RBC report" means the report required in Section 
31A-17-602
.
Section 15. Section 
31A-21-201
 is amended to read:
31A-21-201.
Filing of forms.
(1) (a) Except as exempted under Subsections 
31A-21-101
(2) through (6), a form may
not be used, sold, or offered for sale until the form is filed with the commissioner.
(b) A form is considered filed with the commissioner when the commissioner receives:
(i) the form;
(ii) the applicable filing fee as prescribed under Section 
31A-3-103
; and
(iii) the applicable transmittal forms as required by the commissioner.
(2) In filing a form for use in this state the insurer is responsible for assuring that the
form is in compliance with this title and rules adopted by the commissioner.
(3) (a) The commissioner may prohibit the use of a form at any time upon a finding
that:
(i) the form:
(A) is inequitable;
(B) is unfairly discriminatory;
(C) is misleading;
(D) is deceptive;
(E) is obscure;
(F) is unfair;
(G) encourages misrepresentation; or
(H) is not in the public interest;
(ii) the form provides benefits or contains another provision that endangers the solidity
of the insurer;
(iii) except for a life or accident and health insurance policy form, the form is an
insurance policy or application for an insurance policy, that fails to conspicuously provide:
(A) the exact name of the insurer; and
(B) the state of domicile of the insurer filing the insurance policy or application for the
insurance policy;
(iv) except an application required by Section 
31A-22-635
, the form is a life or
accident and health insurance [
policy
] form that fails to conspicuously provide:
(A) the exact name of the insurer;
(B) the state of domicile of the insurer [
filing the insurance policy or application for the
insurance policy
]; and
(C) for a life insurance policy only, the address of the administrative office of the
insurer filing the form;
(v) the form violates a statute or a rule adopted by the commissioner; or
(vi) the form is otherwise contrary to law.
(b) (i) When the commissioner prohibits the use of a form under Subsection (3)(a), the
commissioner may order that, on or before a date not less than 15 days after the day on which
the commissioner issues the order, the use of the form be discontinued.
(ii) Once use of a form is prohibited, the form may not be used until appropriate
changes are filed with and reviewed by the commissioner.
(iii) When the commissioner prohibits the use of a form under Subsection (3)(a), the
commissioner may require the insurer to disclose contract deficiencies to the existing
policyholders.
(c) If the commissioner prohibits use of a form under this Subsection (3), the
prohibition shall:
(i) be in writing;
(ii) constitute an order; and
(iii) state the reasons for the prohibition.
(4) (a) If, after a hearing, the commissioner determines that it is in the public interest,
the commissioner may require by rule or order that a form be subject to the commissioner's
approval before an insurer uses the form.
(b) The rule or order described in Subsection (4)(a) shall prescribe the filing
procedures for a form if the procedures are different from the procedures stated in this section.
(c) The type of form that under Subsection (4)(a) the commissioner may require
approval of before use includes:
(i) a form for a particular class of insurance;
(ii) a form for a specific line of insurance;
(iii) a specific type of form; or
(iv) a form for a specific market segment.
(5) (a) An insurer shall maintain a complete and accurate record of the following for
the time period described in Subsection (5)(b):
(i) a form:
(A) filed under this section for use; or
(B) that is in use; and
(ii) a document filed under this section with a form described in Subsection (5)(a)(i).
(b) The insurer shall maintain a record required under Subsection (5)(a) for the balance
of the current year, plus five years from:
(i) the last day on which the form is used; or
(ii) the last day an insurance policy that is issued using the form is in effect.
Section 16. Section 
31A-21-303
 is amended to read:
31A-21-303.
Cancellation, issuance, and renewal.
(1) (a) Except as otherwise provided in this section, other statutes, or by rule under
Subsection (1)(c), this section applies to all policies of insurance:
(i) except for:
(A) life insurance;
(B) accident and health insurance; and
(C) annuities; and
(ii) if the policies of insurance are issued on forms that are subject to filing under
Subsection 
31A-21-201
(1).
(b) A policy may provide terms more favorable to insureds than this section requires.
(c) The commissioner may by rule totally or partially exempt from this section classes
of insurance policies in which the insureds do not need protection against arbitrary or
unannounced termination.
(d) The rights provided by this section are in addition to and do not prejudice any other
rights the insureds may have at common law or under other statutes.
(2) (a) As used in this Subsection (2), "grounds" means:
(i) material misrepresentation;
(ii) substantial change in the risk assumed, unless the insurer should reasonably have
foreseen the change or contemplated the risk when entering into the contract;
(iii) substantial breaches of contractual duties, conditions, or warranties;
(iv) attainment of the age specified as the terminal age for coverage, in which case the
insurer may cancel by notice under Subsection (2)(c), accompanied by a tender of proportional
return of premium; or
(v) in the case of motor vehicle insurance, revocation or suspension of the driver's
license of:
(A) the named insured; or
(B) any other person who customarily drives the motor vehicle.
(b) (i) Except as provided in Subsection (2)(e) or unless the conditions of Subsection
(2)(b)(ii) are met, an insurance policy may not be canceled by the insurer before the earlier of:
(A) the expiration of the agreed term; or
(B) one year from the effective date of the policy or renewal.
(ii) Notwithstanding Subsection (2)(b)(i), an insurance policy may be canceled by the
insurer for:
(A) nonpayment of a premium when due; or
(B) on grounds defined in Subsection (2)(a).
(c) (i) The cancellation provided by Subsection (2)(b), except cancellation for
nonpayment of premium, is effective no sooner than 30 days after the delivery or first-class
mailing of a written notice to the policyholder.
(ii) Cancellation for nonpayment of premium of a personal lines policy is effective no
sooner than 10 days after delivery or first-class mailing of a written notice to the policyholder.
(iii) Cancellation for nonpayment of premium of a commercial lines policy is effective
no sooner than 10 days after delivery or first-class mailing of a written notice to:
(A) the policyholder;
(B) each assignee of the policyholder, if the assignee is named in the policy; and
(C) each loss payee or mortgagee or lienholder under property insurance of the
policyholder, if the loss payee, mortgagee, or lienholder is named in the policy.
(iv) An insurer shall deliver or send by first-class mail a copy of the notice of
cancellation for nonpayment of premium described in Subsection (2)(c)(iii) to an agent of
record of the policyholder on or before the day on which the insurer provides the notice to the
policyholder.
(d) (i) Notice of cancellation for nonpayment of premium shall include a statement of
the reason for cancellation.
(ii) Subsection (7) applies to the notice required for grounds of cancellation other than
nonpayment of premium.
(e) (i) Subsections (2)(a) through (d) do not apply to any insurance contract that has not
been previously renewed if the contract has been in effect less than 60 days on the day on
which the written notice of cancellation is mailed or delivered.
(ii) A cancellation under this Subsection (2)(e) may not be effective until at least 10
days after the day on which a written notice of cancellation is delivered to the insured.
(iii) If the notice required by this Subsection (2)(e) is sent by first-class mail, postage
prepaid, to the insured at the insured's last-known address, delivery is considered accomplished
after the passing, since the mailing date, of the mailing time specified in the Utah Rules of
Civil Procedure.
(iv) A policy cancellation subject to this Subsection (2)(e) is not subject to the
procedures described in Subsection (7).
(3) A policy may be issued for a term longer than one year or for an indefinite term if
the policy includes a clause providing for cancellation by the insurer by giving notice as
provided in Subsection (4)(b)(i) 30 days before an anniversary date.
(4) (a) Subject to Subsections (2), (3), and (4)(b), a policyholder has a right to have the
policy renewed:
(i) on the terms then being applied by the insurer to similar risks; and
(ii) (A) for an additional period of time equivalent to the expiring term if the agreed
term is one year or less; or
(B) for one year if the agreed term is longer than one year.
(b) Except as provided in Subsections (4)(c) and (5), the right to renewal under
Subsection (4)(a) is extinguished if:
(i) at least 30 days before the day on which the policy expires or completes an
anniversary, the insurer delivers or sends by first-class mail a notice of intention not to renew
the policy beyond the agreed expiration or anniversary date to the policyholder at the
policyholder's last-known address;
(ii) not more than 45 nor less than 14 days before the day on which the renewal
premium is due, the insurer delivers or sends by first-class mail a notice to the policyholder at
the policyholder's last-known address, clearly stating:
(A) the renewal premium;
(B) how the renewal premium may be paid, including the due date for payment of the
renewal premium;
(C) that failure to pay the renewal premium extinguishes the policyholder's right to
renewal; and
(D) subject to Subsection (4)(e), that the extinguishment of the right to renew for
nonpayment of premium is effective no sooner than at least 10 days after delivery or first-class
mailing of a written notice to the policyholder that the policyholder has failed to pay the
premium when due;
(iii) the policyholder has:
(A) accepted replacement coverage; or
(B) requested or agreed to nonrenewal; or
(iv) the policy is expressly designated as nonrenewable.
(c) Unless the conditions of Subsection (4)(b)(iii) or (iv) apply, an insurer may not fail
to renew an insurance policy as a result of a telephone call or other inquiry that:
(i) references a policy coverage; and
(ii) does not result in the insured requesting payment of a claim.
(d) Failure to renew under this Subsection (4) is subject to Subsection (5).
(e) (i) (A) If the policy is a personal lines policy, during the period that begins when an
insurer delivers or sends by first-class mail the notice described in Subsection (4)(b)(ii)(D) and
ends when the premium is paid, coverage exists and premiums are due.
(B) If the policy is a commercial lines policy, during the period that begins when an
insurer delivers or sends by first-class mail the notice described in Subsection (2)(c)(iii) and
ends when the premium is paid, coverage exists and premiums are due.
(ii) (A) If after receiving the notice required by Subsection (4)(b)(ii)(D) a personal
lines policyholder fails to pay the renewal premium, the coverage is extinguished as of the date
the renewal premium is originally due.
(B) If after receiving the notice required under Subsection (2)(c)(iii), a commercial
lines policyholder fails to pay the renewal premium within the 10 days before the day on which
cancellation for nonpayment is effective, the coverage is extinguished as of the day on which
the renewal premium is originally due.
(iii) Delivery of the notice required by Subsection (2)(c)(iii), (2)(c)(iv), or (4)(b)(ii)(D)
includes electronic delivery in accordance with Section 
31A-21-316
.
(iv) An insurer is not subject to Subsection (4)(b)(ii)(D) if:
(A) the insurer provides notice of the extinguishment of the right to renew for failure to
pay premium at least 15 days, but no longer than 45 days, before the day on which the renewal
payment is due; and
(B) the policy is a personal lines policy.
(v) Subsection (4)(b)(ii)(D) does not apply to a policy that provides coverage for 30
days or less.
(5) Notwithstanding Subsection (4), an insurer may not fail to renew the following
personal lines insurance policies solely on the basis of:
(a) in the case of a motor vehicle insurance policy:
(i) a claim from the insured that:
(A) results from an accident in which:
(I) the insured is not at fault; and
(II) the driver of the motor vehicle that is covered by the motor vehicle insurance
policy is 21 years of age or older; and
(B) is the only claim meeting the condition of Subsection (5)(a)(i)(A) within a
36-month period;
(ii) a single traffic violation by an insured that:
(A) is a violation of a speed limit under Title 41, Chapter 6a, Traffic Code;
(B) is not in excess of 10 miles per hour over the speed limit;
(C) is not a traffic violation under:
(I) Section 
41-6a-601
;
(II) Section 
41-6a-604
; or
(III) Section 
41-6a-605
;
(D) is not a violation by an insured driver who is younger than 21 years of age; and
(E) is the only violation meeting the conditions of Subsections (5)(a)(ii)(A) through
(D) within a 36-month period; or
(iii) a claim for damage that:
(A) results solely from:
(I) wind;
(II) hail;
(III) lightning; or
(IV) an earthquake;
(B) is not preventable by the exercise of reasonable care; and
(C) is the only claim meeting the conditions of Subsections (5)(a)(iii)(A) and (B)
within a 36-month period; and
(b) in the case of a homeowner's insurance policy, a claim by the insured that is for
damage that:
(i) results solely from:
(A) wind;
(B) hail; or
(C) lightning;
(ii) is not preventable by the exercise of reasonable care; and
(iii) is the only claim meeting the conditions of Subsections (5)(b)(i) and (ii) within a
36-month period.
(6) (a) (i) Subject to Subsection (6)(b), if the insurer offers or purports to renew the
policy, but on less favorable terms or at higher rates, the new terms or rates take effect on the
renewal date if the insurer delivered or sent by first-class mail to the policyholder notice of the
new terms or rates at least 30 days before the day on which the previous policy expires.
(ii) If the insurer did not give the prior notification described in Subsection (6)(a)(i) to
the policyholder, the new terms or rates do not take effect until 30 days after the day on which
the insurer delivers or sends by first-class mail the notice, in which case the policyholder may
elect to cancel the renewal policy at any time during the 30-day period.
(iii) Return premiums or additional premium charges shall be calculated
proportionately on the basis that the old rates apply.
(b) 
Except as provided in Subsection (6)(c),
 Subsection (6)(a) does not apply if the
only change in terms that is adverse to the policyholder is:
(i) a rate increase generally applicable to the class of business to which the policy
belongs;
(ii) a rate increase resulting from a classification change based on the altered nature or
extent of the risk insured against; or
(iii) a policy form change made to make the form consistent with Utah law.
(c) Subsections (6)(b)(i) and (ii) do not apply to a rate increase of 25% or more on a
commercial policy.
(7) (a) If a notice of cancellation or nonrenewal under Subsection (2)(c) does not state
with reasonable precision the facts on which the insurer's decision is based, the insurer shall
send by first-class mail or deliver that information within 10 working days after receipt of a
written request by the policyholder.
(b) A notice under Subsection (2)(c) is not effective unless it contains information
about the policyholder's right to make the request.
(8) (a) An insurer that gives a notice of nonrenewal or cancellation of insurance on a
motor vehicle insurance policy issued in accordance with the requirements of Chapter 22, Part
3, Motor Vehicle Insurance, for nonpayment of a premium shall provide notice of nonrenewal
or cancellation to a lienholder if the insurer has been provided the name and mailing address of
the lienholder.
(b) An insurer shall provide the notice described in Subsection (8)(a) to the lienholder
by first-class mail or, if agreed by the parties, any electronic means of communication.
(c) A lienholder shall provide a current physical address of notification or an electronic
address of notification to an insurer that is required to make a notification under Subsection
(8)(a).
(9) If a risk-sharing plan under Section 
31A-2-214
 exists for the kind of coverage
provided by the insurance being cancelled or nonrenewed, a notice of cancellation or
nonrenewal required under Subsection (2)(c) or (4)(b)(i) may not be effective unless the notice
contains instructions to the policyholder for applying for insurance through the available
risk-sharing plan.
(10) There is no liability on the part of, and no cause of action against, any insurer, its
authorized representatives, agents, employees, or any other person furnishing to the insurer
information relating to the reasons for cancellation or nonrenewal or for any statement made or
information given by them in complying or enabling the insurer to comply with this section
unless actual malice is proved by clear and convincing evidence.
(11) This section does not alter any common law right of contract rescission for
material misrepresentation.
(12) If a person is required to pay a premium in accordance with this section:
(a) the person may make the payment using:
(i) the United States Postal Service;
(ii) a delivery service the commissioner describes or designates by rule made in
accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act; or
(iii) electronic means; and
(b) the payment is considered to be made:
(i) for a payment that is mailed using the method described in Subsection (12)(a)(i), on
the date on which the payment is postmarked;
(ii) for a payment that is delivered using the method described in Subsection (12)(a)(ii),
on the date on which the delivery service records or marks the payment as having been received
by the delivery service; or
(iii) for a payment that is made using the method described in Subsection (12)(a)(iii),
on the date on which the payment is made electronically.
Section 17. Section 
31A-22-305.3
 is amended to read:
31A-22-305.3.
Underinsured motorist coverage.
(1) As used in this section:
(a) "Covered person" has the same meaning as defined in Section 
31A-22-305
.
(b) (i) "Underinsured motor vehicle" includes a motor vehicle, the operation,
maintenance, or use of which is covered under a liability policy at the time of an injury-causing
occurrence, but which has insufficient liability coverage to compensate fully the injured party
for all special and general damages.
(ii) The term "underinsured motor vehicle" does not include:
(A) a motor vehicle that is covered under the liability coverage of the same policy that
also contains the underinsured motorist coverage;
(B) an uninsured motor vehicle as defined in Subsection 
31A-22-305
(2);
(C) a motor vehicle owned or leased by:
(I) a named insured;
(II) a named insured's spouse; or
(III) a dependent of a named insured.
(2) (a) Underinsured motorist coverage under Subsection 
31A-22-302
(1)(c) provides
coverage for a covered person who is legally entitled to recover damages from an owner or
operator of an underinsured motor vehicle because of bodily injury, sickness, disease, or death.
(b) A covered person occupying or using a motor vehicle owned, leased, or furnished
to the covered person, the covered person's spouse, or covered person's resident relative may
recover underinsured benefits only if the motor vehicle is:
(i) described in the policy under which a claim is made; or
(ii) a newly acquired or replacement motor vehicle covered under the terms of the
policy.
(3) (a) For purposes of this Subsection (3), "new policy" means:
(i) any policy that is issued that does not include a renewal or reinstatement of an
existing policy; or
(ii) a change to an existing policy that results in:
(A) a named insured being added to or deleted from the policy; or
(B) a change in the limits of the named insured's motor vehicle liability coverage.
(b) For new policies written on or after January 1, 2001, the limits of underinsured
motorist coverage shall be equal to the lesser of the limits of the named insured's motor vehicle
liability coverage or the maximum underinsured motorist coverage limits available by the
insurer under the named insured's motor vehicle policy, unless a named insured rejects or
purchases coverage in a lesser amount by signing an acknowledgment form that:
(i) is filed with the department;
(ii) is provided by the insurer;
(iii) waives the higher coverage;
(iv) need only state in this or similar language that "underinsured motorist coverage
provides benefits or protection to you and other covered persons for bodily injury resulting
from an accident caused by the fault of another party where the other party has insufficient
liability insurance"; and
(v) discloses the additional premiums required to purchase underinsured motorist
coverage with limits equal to the lesser of the limits of the named insured's motor vehicle
liability coverage or the maximum underinsured motorist coverage limits available by the
insurer under the named insured's motor vehicle policy.
(c) Any selection or rejection under Subsection (3)(b) continues for that issuer of the
liability coverage until the insured requests, in writing, a change of underinsured motorist
coverage from that liability insurer.
(d) (i) Subsections (3)(b) and (c) apply retroactively to any claim arising on or after
January 1, 2001, for which, as of May 14, 2013, an insured has not made a written demand for
arbitration or filed a complaint in a court of competent jurisdiction.
(ii) The Legislature finds that the retroactive application of Subsections (3)(b) and (c)
clarifies legislative intent and does not enlarge, eliminate, or destroy vested rights.
(e) (i) As used in this Subsection (3)(e), "additional motor vehicle" means a change
that increases the total number of vehicles insured by the policy, and does not include
replacement, substitute, or temporary vehicles.
(ii) The adding of an additional motor vehicle to an existing personal lines or
commercial lines policy does not constitute a new policy for purposes of Subsection (3)(a).
(iii) If an additional motor vehicle is added to a personal lines policy where
underinsured motorist coverage has been rejected, or where underinsured motorist limits are
lower than the named insured's motor vehicle liability limits, the insurer shall provide a notice
to a named insured within 30 days that:
(A) in the same manner described in Subsection (3)(b)(iv), explains the purpose of
underinsured motorist coverage; and
(B) encourages the named insured to contact the insurance company or insurance
producer for quotes as to the additional premiums required to purchase underinsured motorist
coverage with limits equal to the lesser of the limits of the named insured's motor vehicle
liability coverage or the maximum underinsured motorist coverage limits available by the
insurer under the named insured's motor vehicle policy.
(f) A change in policy number resulting from any policy change not identified under
Subsection (3)(a)(ii) does not constitute a new policy.
(g) (i) Subsection (3)(a) applies retroactively to any claim arising on or after January 1,
2001 for which, as of May 1, 2012, an insured has not made a written demand for arbitration or
filed a complaint in a court of competent jurisdiction.
(ii) The Legislature finds that the retroactive application of Subsection (3)(a):
(A) does not enlarge, eliminate, or destroy vested rights; and
(B) clarifies legislative intent.
(h) A self-insured, including a governmental entity, may elect to provide underinsured
motorist coverage in an amount that is less than its maximum self-insured retention under
Subsections (3)(b) and (l) by issuing a declaratory memorandum or policy statement from the
chief financial officer or chief risk officer that declares the:
(i) self-insured entity's coverage level; and
(ii) process for filing an underinsured motorist claim.
(i) Underinsured motorist coverage may not be sold with limits that are less than:
(i) $10,000 for one person in any one accident; and
(ii) at least $20,000 for two or more persons in any one accident.
(j) An acknowledgment under Subsection (3)(b) continues for that issuer of the
underinsured motorist coverage until the named insured, in writing, requests different
underinsured motorist coverage from the insurer.
(k) (i) The named insured's underinsured motorist coverage, as described in Subsection
(2), is secondary to the liability coverage of an owner or operator of an underinsured motor
vehicle, as described in Subsection (1).
(ii) Underinsured motorist coverage may not be set off against the liability coverage of
the owner or operator of an underinsured motor vehicle, but shall be added to, combined with,
or stacked upon the liability coverage of the owner or operator of the underinsured motor
vehicle to determine the limit of coverage available to the injured person.
(l) (i) In conjunction with the first two renewal notices sent after January 1, 2001, for
policies existing on that date, the insurer shall disclose in the same medium as the premium
renewal notice, an explanation of:
(A) the purpose of underinsured motorist coverage in the same manner as described in
Subsection (3)(b)(iv); and
(B) a disclosure of the additional premiums required to purchase underinsured motorist
coverage with limits equal to the lesser of the limits of the named insured's motor vehicle
liability coverage or the maximum underinsured motorist coverage limits available by the
insurer under the named insured's motor vehicle policy.
(ii) The disclosure required under this Subsection (3)(l) shall be sent to all named
insureds that carry underinsured motorist coverage limits in an amount less than the named
insured's motor vehicle liability policy limits or the maximum underinsured motorist coverage
limits available by the insurer under the named insured's motor vehicle policy.
(m) For purposes of this Subsection (3), a notice or disclosure sent to a named insured
in a household constitutes notice or disclosure to all insureds within the household.
(4) (a) (i) Except as provided in this Subsection (4), a covered person injured in a
motor vehicle described in a policy that includes underinsured motorist benefits may not elect
to collect underinsured motorist coverage benefits from another motor vehicle insurance policy.
(ii) The limit of liability for underinsured motorist coverage for two or more motor
vehicles may not be added together, combined, or stacked to determine the limit of insurance
coverage available to an injured person for any one accident.
(iii) Subsection (4)(a)(ii) applies to all persons except a covered person described
under Subsections (4)(b)(i) and (ii).
(b) (i) A covered person injured as a pedestrian by an underinsured motor vehicle may
recover underinsured motorist benefits under any one other policy in which they are described
as a covered person.
(ii) Except as provided in Subsection (4)(b)(iii), a covered person injured while
occupying, using, or maintaining a motor vehicle that is not owned, leased, or furnished to the
covered person, the covered person's spouse, or the covered person's resident parent or resident
sibling, may also recover benefits under any one other policy under which the covered person is
also a covered person.
(iii) (A) A covered person may recover benefits from no more than two additional
policies, one additional policy from each parent's household if the covered person is:
(I) a dependent minor of parents who reside in separate households; and
(II) injured while occupying or using a motor vehicle that is not owned, leased, or
furnished to the covered person, the covered person's resident parent, or the covered person's
resident sibling.
(B) Each parent's policy under this Subsection (4)(b)(iii) is liable only for the
percentage of the damages that the limit of liability of each parent's policy of underinsured
motorist coverage bears to the total of both parents' underinsured coverage applicable to the
accident.
(iv) A covered person's recovery under any available policies may not exceed the full
amount of damages.
(v) Underinsured coverage on a motor vehicle occupied at the time of an accident is
primary coverage, and the coverage elected by a person described under Subsections
31A-22-305
(1)(a), (b), and (c) is secondary coverage.
(vi) The primary and the secondary coverage may not be set off against the other.
(vii) A covered person as described under Subsection (4)(b)(i) or is entitled to the
highest limits of underinsured motorist coverage under only one additional policy per
household applicable to that covered person as a named insured, spouse, or relative.
(viii) A covered injured person is not barred against making subsequent elections if
recovery is unavailable under previous elections.
(ix) (A) As used in this section, "interpolicy stacking" means recovering benefits for a
single incident of loss under more than one insurance policy.
(B) Except to the extent permitted by this Subsection (4), interpolicy stacking is
prohibited for underinsured motorist coverage.
(c) Underinsured motorist coverage:
(i) does not cover any benefit paid or payable under Title 34A, Chapter 2, Workers'
Compensation Act, except that the covered person is credited an amount described in
Subsection 
34A-2-106
(5); 
(ii) may not be subrogated by a workers' compensation insurance carrier;
(iii) may not be reduced by benefits provided by workers' compensation insurance;
(iv) may be reduced by health insurance subrogation only after the covered person is
made whole;
(v) may not be collected for bodily injury or death sustained by a person:
(A) while committing a violation of Section 
41-1a-1314
;
(B) who, as a passenger in a vehicle, has knowledge that the vehicle is being operated
in violation of Section 
41-1a-1314
; or
(C) while committing a felony; and
(vi) notwithstanding Subsection (4)(c)(v), may be recovered:
(A) for a person [
under 18 years of age
] 
younger than 18 years old
 who is injured
within the scope of Subsection (4)(c)(v), but is limited to medical and funeral expenses; or
(B) by a law enforcement officer as defined in Section 
53-13-103
, who is injured
within the course and scope of the law enforcement officer's duties.
(5) The inception of the loss under Subsection 
31A-21-313
(1) for underinsured
motorist claims occurs upon the date of the last liability policy payment.
(6) An underinsured motorist insurer does not have a right of reimbursement against a
person liable for the damages resulting from an injury-causing occurrence if the person's
liability insurer has tendered the policy limit and the limits have been accepted by the claimant.
(7) Except as otherwise provided in this section, a covered person may seek, subject to
the terms and conditions of the policy, additional coverage under any policy:
(a) that provides coverage for damages resulting from motor vehicle accidents; and
(b) that is not required to conform to Section 
31A-22-302
.
(8) (a) When a claim is brought by a named insured or a person described in
Subsection 
31A-22-305
(1) and is asserted against the covered person's underinsured motorist
carrier, the claimant may elect to resolve the claim:
(i) by submitting the claim to binding arbitration; or
(ii) through litigation.
(b) Unless otherwise provided in the policy under which underinsured benefits are
claimed, the election provided in Subsection (8)(a) is available to the claimant only, except that
if the policy under which insured benefits are claimed provides that either an insured or the
insurer may elect arbitration, the insured or the insurer may elect arbitration and that election to
arbitrate shall stay the litigation of the claim under Subsection (8)(a)(ii).
(c) Once a claimant elects to commence litigation under Subsection (8)(a)(ii), the
claimant may not elect to resolve the claim through binding arbitration under this section
without the written consent of the underinsured motorist coverage carrier.
(d) For purposes of the statute of limitations applicable to a claim described in
Subsection (8)(a), if the claimant does not elect to resolve the claim through litigation, the
claim is considered filed when the claimant submits the claim to binding arbitration in
accordance with this Subsection (8).
(e) (i) Unless otherwise agreed to in writing by the parties, a claim that is submitted to
binding arbitration under Subsection (8)(a)(i) shall be resolved by a single arbitrator.
(ii) All parties shall agree on the single arbitrator selected under Subsection (8)(e)(i).
(iii) If the parties are unable to agree on a single arbitrator as required under Subsection
(8)(e)(ii), the parties shall select a panel of three arbitrators.
(f) If the parties select a panel of three arbitrators under Subsection (8)(e)(iii):
(i) each side shall select one arbitrator; and
(ii) the arbitrators appointed under Subsection (8)(f)(i) shall select one additional
arbitrator to be included in the panel.
(g) Unless otherwise agreed to in writing:
(i) each party shall pay an equal share of the fees and costs of the arbitrator selected
under Subsection (8)(e)(i); or
(ii) if an arbitration panel is selected under Subsection (8)(e)(iii):
(A) each party shall pay the fees and costs of the arbitrator selected by that party; and
(B) each party shall pay an equal share of the fees and costs of the arbitrator selected
under Subsection (8)(f)(ii).
(h) Except as otherwise provided in this section or unless otherwise agreed to in
writing by the parties, an arbitration proceeding conducted under this section is governed by
Title 78B, Chapter 11, Utah Uniform Arbitration Act.
(i) (i) The arbitration shall be conducted in accordance with Rules 26(a)(4) through (f),
27 through 37, 54, and 68 of the Utah Rules of Civil Procedure, once the requirements of
Subsections (9)(a) through (c) are satisfied.
(ii) The specified tier as defined by Rule 26(c)(3) of the Utah Rules of Civil Procedure
shall be determined based on the claimant's specific monetary amount in the written demand
for payment of uninsured motorist coverage benefits as required in Subsection (9)(a)(i)(A).
(iii) Rules 26.1 and 26.2 of the Utah Rules of Civil Procedure do not apply to
arbitration claims under this part.
(j) An issue of discovery shall be resolved by the arbitrator or the arbitration panel.
(k) A written decision by a single arbitrator or by a majority of the arbitration panel
constitutes a final decision.
(l) (i) Except as provided in Subsection (9), the amount of an arbitration award may not
exceed the underinsured motorist policy limits of all applicable underinsured motorist policies,
including applicable underinsured motorist umbrella policies.
(ii) If the initial arbitration award exceeds the underinsured motorist policy limits of all
applicable underinsured motorist policies, the arbitration award shall be reduced to an amount
equal to the combined underinsured motorist policy limits of all applicable underinsured
motorist policies.
(m) The arbitrator or arbitration panel may not decide an issue of coverage or
extra-contractual damages, including:
(i) whether the claimant is a covered person;
(ii) whether the policy extends coverage to the loss; or
(iii) an allegation or claim asserting consequential damages or bad faith liability.
(n) The arbitrator or arbitration panel may not conduct arbitration on a class-wide or
class-representative basis.
(o) If the arbitrator or arbitration panel finds that the arbitration is not brought, pursued,
or defended in good faith, the arbitrator or arbitration panel may award reasonable attorney fees
and costs against the party that failed to bring, pursue, or defend the arbitration in good faith.
(p) An arbitration award issued under this section shall be the final resolution of all
claims not excluded by Subsection (8)(m) between the parties unless:
(i) the award is procured by corruption, fraud, or other undue means; 
or
(ii) either party, within 20 days after service of the arbitration award:
(A) files a complaint requesting a trial de novo in the district court; and
(B) serves the nonmoving party with a copy of the complaint requesting a trial de novo
under Subsection (8)(p)(ii)(A).
(q) (i) Upon filing a complaint for a trial de novo under Subsection (8)(p), a claim shall
proceed through litigation pursuant to the Utah Rules of Civil Procedure and Utah Rules of
Evidence in the district court.
(ii) In accordance with Rule 38, Utah Rules of Civil Procedure, either party may
request a jury trial with a complaint requesting a trial de novo under Subsection (8)(p)(ii)(A).
(r) (i) If the claimant, as the moving party in a trial de novo requested under Subsection
(8)(p), does not obtain a verdict that is at least $5,000 and is at least 20% greater than the
arbitration award, the claimant is responsible for all of the nonmoving party's costs.
(ii) If the underinsured motorist carrier, as the moving party in a trial de novo requested
under Subsection (8)(p), does not obtain a verdict that is at least 20% less than the arbitration
award, the underinsured motorist carrier is responsible for all of the nonmoving party's costs.
(iii) Except as provided in Subsection (8)(r)(iv), the costs under this Subsection (8)(r)
shall include:
(A) any costs set forth in Rule 54(d), Utah Rules of Civil Procedure; and
(B) the costs of expert witnesses and depositions.
(iv) An award of costs under this Subsection (8)(r) may not exceed $2,500 unless
Subsection (9)(h)(iii) applies.
(s) For purposes of determining whether a party's verdict is greater or less than the
arbitration award under Subsection (8)(r), a court may not consider any recovery or other relief
granted on a claim for damages if the claim for damages:
(i) was not fully disclosed in writing prior to the arbitration proceeding; or
(ii) was not disclosed in response to discovery contrary to the Utah Rules of Civil
Procedure.
(t) If a district court determines, upon a motion of the nonmoving party, that a moving
party's use of the trial de novo process is filed in bad faith in accordance with Section
78B-5-825
, the district court may award reasonable attorney fees to the nonmoving party.
(u) Nothing in this section is intended to limit a claim under another portion of an
applicable insurance policy.
(v) If there are multiple underinsured motorist policies, as set forth in Subsection (4),
the claimant may elect to arbitrate in one hearing the claims against all the underinsured
motorist carriers.
(9) (a) Within 30 days after a covered person elects to submit a claim for underinsured
motorist benefits to binding arbitration or files litigation, the covered person shall provide to
the underinsured motorist carrier:
(i) a written demand for payment of underinsured motorist coverage benefits, setting
forth:
(A) subject to Subsection (9)(l), the specific monetary amount of the demand,
including a computation of the covered person's claimed past medical expenses, claimed past
lost wages, and all other claimed past economic damages; and
(B) the factual and legal basis and any supporting documentation for the demand;
(ii) a written statement under oath disclosing:
(A) (I) the names and last known addresses of all health care providers who have
rendered health care services to the covered person that are material to the claims for which the
underinsured motorist benefits are sought for a period of five years preceding the date of the
event giving rise to the claim for underinsured motorist benefits up to the time the election for
arbitration or litigation has been exercised; and
(II) the names and last known addresses of the health care providers who have rendered
health care services to the covered person, which the covered person claims are immaterial to
the claims for which underinsured motorist benefits are sought, for a period of five years
preceding the date of the event giving rise to the claim for underinsured motorist benefits up to
the time the election for arbitration or litigation has been exercised that have not been disclosed
under Subsection (9)(a)(ii)(A)(I);
(B) (I) the names and last known addresses of all health insurers or other entities to
whom the covered person has submitted claims for health care services or benefits material to
the claims for which underinsured motorist benefits are sought, for a period of five years
preceding the date of the event giving rise to the claim for underinsured motorist benefits up to
the time the election for arbitration or litigation has been exercised; and
(II) the names and last known addresses of the health insurers or other entities to whom
the covered person has submitted claims for health care services or benefits, which the covered
person claims are immaterial to the claims for which underinsured motorist benefits are sought,
for a period of five years preceding the date of the event giving rise to the claim for
underinsured motorist benefits up to the time the election for arbitration or litigation have not
been disclosed;
(C) if lost wages, diminished earning capacity, or similar damages are claimed, all
employers of the covered person for a period of five years preceding the date of the event
giving rise to the claim for underinsured motorist benefits up to the time the election for
arbitration or litigation has been exercised;
(D) other documents to reasonably support the claims being asserted; and
(E) all state and federal statutory lienholders including a statement as to whether the
covered person is a recipient of Medicare or Medicaid benefits or Utah Children's Health
Insurance Program benefits under Title 26, Chapter 40, Utah Children's Health Insurance Act,
or if the claim is subject to any other state or federal statutory liens; and
(iii) signed authorizations to allow the underinsured motorist carrier to only obtain
records and billings from the individuals or entities disclosed under Subsections
(9)(a)(ii)(A)(I), (B)(I), and (C).
(b) (i) If the underinsured motorist carrier determines that the disclosure of undisclosed
health care providers or health care insurers under Subsection (9)(a)(ii) is reasonably necessary,
the underinsured motorist carrier may:
(A) make a request for the disclosure of the identity of the health care providers or
health care insurers; and
(B) make a request for authorizations to allow the underinsured motorist carrier to only
obtain records and billings from the individuals or entities not disclosed.
(ii) If the covered person does not provide the requested information within 10 days:
(A) the covered person shall disclose, in writing, the legal or factual basis for the
failure to disclose the health care providers or health care insurers; and
(B) either the covered person or the underinsured motorist carrier may request the
arbitrator or arbitration panel to resolve the issue of whether the identities or records are to be
provided if the covered person has elected arbitration.
(iii) The time periods imposed by Subsection (9)(c)(i) are tolled pending resolution of
the dispute concerning the disclosure and production of records of the health care providers or
health care insurers.
(c) (i) An underinsured motorist carrier that receives an election for arbitration or a
notice of filing litigation and the demand for payment of underinsured motorist benefits under
Subsection (9)(a)(i) shall have a reasonable time, not to exceed 60 days from the date of the
demand and receipt of the items specified in Subsections (9)(a)(i) through (iii), to:
(A) provide a written response to the written demand for payment provided for in
Subsection (9)(a)(i);
(B) except as provided in Subsection (9)(c)(i)(C), tender the amount, if any, of the
underinsured motorist carrier's determination of the amount owed to the covered person; and
(C) if the covered person is a recipient of Medicare or Medicaid benefits or Utah
Children's Health Insurance Program benefits under Title 26, Chapter 40, Utah Children's
Health Insurance Act, or if the claim is subject to any other state or federal statutory liens,
tender the amount, if any, of the underinsured motorist carrier's determination of the amount
owed to the covered person less:
(I) if the amount of the state or federal statutory lien is established, the amount of the
lien; or
(II) if the amount of the state or federal statutory lien is not established, two times the
amount of the medical expenses subject to the state or federal statutory lien until such time as
the amount of the state or federal statutory lien is established.
(ii) If the amount tendered by the underinsured motorist carrier under Subsection
(9)(c)(i) is the total amount of the underinsured motorist policy limits, the tendered amount
shall be accepted by the covered person.
(d) A covered person who receives a written response from an underinsured motorist
carrier as provided for in Subsection (9)(c)(i), may:
(i) elect to accept the amount tendered in Subsection (9)(c)(i) as payment in full of all
underinsured motorist claims; or
(ii) elect to:
(A) accept the amount tendered in Subsection (9)(c)(i) as partial payment of all
underinsured motorist claims; and
(B) continue to litigate or arbitrate the remaining claim in accordance with the election
made under Subsections (8)(a), (b), and (c).
(e) If a covered person elects to accept the amount tendered under Subsection (9)(c)(i)
as partial payment of all underinsured motorist claims, the final award obtained through
arbitration, litigation, or later settlement shall be reduced by any payment made by the
underinsured motorist carrier under Subsection (9)(c)(i).
(f) In an arbitration proceeding on the remaining underinsured claims:
(i) the parties may not disclose to the arbitrator or arbitration panel the amount paid
under Subsection (9)(c)(i) until after the arbitration award has been rendered; and
(ii) the parties may not disclose the amount of the limits of underinsured motorist
benefits provided by the policy.
(g) If the final award obtained through arbitration or litigation is greater than the
average of the covered person's initial written demand for payment provided for in Subsection
(9)(a)(i) and the underinsured motorist carrier's initial written response provided for in
Subsection (9)(c)(i), the underinsured motorist carrier shall pay:
(i) the final award obtained through arbitration or litigation, except that if the award
exceeds the policy limits of the subject underinsured motorist policy by more than $15,000, the
amount shall be reduced to an amount equal to the policy limits plus $15,000; and
(ii) any of the following applicable costs:
(A) any costs as set forth in Rule 54(d), Utah Rules of Civil Procedure;
(B) the arbitrator or arbitration panel's fee; and
(C) the reasonable costs of expert witnesses and depositions used in the presentation of
evidence during arbitration or litigation.
(h) (i) The covered person shall provide an affidavit of costs within five days of an
arbitration award.
(ii) (A) Objection to the affidavit of costs shall specify with particularity the costs to
which the underinsured motorist carrier objects.
(B) The objection shall be resolved by the arbitrator or arbitration panel.
(iii) The award of costs by the arbitrator or arbitration panel under Subsection (9)(g)(ii)
may not exceed $5,000.
(i) (i) A covered person shall disclose all material information, other than rebuttal
evidence, within 30 days after a covered person elects to submit a claim for underinsured
motorist coverage benefits to binding arbitration or files litigation as specified in Subsection
(9)(a).
(ii) If the information under Subsection (9)(i)(i) is not disclosed, the covered person
may not recover costs or any amounts in excess of the policy under Subsection (9)(g).
(j) This Subsection (9) does not limit any other cause of action that arose or may arise
against the underinsured motorist carrier from the same dispute.
(k) The provisions of this Subsection (9) only apply to motor vehicle accidents that
occur on or after March 30, 2010.
(l) (i) The written demand requirement in Subsection (9)(a)(i)(A) does not affect the
covered person's requirement to provide a computation of any other economic damages
claimed, and the one or more respondents shall have a reasonable time after the receipt of the
computation of any other economic damages claimed to conduct fact and expert discovery as to
any additional damages claimed. The changes made by Laws of Utah 2014, Chapter 290,
Section 11, and Chapter 300, Section 11, to this Subsection (9)(l) and Subsection (9)(a)(i)(A)
apply to a claim submitted to binding arbitration or through litigation on or after May 13, 2014.
(ii) The changes made by Laws of Utah 2014, Chapter 290, Section 11, and Chapter
300, Section 11, under Subsections (9)(a)(ii)(A)(II) and (B)(II) apply to a claim submitted to
binding arbitration or through litigation on or after May 13, 2014.
Section 18. Section 
31A-22-602
 is amended to read:
31A-22-602.
Premium rates.
(1) Except as provided in Subsection 
31A-22-701
(4), this section does not apply to
group accident and health insurance.
(2) The benefits in an accident and health insurance policy shall be reasonable in
relation to the premiums charged.
(3) The commissioner shall prohibit the use of [
a policy offering
] 
an
 accident and
health insurance form or rates if the form or rates do not satisfy Subsection (2).
Section 19. Section 
31A-22-618.6
 is amended to read:
31A-22-618.6.
Discontinuance, nonrenewal, or changes to group health benefit
plans.
(1) Except as otherwise provided in this section, a group health benefit plan for a plan
sponsor is renewable and continues in force:
(a) with respect to all eligible employees and dependents; and
(b) at the option of the plan sponsor.
(2) A 
group
 health benefit plan for a plan sponsor may be discontinued or nonrenewed:
(a) for noncompliance with the insurer's employer contribution requirements; 
(b) if there is no longer any enrollee under the group health 
benefit
 plan who lives,
resides, or works in:
(i) the service area of the insurer; or
(ii) the area for which the insurer is authorized to do business;
(c) for coverage made available in the small or large employer market only through an
association, if:
(i) the employer's membership in the association ceases; and
(ii) the coverage is [
terminated
] 
discontinued or nonrenewed
 uniformly without regard
to any health status-related factor relating to any covered individual; or
(d) for noncompliance with the insurer's minimum employee participation
requirements, except as provided in Subsection (3).
(3) If a small employer no longer employs at least one eligible employee, a carrier may
not discontinue or not renew the 
group
 health benefit plan until the first renewal date following
the beginning of a new plan year, even if the carrier knows at the beginning of the plan year
that the employer no longer has at least one eligible employee.
(4) (a) A small employer that, after purchasing a 
group
 health benefit plan in the small
group market, employs on average more than 50 eligible employees on each business day in a
calendar year may continue to renew the 
group
 health benefit plan purchased in the small group
market.
(b) A large employer that, after purchasing a 
group
 health benefit plan in the large
group market, employs on average fewer than 51 eligible employees on each business day in a
calendar year may continue to renew the 
group
 health benefit plan purchased in the large group
market. 
(5) A health benefit plan for a plan sponsor may be discontinued 
or nonrenewed
 if:
(a) a condition described in Subsection (2) exists;
(b) the plan sponsor fails to pay premiums or contributions in accordance with the
terms of the contract;
(c) the plan sponsor:
(i) performs an act or practice that constitutes fraud; or
(ii) makes an intentional misrepresentation of material fact under the terms of the
coverage;
(d) the insurer:
(i) elects to discontinue offering a particular 
group
 health benefit plan delivered or
issued for delivery in this state;
(ii) provides notice of the discontinuation in writing to each plan sponsor, employee,
and dependent of an employee, at least 90 days before the day on which the coverage
discontinues;
(iii) provides notice of the discontinuation in writing to the commissioner, and at least
three working days before the day on which the notice is sent to each affected plan sponsor,
employee, and dependent of an employee;
(iv) offers to each plan sponsor, on a guaranteed issue basis, the option to purchase all
other 
group
 health benefit plans currently being offered by the insurer in the market or, in the
case of a large employer, any other 
group
 health benefit plans currently being offered in that
market; and
(v) in exercising the option to discontinue [
that
] 
the group
 health benefit plan and in
offering the option of coverage in this section, acts uniformly without regard to the claims
experience of a plan sponsor, any health status-related factor relating to any covered participant
or beneficiary, or any health status-related factor relating to any new participant or beneficiary
who may become eligible for the coverage; or
(e) the insurer:
(i) elects to discontinue 
offering
 all of the insurer's 
group
 health benefit plans in:
(A) the small employer market;
(B) the large employer market; or
(C) both the small employer and large employer markets;
(ii) provides notice of the discontinuation in writing to each plan sponsor, employee,
and dependent of an employee at least 180 days before the day on which the coverage
discontinues;
(iii) provides notice of the discontinuation in writing to the commissioner in each state
in which an affected insured individual is known to reside and, at least 30 working days before
the day on which the notice is sent to each affected plan sponsor, employee, and dependent of
an employee;
(iv) discontinues and nonrenews all plans issued or delivered for issuance in the market
described in Subsection (5)(e)(i) ; and
(v) 
(A)
 provides a plan of orderly withdrawal as required by Section 
31A-4-115
[
.
]
; or
(B) places the plan with an affiliate of the insurer with a plan of the same or similar
coverage.
(6) (a) Except as provided in Subsection (6)(d), an eligible employee may be
discontinued if after issuance of coverage the eligible employee:
(i) engages in an act or practice in connection with the coverage that constitutes fraud;
or
(ii) makes an intentional misrepresentation of material fact in connection with the
coverage.
(b) An eligible employee whose coverage is discontinued under Subsection (6)(a) may
reenroll:
(i) 12 months after the day on which the employee's coverage discontinues; and
(ii) if the plan sponsor's coverage is in effect at the time the eligible employee applies
to reenroll.
(c) At the time the eligible employee's coverage discontinues under Subsection (6)(a),
the insurer shall notify the eligible employee of the right to reenroll as described in Subsection
(6)(b).
(d) An eligible employee's coverage may not be discontinued under this Subsection (6)
because of a fraud or misrepresentation that relates to health status.
(7) For purposes of this section, a reference to "plan sponsor" includes a reference to
the employer:
(a) with respect to coverage provided to an employer member of the association; and
(b) if the 
group
 health benefit plan is made available by an insurer in the employer
market only through:
(i) an association;
(ii) a trust; or
(iii) a discretionary group.
(8) An insurer may modify a 
group
 health benefit plan for a plan sponsor only:
(a) at the time of coverage renewal; and
(b) if the modification is effective uniformly among all plans [
with that product
].
Section 20. Section 
31A-22-618.7
 is amended to read:
31A-22-618.7.
Discontinuance, nonrenewal, and modification for individual
health benefit plans.
(1) (a) Except as otherwise provided in this section, a health benefit plan offered on an
individual basis is renewable and continues in force:
(i) with respect to all enrollees or dependents; and
(ii) at the option of the enrollee.
(b) Subsection (1)(a) applies regardless of:
(i) whether the contract is issued through:
(A) a trust;
(B) an association;
(C) a discretionary group; or
(D) other similar grouping; or
(ii) the situs of delivery of the policy or contract.
(2) An individual health benefit plan may be discontinued or nonrenewed:
(a) if:
(i) there is no longer an enrollee under the individual health benefit plan who lives,
resides, or works in:
(A) the service area of the insurer; or
(B) the area for which the insurer is authorized to do business; and
(ii) coverage is [
terminated
] 
discontinued or nonrenewed
 uniformly without regard to
any health status-related factor relating to any covered enrollee; or
(b) for coverage made available through an association, if:
(i) the enrollee's membership in the association ceases; and
(ii) the coverage is [
terminated
] 
discontinued or nonrenewed
 uniformly without regard
to any health status-related factor relating to any covered enrollee.
(3) An individual health benefit plan may be discontinued 
or nonrenewed
 if:
(a) a condition described in Subsection (2) exists;
(b) the enrollee fails to pay premiums or contributions in accordance with the terms of
the health benefit plan, including any timeliness requirements;
(c) the enrollee:
(i) performs an act or practice in connection with the coverage that constitutes fraud; or
(ii) makes an intentional misrepresentation of material fact under the terms of the
coverage;
(d) the insurer:
(i) elects to discontinue offering a particular 
individual
 health benefit plan [
product
]
delivered or issued for delivery in this state; and
(ii) (A) provides notice of the discontinuation in writing to each enrollee provided
coverage at least 90 days before the day on which the coverage discontinues;
(B) provides notice of the discontinuation in writing to the commissioner and, at least
three working days before the day on which the notice is sent, to each affected enrollee;
(C) offers to each covered enrollee on a guaranteed issue basis the option to purchase
all other individual health benefit plans currently being offered by the insurer for individuals in
that market; and
(D) acts uniformly without regard to any health status-related factor of covered
enrollees or dependents of covered enrollees who may become eligible for coverage; or
(e) the insurer:
(i) elects to discontinue 
offering
 all of the insurer's 
individual
 health benefit plans in
the individual market; [
and
]
(ii) [
(A)
] provides notice of the discontinuation in writing to each enrollee provided
coverage at least 180 days before the day on which the coverage discontinues;
[
(B)
] 
(iii)
 provides notice of the discontinuation in writing to the commissioner in each
state in which an affected enrollee is known to reside and, at least 30 working days before the
day on which the insurer sends the notice, to each affected enrollee;
[
(C)
] 
(iv)
 discontinues and nonrenews all 
individual
 health benefit plans the insurer
issues or delivers for issuance in the individual market; [
and
]
[
(D)
] 
(v)
 acts uniformly without regard to any health status-related factor of covered
enrollees or dependents of covered enrollees who may become eligible for coverage[
.
]
; and
(vi) (A) provides a plan of orderly withdrawal in accordance with Section 
31A-4-115
;
or
(B) places the plan with an affiliate of the insurer with a plan of the same or similar
coverage.
(4) An insurer may modify an individual health benefit plan only:
(a) at the time of coverage renewal; and
(b) if the modification is effective uniformly among all 
individual
 health benefit plans.
Section 21. Section 
31A-22-618.8
 is amended to read:
31A-22-618.8.
Discontinuance and nonrenewal limitations for health benefit
plans.
(1) Subject to Section 
31A-4-115
, an insurer that elects to discontinue offering a health
benefit plan under [
Subsections
] 
Subsection
31A-22-618.6
(5)(e) [
and
] 
or
31A-22-618.7
(3)(e)
is prohibited from writing new business:
(a) in the market in this state for which the insurer discontinues or does not renew; and
(b) for a period of five years beginning on the day on which the last coverage that is
discontinued.
(2) If an insurer is doing business in one established geographic service area of the
state, [
Sections
] 
Subsections
31A-22-618.6
(5)(e)
 and 
31A-22-618.7
(3)(e)
 apply only to the
insurer's operations in that service area.
(3) The commissioner may, by rule or order, define the scope of service area.
Section 22. Section 
31A-22-627
 is amended to read:
31A-22-627.
Coverage of emergency medical services.
(1) A health insurance policy or managed care organization contract:
(a) shall provide coverage of emergency services; and
(b) may not:
(i) require any form of preauthorization for treatment of an emergency medical
condition until after the insured's condition has been stabilized;
(ii) deny a claim for any covered evaluation, covered diagnostic test, or other covered
treatment considered medically necessary to stabilize the emergency medical condition of an
insured; or
(iii) impose any cost-sharing requirement for out-of-network that exceeds the
cost-sharing requirement imposed for in-network.
(2) (a) A health insurance policy or managed care organization contract may require
authorization for the continued treatment of an emergency medical condition after the insured's
condition has been stabilized.
(b) If authorization described in Subsection (2)(a) is required, an insurer who does not
accept or reject a request for authorization may not deny a claim for any evaluation, diagnostic
testing, or other treatment considered medically necessary that occurred between the time the
request was received and the time the insurer rejected the request for authorization.
(3) For purposes of this section:
[
(a) "Emergency medical condition" means a medical condition manifesting itself by
acute symptoms of sufficient severity, including severe pain, such that a prudent layperson,
who possesses an average knowledge of medicine and health, would reasonably expect the
absence of immediate medical attention through a hospital emergency department to result in:
]
[
(i) placing the insured's health, or with respect to a pregnant woman, the health of the
woman or her unborn child, in serious jeopardy;
]
[
(ii) serious impairment to bodily functions; or
]
[
(iii) serious dysfunction of any bodily organ or part.
]
[
(b)
] 
(a)
 "Hospital emergency department" means that area of a hospital in which
emergency services are provided on a 24-hour-a-day basis.
[
(c)
] 
(b)
 "Stabilize" means the same as that term is defined in 42 U.S.C. Sec.
1395dd(e)(3).
(4) Nothing in this section may be construed as:
(a) altering the level or type of benefits that are provided under the terms of a contract
or policy; or
(b) restricting a policy or contract from providing enhanced benefits for certain
emergency medical conditions that are identified in the policy or contract.
(5) Notwithstanding Section 
31A-2-308
, if the commissioner finds an insurer has
violated this section, the commissioner may:
(a) work with the insurer to improve the insurer's compliance with this section; or
(b) impose the following fines:
(i) not more than $5,000; or
(ii) twice the amount of any profit gained from violations of this section. 
Section 23. Section 
31A-22-636
 is amended to read:
31A-22-636.
Standardized health insurance information cards.
(1) As used in this section, "insurer" means:
(a) an insurer governed by this part as described in Section 
31A-22-600
;
(b) a health maintenance organization governed by Chapter 8, Health Maintenance
Organizations and Limited Health Plans;
(c) a third party administrator; and
(d) notwithstanding Subsection 
31A-1-103
(3)(f) and Section 
31A-22-600
, a health,
medical, or conversion policy offered under Title 49, Chapter 20, Public Employees' Benefit
and Insurance Program Act.
(2) In accordance with Subsection (3), an insurer shall use and issue a health benefit
plan information card for the insurer's enrollees upon the purchase or renewal of, or enrollment
in, a health benefit plan [
on or after July 1, 2010
].
(3) The health benefit plan 
information
 card shall include:
(a) the covered person's name;
(b) the name of the carrier and the carrier network name;
(c) the contact information for the carrier or health benefit plan administrator;
(d) general information regarding copayments and deductibles; and
(e) an indication of whether the health benefit plan is regulated by the state.
(4) (a) The commissioner shall work with the Department of Health, the Health Data
Authority, health care providers groups, and with state and national organizations that [
are
developing
] 
develop
 uniform standards for the electronic exchange of health insurance claims
or uniform standards for the electronic exchange of clinical health records.
(b) [
When the commissioner determines that the groups described in Subsection (4)(a)
have reached a consensus regarding the electronic technology and standards necessary to
electronically exchange insurance enrollment and coverage information, the commissioner
shall begin the rulemaking process under
] 
The commissioner may make rules in accordance
with
 Title 63G, Chapter 3, Utah Administrative Rulemaking Act, to adopt standardized
electronic interchange technology.
(c) After rules are adopted under Subsection (4)(a), health care providers and their
licensing boards under Title 58, Occupations and Professions, and health facilities licensed
under Title 26, Chapter 21, Health Care Facility Licensing and Inspection Act, shall work
together to implement the adoption of card swipe technology.
Section 24. Section 
31A-22-657
 is enacted to read:
 31A-22-657.
Application of health insurance mandates.
(1) As used in this section:
(a) "Cost-sharing requirement" means a copayment, coinsurance, or deductible
required by or on behalf of an enrollee in order to receive a benefit under a qualified
high-deductible health plan.
(b) "Health savings account" means the same as that term is defined in 26 U.S.C. Sec.
223(d)(1).
(c) "Qualified high-deductible health plan" means a high-deductible health plan as
defined in 26 U.S.C. Sec. 223(c)(2)(A) that is used in conjunction with a health savings
account.
(d) "Cost-sharing mandate" means a statutory requirement limiting a cost-sharing
requirement.
(2) (a) Except as provided in Subsection (2)(b), if under federal law, a cost-sharing
mandate would result in an enrollee becoming ineligible for a health savings account, the
cost-sharing mandate applies only to the enrollee's qualified high-deductible health plan after
the enrollee satisfies the enrollee's health plan deductible.
(b) Subsection (2)(a) does not apply to an item or service that is preventive care under
U.S.C. Sec. 223(c)(2)(C).
Section 25. Section 
31A-22-727
 is enacted to read:
 31A-22-727.
Renewal, cancellation, and modification.
(1) Except as provided in Section 
31A-22-618.6
, for a group insurance policy offering
accident and health insurance or a blanket insurance policy offering accident and health
insurance, an insurer may:
(a) decline to renew the policy on the date the policy term expires for a reason stated in
the policy; or
(b) cancel the policy at any time for:
(i) nonpayment of a premium when due;
(ii) intentional misrepresentation of a material fact in connection with the coverage;
(iii) performance of an act or practice that constitutes fraud in connection with the
coverage; or
(iv) noncompliance with an employer eligibility provision.
(2) Except for a modification required by law, an insurer may only modify a policy at
renewal.
(3) Subsection (2) does not apply to an endorsement by which the insurer:
(a) effectuates a request the policyholder made in writing; or
(b) exercises a specifically reserved right under the policy.
Section 26. Section 
31A-23a-111
 is amended to read:
31A-23a-111.
Revoking, suspending, surrendering, lapsing, limiting, or otherwise
terminating a license -- Forfeiture -- Rulemaking for renewal or reinstatement.
(1) A license type issued under this chapter remains in force until:
(a) revoked or suspended under Subsection (5);
(b) surrendered to the commissioner and accepted by the commissioner in lieu of
administrative action;
(c) the licensee dies or is adjudicated incompetent as defined under:
(i) Title 75, Chapter 5, Part 3, Guardians of Incapacitated Persons; or
(ii) Title 75, Chapter 5, Part 4, Protection of Property of Persons Under Disability and
Minors;
(d) lapsed under Section 
31A-23a-113
; or
(e) voluntarily surrendered.
(2) The following may be reinstated within one year after the day on which the license
is no longer in force:
(a) a lapsed license; or
(b) a voluntarily surrendered license, except that a voluntarily surrendered license may
not be reinstated after the license period in which the license is voluntarily surrendered.
(3) Unless otherwise stated in a written agreement for the voluntary surrender of a
license, submission and acceptance of a voluntary surrender of a license does not prevent the
department from pursuing additional disciplinary or other action authorized under:
(a) this title; or
(b) rules made under this title in accordance with Title 63G, Chapter 3, Utah
Administrative Rulemaking Act.
(4) A line of authority issued under this chapter remains in force until:
(a) the qualifications pertaining to a line of authority are no longer met by the licensee;
or
(b) the supporting license type:
(i) is revoked or suspended under Subsection (5);
(ii) is surrendered to the commissioner and accepted by the commissioner in lieu of
administrative action;
(iii) lapses under Section 
31A-23a-113
; or
(iv) is voluntarily surrendered; or
(c) the licensee dies or is adjudicated incompetent as defined under:
(i) Title 75, Chapter 5, Part 3, Guardians of Incapacitated Persons; or
(ii) Title 75, Chapter 5, Part 4, Protection of Property of Persons Under Disability and
Minors.
(5) (a) If the commissioner makes a finding under Subsection (5)(b), as part of an
adjudicative proceeding under Title 63G, Chapter 4, Administrative Procedures Act, the
commissioner may:
(i) revoke:
(A) a license; or
(B) a line of authority;
(ii) suspend for a specified period of 12 months or less:
(A) a license; or
(B) a line of authority;
(iii) limit in whole or in part:
(A) a license; or
(B) a line of authority;
(iv) deny a license application;
(v) assess a forfeiture under Subsection 
31A-2-308
(1)(b)(i) or (1)(c)(i); or
(vi) take a combination of actions under Subsections (5)(a)(i) through (iv) and
Subsection (5)(a)(v).
(b) The commissioner may take an action described in Subsection (5)(a) if the
commissioner finds that the licensee or license applicant:
(i) is unqualified for a license or line of authority under Section 
31A-23a-104
,
31A-23a-105
, or 
31A-23a-107
;
(ii) violates:
(A) an insurance statute;
(B) a rule that is valid under Subsection 
31A-2-201
(3); or
(C) an order that is valid under Subsection 
31A-2-201
(4);
(iii) is insolvent or the subject of receivership, conservatorship, rehabilitation, or other
delinquency proceedings in any state;
(iv) fails to pay a final judgment rendered against the person [
in this state
] within 60
days after the day on which the judgment became final;
(v) fails to meet the same good faith obligations in claims settlement that is required of
admitted insurers;
(vi) is affiliated with and under the same general management or interlocking
directorate or ownership as another insurance producer that transacts business in this state
without a license;
(vii) refuses:
(A) to be examined; or
(B) to produce its accounts, records, and files for examination;
(viii) has an officer who refuses to:
(A) give information with respect to the insurance producer's affairs; or
(B) perform any other legal obligation as to an examination;
(ix) provides information in the license application that is:
(A) incorrect;
(B) misleading;
(C) incomplete; or
(D) materially untrue;
(x) violates an insurance law, valid rule, or valid order of another regulatory agency in
any jurisdiction;
(xi) obtains or attempts to obtain a license through misrepresentation or fraud;
(xii) improperly withholds, misappropriates, or converts money or properties received
in the course of doing insurance business;
(xiii) intentionally misrepresents the terms of an actual or proposed:
(A) insurance contract;
(B) application for insurance; or
(C) life settlement;
(xiv) has been convicted of:
(A) a felony; or
(B) a misdemeanor involving fraud, misrepresentation, theft, or dishonesty;
(xv) admits or is found to have committed an insurance unfair trade practice or fraud;
(xvi) in the conduct of business in this state or elsewhere:
(A) uses fraudulent, coercive, or dishonest practices; or
(B) demonstrates incompetence, untrustworthiness, or financial irresponsibility;
(xvii) has had an insurance license or other professional or occupational license, or an
equivalent to an insurance license or registration, or other professional or occupational license
or registration:
(A) denied;
(B) suspended;
(C) revoked; or
(D) surrendered to resolve an administrative action;
(xviii) forges another's name to:
(A) an application for insurance; or
(B) a document related to an insurance transaction;
(xix) improperly uses notes or another reference material to complete an examination
for an insurance license;
(xx) knowingly accepts insurance business from an individual who is not licensed;
(xxi) fails to comply with an administrative or court order imposing a child support
obligation;
(xxii) fails to:
(A) pay state income tax; or
(B) comply with an administrative or court order directing payment of state income
tax;
(xxiii) has been convicted of violating the federal Violent Crime Control and Law
Enforcement Act of 1994, 18 U.S.C. Sec. 1033 and has not obtained written consent to engage
in the business of insurance or participate in such business as required by 18 U.S.C. Sec. 1033;
(xxiv) engages in a method or practice in the conduct of business that endangers the
legitimate interests of customers and the public; or
(xxv) has been convicted of any criminal felony involving dishonesty or breach of trust
and has not obtained written consent to engage in the business of insurance or participate in
such business as required by 18 U.S.C. Sec. 1033.
(c) For purposes of this section, if a license is held by an agency, both the agency itself
and any individual designated under the license are considered to be the holders of the license.
(d) If an individual designated under the agency license commits an act or fails to
perform a duty that is a ground for suspending, revoking, or limiting the individual's license,
the commissioner may suspend, revoke, or limit the license of:
(i) the individual;
(ii) the agency, if the agency:
(A) is reckless or negligent in its supervision of the individual; or
(B) knowingly participates in the act or failure to act that is the ground for suspending,
revoking, or limiting the license; or
(iii) (A) the individual; and
(B) the agency if the agency meets the requirements of Subsection (5)(d)(ii).
(6) A licensee under this chapter is subject to the penalties for acting as a licensee
without a license if:
(a) the licensee's license is:
(i) revoked;
(ii) suspended;
(iii) limited;
(iv) surrendered in lieu of administrative action;
(v) lapsed; or
(vi) voluntarily surrendered; and
(b) the licensee:
(i) continues to act as a licensee; or
(ii) violates the terms of the license limitation.
(7) A licensee under this chapter shall immediately report to the commissioner:
(a) a revocation, suspension, or limitation of the person's license in another state, the
District of Columbia, or a territory of the United States;
(b) the imposition of a disciplinary sanction imposed on that person by another state,
the District of Columbia, or a territory of the United States; or
(c) a judgment or injunction entered against that person on the basis of conduct
involving:
(i) fraud;
(ii) deceit;
(iii) misrepresentation; or
(iv) a violation of an insurance law or rule.
(8) (a) An order revoking a license under Subsection (5) or an agreement to surrender a
license in lieu of administrative action may specify a time, not to exceed five years, within
which the former licensee may not apply for a new license.
(b) If no time is specified in an order or agreement described in Subsection (8)(a), the
former licensee may not apply for a new license for five years from the day on which the order
or agreement is made without the express approval by the commissioner.
(9) The commissioner shall promptly withhold, suspend, restrict, or reinstate the use of
a license issued under this part if so ordered by a court.
(10) The commissioner shall by rule prescribe the license renewal and reinstatement
procedures in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
Section 27. Section 
31A-27a-104
 is amended to read:
31A-27a-104.
Persons covered.
(1) This chapter applies to:
(a) an insurer who:
(i) is doing, or has done, an insurance business in this state; and
(ii) against whom a claim arising from that business may exist;
(b) a person subject to examination by the commissioner;
(c) an insurer who purports to do an insurance business in this state;
(d) an insurer who has an insured who is resident in this state; and
(e) in addition to Subsections (1)(a) through (d), a person doing business as follows:
(i) under Chapter 6a, Service Contracts;
(ii) under Chapter 7, Nonprofit Health Service Insurance Corporations;
(iii) under Chapter 8a, Health Discount Program Consumer Protection Act;
(iv) under Chapter 9, Insurance Fraternals;
(v) under Chapter 11, Motor Clubs;
(vi) under Chapter 15, Unauthorized Insurers, Surplus Lines, and Risk Retention
Groups;
(vii) as a bail bond surety company under Chapter 35, Bail Bond Act;
(viii) under Chapter 37, Captive Insurance Companies Act;
(ix) a title insurance company;
(x) a prepaid health care delivery plan; and
(xi) a person not described in Subsections (1)(e)(i) through (x) that is organized or
doing insurance business, or in the process of organizing with the intent to do insurance
business in this state.
(2) Notwithstanding Sections 
31A-1-301
 and 
31A-27a-102
, this chapter does not apply
to a person licensed by the insurance commissioner as one or more of the following in this state
unless the person engages in the business of insurance as an insurer
, is an affiliate as defined in
Subsection 31A-1-301(5), or is a person under the control of an affiliate
:
(a) an insurance agency;
(b) an insurance producer;
(c) a limited line producer;
(d) an insurance consultant;
(e) a managing general agent;
(f) reinsurance intermediary;
(g) an individual title insurance producer or agency title insurance producer;
(h) a third party administrator;
(i) an insurance adjustor;
(j) a life settlement provider; or
(k) a life settlement producer.
Section 28. Section 
31A-27a-111
 is amended to read:
31A-27a-111.
Actions by and against the receiver.
(1) (a) An allegation by the receiver of improper or fraudulent conduct against a person
may not be the basis of a defense to the enforcement of a contractual obligation owed to the
insurer by a third party.
(b) Notwithstanding Subsection (1)(a), a third party described in this Subsection (1) is
not barred by this section from seeking to establish independently as a defense that the conduct
is materially and substantially related to the contractual obligation for which enforcement is
sought.
(2) (a) Subject to Subsection (2)(b), a prior wrongful or negligent action of any present
or former 
receiver, receiver's assistant, receiver's contractor,
 officer, manager, director, trustee,
owner, employee, or agent of the insurer may not be asserted as a defense to a claim by the
receiver:
(i) under a theory of:
(A) estoppel;
(B) comparative fault;
(C) intervening cause;
(D) proximate cause;
(E) reliance; or
(F) mitigation of damages; or
(ii) otherwise.
(b) Notwithstanding Subsection (2)(a):
(i) the affirmative defense of fraud in the inducement may be asserted against the
receiver in a claim based on a contract; and
(ii) a principal under a surety bond or a surety undertaking is entitled to credit against
any reimbursement obligation to the receiver for the value of any property pledged to secure the
reimbursement obligation to the extent that:
(A) the receiver has possession or control of the property; or
(B) the insurer or its agents misappropriated, including commingling, the property.
(c) Evidence of fraud in the inducement is admissible only if it is contained in the
records of the insurer.
(3) Action or inaction by an insurance regulatory authority may not be asserted as a
defense to a claim by the receiver.
(4) (a) Subject to Subsection (4)(b), a judgment or order entered against an insured or
the insurer in contravention of a stay or injunction under this chapter, or at any time by default
or collusion, may not be considered as evidence of liability or of the quantum of damages in
adjudicating claims filed in the estate arising out of the subject matter of the judgment or order.
(b) Subsection (4)(a) does not apply to an affected guaranty association's claim for
amounts paid on a settlement or judgment in pursuit of the affected guaranty association's
statutory obligations.
(5) (a) Subject to Subsection (5)(b), the following do not affect the amount that a
receiver may recover from a third party, regardless of any provision in an agreement to the
contrary:
(i) the insurer's insolvency; or
(ii) the insurer's or receiver's failure to pay all or a portion of an amount or a claim to
the third party.
(b) If an agreement between the insurer and a third party requires a payment by the
insurer before the insurer may recover from the third party, the amount the receiver may
recover from the third party under Subsection (5)(a) is limited to an amount equal to the greater
of:
(i) the amount paid by the insurer or by another person on behalf of the insurer to the
third party; or
(ii) the amount allowed as a claim for payment under:
(A) an approved report described in Section 
31A-27a-608
;
(B) an order of the receivership court; or
(C) a plan of rehabilitation.
(6) The receiver may not be considered a governmental entity for the purposes of any
state law awarding fees to a litigant who prevails against a governmental entity.
Section 29. Section 
31A-30-103
 is amended to read:
31A-30-103.
Definitions.
As used in this chapter:
(1) "Actuarial certification" means a written statement by a member of the American
Academy of Actuaries or other individual approved by the commissioner that a covered carrier
is in compliance with this chapter, based upon the examination of the covered carrier, including
review of the appropriate records and of the actuarial assumptions and methods used by the
covered carrier in establishing premium rates for applicable health benefit plans.
(2) "Affiliate" or "affiliated" means a person who directly or indirectly through one or
more intermediaries, controls or is controlled by, or is under common control with, a specified
person.
(3) "Base premium rate" means, for each class of business as to a rating period, the
lowest premium rate charged or that could have been charged under a rating system for that
class of business by the covered carrier to covered insureds with similar case characteristics for
health benefit plans with the same or similar coverage.
(4) (a) "Bona fide employer association" means an association of employers:
(i) that meets the requirements of [
Subsection 
31A-22-701
(2)(b)
] 
Section 
31A-22-505
;
(ii) in which the employers of the association, either directly or indirectly, exercise
control over the plan;
(iii) that is organized:
(A) based on a commonality of interest between the employers and their employees
that participate in the plan by some common economic or representation interest or genuine
organizational relationship unrelated to the provision of benefits; and
(B) to act in the best interests of its employers to provide benefits for the employer's
employees and their spouses and dependents, and other benefits relating to employment; and
(iv) whose association sponsored health plan complies with 45 C.F.R. 146.121.
(b) The commissioner shall consider the following with regard to determining whether
an association of employers is a bona fide employer association under Subsection (4)(a):
(i) how association members are solicited;
(ii) who participates in the association;
(iii) the process by which the association was formed;
(iv) the purposes for which the association was formed, and what, if any, were the
pre-existing relationships of its members;
(v) the powers, rights and privileges of employer members; and
(vi) who actually controls and directs the activities and operations of the benefit
programs.
(5) "Carrier" means a person that provides health insurance in this state including:
(a) an insurance company;
(b) a prepaid hospital or medical care plan;
(c) a health maintenance organization;
(d) a multiple employer welfare arrangement; and
(e) another person providing a health insurance plan under this title.
(6) (a) Except as provided in Subsection (6)(b), "case characteristics" means
demographic or other objective characteristics of a covered insured that are considered by the
carrier in determining premium rates for the covered insured.
(b) "Case characteristics" do not include:
(i) duration of coverage since the policy was issued;
(ii) claim experience; and
(iii) health status.
(7) "Class of business" means all or a separate grouping of covered insureds that is
permitted by the commissioner in accordance with Section 
31A-30-105
.
(8) "Covered carrier" means an individual carrier or small employer carrier subject to
this chapter.
(9) "Covered individual" means an individual who is covered under a health benefit
plan subject to this chapter.
(10) "Covered insureds" means small employers and individuals who are issued a
health benefit plan that is subject to this chapter.
(11) "Dependent" means an individual to the extent that the individual is defined to be
a dependent by:
(a) the health benefit plan covering the covered individual; and
(b) Chapter 22, Part 6, Accident and Health Insurance.
(12) "Established geographic service area" means a geographical area approved by the
commissioner within which the carrier is authorized to provide coverage.
(13) "Index rate" means, for each class of business as to a rating period for covered
insureds with similar case characteristics, the arithmetic average of the applicable base
premium rate and the corresponding highest premium rate.
(14) "Individual carrier" means a carrier that provides coverage on an individual basis
through a health benefit plan regardless of whether:
(a) coverage is offered through:
(i) an association;
(ii) a trust;
(iii) a discretionary group; or
(iv) other similar groups; or
(b) the policy or contract is situated out-of-state.
(15) "Individual conversion policy" means a conversion policy issued to:
(a) an individual; or
(b) an individual with a family.
(16) "New business premium rate" means, for each class of business as to a rating
period, the lowest premium rate charged or offered, or that could have been charged or offered,
by the carrier to covered insureds with similar case characteristics for newly issued health
benefit plans with the same or similar coverage.
(17) "Premium" means money paid by covered insureds and covered individuals as a
condition of receiving coverage from a covered carrier, including fees or other contributions
associated with the health benefit plan.
(18) (a) "Rating period" means the calendar period for which premium rates
established by a covered carrier are assumed to be in effect, as determined by the carrier.
(b) A covered carrier may not have:
(i) more than one rating period in any calendar month; and
(ii) no more than 12 rating periods in any calendar year.
(19) "Small employer carrier" means a carrier that provides health benefit plans
covering eligible employees of one or more small employers in this state, regardless of
whether:
(a) coverage is offered through:
(i) an association;
(ii) a trust;
(iii) a discretionary group; or
(iv) other similar grouping; or
(b) the policy or contract is situated out-of-state.
Section 30. Section 
31A-35-404
 is amended to read:
31A-35-404.
Minimum financial requirements for bail bond agency license.
(1) (a) A bail bond agency that pledges the assets of a letter of credit from a Utah
depository institution in connection with a judicial proceeding shall maintain an irrevocable
letter of credit with a minimum face value of $300,000 assigned to the state from a Utah
depository institution.
(b) Notwithstanding Subsection (1)(a), a bail bond agency described in Subsection
(1)(a) that is licensed under this chapter on or before December 31, 1999, shall maintain an
irrevocable letter of credit with a minimum face value of $250,000 assigned to the state from a
Utah depository institution.
(2) (a) A bail bond agency that pledges personal or real property, or both, as security
for a bail bond in connection with a judicial proceeding shall maintain a verified financial
statement for the [
current
] 
bail bond agency's immediately preceding fiscal
 year:
(i) reviewed by a certified public accountant; and
(ii) showing a minimum net worth of:
(A) $300,000, at least $100,000 of which is in liquid assets; or
(B) if the bail bond agency is licensed under this chapter on or before December 31,
1999, $250,000, at least $50,000 of which is in liquid assets.
(b) For purposes of this Subsection (2), only real or personal property located in Utah
may be included in the net worth of the bail bond agency.
(3) A bail bond agency shall maintain a qualifying power of attorney issued by a surety
insurer if:
(a) the bail bond agency is the agent of the surety insurer; and
(b) the surety insurer:
(i) sells bail bonds;
(ii) is in good standing in its state of domicile; and
(iii) is granted a certificate to write bail bonds in Utah.
(4) The commissioner may revoke the license of a bail bond agency that fails to
maintain the minimum financial requirements required under this section.
(5) The commissioner may set by rule the limits on the aggregate amounts of bail
bonds issued by a bail bond agency.
Section 31. Section 
31A-48-102
 is amended to read:
31A-48-102.
Definitions.
As used in this chapter:
(1) 
(a)
 "Drug" means [
a prescription drug, as defined in Section 
58-17b-102
.
] 
a
substance that is:
(i) (A) intended for use in the diagnosis, cure, mitigation, treatment, or prevention of
disease in humans; and
(B) recognized in or in a supplement to the official United States Pharmacopoeia, the
Homeopathic Pharmacopoeia of the United States, or the official National Formulary;
(ii) required by an applicable federal or state law or rule to be dispensed by prescription
only;
(iii) restricted to administration by practitioners only;
(iv) a substance other than food intended to affect the structure or a function of the
human body; or
(v) intended for use as a component of a substance described in Subsection (1)(a)(i),
(ii), (iii), or (iv).
(b) "Drug" does not include a dietary supplement.
(2) "Insurer" means the same as that term is defined in Section 
31A-22-634
.
(3) "Manufacturer" means a person that is engaged in the manufacturing of a drug that
is available for purchase by residents of the state.
(4) "Rebate" means the same as that term is defined in Section 
31A-46-102
.
(5) "Wholesale acquisition cost" means the same as that term is defined in 42 U.S.C.
Sec. 1395w-3a.
Section 32. Section 
31A-48-103
 is amended to read:
31A-48-103.
Manufacturer reports -- Insurer report -- Publication by
department.
(1) (a) A manufacturer of a drug shall, beginning January 1, 2022, report to the
department the information described in Subsection (1)(b) no more than 30 days after the day
on which an increase to the wholesale acquisition cost of the drug results in an increase to the
wholesale acquisition cost of the drug of:
(i) greater than 16% over the preceding two calendar years; or
(ii) greater than 10% over the preceding calendar year.
(b) The manufacturer shall report:
(i) (A) the name of the drug;
(B) the dosage form of the drug; and
(C) the strength of the drug;
(ii) whether the drug is a brand name drug or a generic drug;
(iii) the effective date of the increase in the wholesale acquisition cost of the drug;
(iv) a written description, suitable for public release, of the factors that led to the
increase in the wholesale acquisition cost of the drug and the significance of each factor;
(v) the manufacturer's aggregate company-wide research and development costs for the
most recent year for which final audit data is available;
(vi) the name of each of the manufacturer's drugs approved by the United States Food
and Drug Administration during the preceding three calendar years; and
(vii) the names of drugs manufactured by the manufacturer that lost patent exclusivity
in the United States during the preceding three calendar years.
(c) Subsection (1)(a) applies only to a drug with a wholesale acquisition cost of at least
$100 for a 30-day supply before the effective date of the increase in the wholesale acquisition
cost of the drug.
(d) [
A manufacturer's obligations under this Subsection (1) are fully satisfied by
submission
] 
The quality and types
 of information and data that a manufacturer 
submits under
this Subsection (1) shall be consistent with the quality and types of information and data that
the manufacturer
 includes in the manufacturer's annual consolidated report on Securities and
Exchange Commission Form 10-K or any other public disclosure.
(e) The department shall consult with representatives of manufacturers to establish a
single, standardized format for reporting information under this section that minimizes the
administrative burden of reporting for manufacturers and the state.
[
(f) Information provided to the department under Subsection (1)(b) may not be
released in a manner that:
]
[
(i) would allow for the identification of an individual drug, therapeutic class of drugs,
or manufacturer; or
]
[
(ii) is likely to compromise the financial, competitive, or proprietary nature of the
information.
]
(2) On or before August 1, 2021, and on or before August 1 of each year thereafter, an
insurer shall report to the department in aggregate the following information for the preceding
calendar year for health benefit plans offered by the insurer:
(a) for the 25 drugs for which spending by the insurer was the greatest, after adjusting
for rebates:
(i) the name of the drug;
(ii) the dosage form of the drug; and
(iii) the strength of the drug;
(b) the percentage increase over the previous year in net spending for all drugs, after
adjusting for rebates; [
and
]
(c) the percentage of the increase in premiums over the previous year attributable to all
drugs; and
(d) the percentage of the increase in premiums over the previous year attributable to
specialty drugs.
(3) The department shall publish on the department's website:
(a) no later than 60 days after receiving the information, information reported to the
department under Subsection (1); and
(b) no later than December 1 of each year, information reported to the department
under Subsection (2).
(4) 
(a)
 The department may not publish information under [
Subsection (3)(b)
] 
this
section
 in a manner that
:
(i)
 allows the identity of an insurer to be determined[
.
]
;
(ii) allows for the identification of an individual drug, a therapeutic class of drugs, or a
manufacturer; or
(iii) is likely to compromise the financial, competitive, or proprietary nature of the
information.
(b) The commissioner shall classify each record submitted under this section as a
protected record under Title 63G, Chapter 2, Government Records Access and Management
Act.
(5) The department shall make rules, as necessary, in accordance with Title 63G,
Chapter 3, Utah Administrative Rulemaking Act, to promote comparability of information
reported to the department under this chapter.
Section 33. Section 
58-13-2.5
 is amended to read:
58-13-2.5.
Standard of proof for emergency care when immunity does not apply.
(1) A person who is a health care provider as defined in Section 
78B-3-403
 who
provides emergency care in good faith, but is not immune from suit because of an expectation
of payment, a legal duty to respond, or other reason under Section 
58-13-2
, may only be liable
for civil damages if fault, as defined in Section 
78B-5-817
, is established by clear and
convincing evidence.
(2) For purposes of Subsection (1), "emergency care" means the treatment of an
emergency medical condition, as defined in Section [
31A-22-627
] 
31A-1-301
, from the time
that the person presents at the emergency department of a hospital and including any
subsequent transfer to another hospital, until the condition has been stabilized and the patient is
either discharged from the emergency department or admitted to another department of the
hospital.
(3) This section does not apply to emergency care provided by a physician if:
(a) the physician has a previously established physician/patient relationship with the
patient outside of the emergency room;
(b) the patient has been seen in the last three months by the physician for the same
condition for which emergency care is sought; and
(c) the physician can access and consult the patient's relevant medical care records
while the physician is making decisions about and providing the emergency care.
(4) (a) Nothing in this section may be construed as:
(i) altering the applicable standard of care for determining fault; or
(ii) applying the standard of proof of clear and convincing evidence to care outside of
emergency care and the mandatory legal duty to treat.
(b) This section applies to emergency care given after June 1, 2009.
(5) This section sunsets in accordance with Section 
63I-1-258
.
Section 34. Section 
63G-2-305
 is amended to read:
63G-2-305.
Protected records.
The following records are protected if properly classified by a governmental entity:
(1) trade secrets as defined in Section 
13-24-2
 if the person submitting the trade secret
has provided the governmental entity with the information specified in Section 
63G-2-309
;
(2) commercial information or nonindividual financial information obtained from a
person if:
(a) disclosure of the information could reasonably be expected to result in unfair
competitive injury to the person submitting the information or would impair the ability of the
governmental entity to obtain necessary information in the future;
(b) the person submitting the information has a greater interest in prohibiting access
than the public in obtaining access; and
(c) the person submitting the information has provided the governmental entity with
the information specified in Section 
63G-2-309
;
(3) commercial or financial information acquired or prepared by a governmental entity
to the extent that disclosure would lead to financial speculations in currencies, securities, or
commodities that will interfere with a planned transaction by the governmental entity or cause
substantial financial injury to the governmental entity or state economy;
(4) records, the disclosure of which could cause commercial injury to, or confer a
competitive advantage upon a potential or actual competitor of, a commercial project entity as
defined in Subsection 
11-13-103
(4);
(5) test questions and answers to be used in future license, certification, registration,
employment, or academic examinations;
(6) records, the disclosure of which would impair governmental procurement
proceedings or give an unfair advantage to any person proposing to enter into a contract or
agreement with a governmental entity, except, subject to Subsections (1) and (2), that this
Subsection (6) does not restrict the right of a person to have access to, after the contract or
grant has been awarded and signed by all parties:
(a) a bid, proposal, application, or other information submitted to or by a governmental
entity in response to:
(i) an invitation for bids;
(ii) a request for proposals;
(iii) a request for quotes;
(iv) a grant; or
(v) other similar document; or
(b) an unsolicited proposal, as defined in Section 
63G-6a-712
;
(7) information submitted to or by a governmental entity in response to a request for
information, except, subject to Subsections (1) and (2), that this Subsection (7) does not restrict
the right of a person to have access to the information, after:
(a) a contract directly relating to the subject of the request for information has been
awarded and signed by all parties; or
(b) (i) a final determination is made not to enter into a contract that relates to the
subject of the request for information; and
(ii) at least two years have passed after the day on which the request for information is
issued;
(8) records that would identify real property or the appraisal or estimated value of real
or personal property, including intellectual property, under consideration for public acquisition
before any rights to the property are acquired unless:
(a) public interest in obtaining access to the information is greater than or equal to the
governmental entity's need to acquire the property on the best terms possible;
(b) the information has already been disclosed to persons not employed by or under a
duty of confidentiality to the entity;
(c) in the case of records that would identify property, potential sellers of the described
property have already learned of the governmental entity's plans to acquire the property;
(d) in the case of records that would identify the appraisal or estimated value of
property, the potential sellers have already learned of the governmental entity's estimated value
of the property; or
(e) the property under consideration for public acquisition is a single family residence
and the governmental entity seeking to acquire the property has initiated negotiations to acquire
the property as required under Section 
78B-6-505
;
(9) records prepared in contemplation of sale, exchange, lease, rental, or other
compensated transaction of real or personal property including intellectual property, which, if
disclosed prior to completion of the transaction, would reveal the appraisal or estimated value
of the subject property, unless:
(a) the public interest in access is greater than or equal to the interests in restricting
access, including the governmental entity's interest in maximizing the financial benefit of the
transaction; or
(b) when prepared by or on behalf of a governmental entity, appraisals or estimates of
the value of the subject property have already been disclosed to persons not employed by or
under a duty of confidentiality to the entity;
(10) records created or maintained for civil, criminal, or administrative enforcement
purposes or audit purposes, or for discipline, licensing, certification, or registration purposes, if
release of the records:
(a) reasonably could be expected to interfere with investigations undertaken for
enforcement, discipline, licensing, certification, or registration purposes;
(b) reasonably could be expected to interfere with audits, disciplinary, or enforcement
proceedings;
(c) would create a danger of depriving a person of a right to a fair trial or impartial
hearing;
(d) reasonably could be expected to disclose the identity of a source who is not
generally known outside of government and, in the case of a record compiled in the course of
an investigation, disclose information furnished by a source not generally known outside of
government if disclosure would compromise the source; or
(e) reasonably could be expected to disclose investigative or audit techniques,
procedures, policies, or orders not generally known outside of government if disclosure would
interfere with enforcement or audit efforts;
(11) records the disclosure of which would jeopardize the life or safety of an
individual;
(12) records the disclosure of which would jeopardize the security of governmental
property, governmental programs, or governmental recordkeeping systems from damage, theft,
or other appropriation or use contrary to law or public policy;
(13) records that, if disclosed, would jeopardize the security or safety of a correctional
facility, or records relating to incarceration, treatment, probation, or parole, that would interfere
with the control and supervision of an offender's incarceration, treatment, probation, or parole;
(14) records that, if disclosed, would reveal recommendations made to the Board of
Pardons and Parole by an employee of or contractor for the Department of Corrections, the
Board of Pardons and Parole, or the Department of Human Services that are based on the
employee's or contractor's supervision, diagnosis, or treatment of any person within the board's
jurisdiction;
(15) records and audit workpapers that identify audit, collection, and operational
procedures and methods used by the State Tax Commission, if disclosure would interfere with
audits or collections;
(16) records of a governmental audit agency relating to an ongoing or planned audit
until the final audit is released;
(17) records that are subject to the attorney client privilege;
(18) records prepared for or by an attorney, consultant, surety, indemnitor, insurer,
employee, or agent of a governmental entity for, or in anticipation of, litigation or a judicial,
quasi-judicial, or administrative proceeding;
(19) (a) (i) personal files of a state legislator, including personal correspondence to or
from a member of the Legislature; and
(ii) notwithstanding Subsection (19)(a)(i), correspondence that gives notice of
legislative action or policy may not be classified as protected under this section; and
(b) (i) an internal communication that is part of the deliberative process in connection
with the preparation of legislation between:
(A) members of a legislative body;
(B) a member of a legislative body and a member of the legislative body's staff; or
(C) members of a legislative body's staff; and
(ii) notwithstanding Subsection (19)(b)(i), a communication that gives notice of
legislative action or policy may not be classified as protected under this section;
(20) (a) records in the custody or control of the Office of Legislative Research and
General Counsel, that, if disclosed, would reveal a particular legislator's contemplated
legislation or contemplated course of action before the legislator has elected to support the
legislation or course of action, or made the legislation or course of action public; and
(b) notwithstanding Subsection (20)(a), the form to request legislation submitted to the
Office of Legislative Research and General Counsel is a public document unless a legislator
asks that the records requesting the legislation be maintained as protected records until such
time as the legislator elects to make the legislation or course of action public;
(21) research requests from legislators to the Office of Legislative Research and
General Counsel or the Office of the Legislative Fiscal Analyst and research findings prepared
in response to these requests;
(22) drafts, unless otherwise classified as public;
(23) records concerning a governmental entity's strategy about:
(a) collective bargaining; or
(b) imminent or pending litigation;
(24) records of investigations of loss occurrences and analyses of loss occurrences that
may be covered by the Risk Management Fund, the Employers' Reinsurance Fund, the
Uninsured Employers' Fund, or similar divisions in other governmental entities;
(25) records, other than personnel evaluations, that contain a personal recommendation
concerning an individual if disclosure would constitute a clearly unwarranted invasion of
personal privacy, or disclosure is not in the public interest;
(26) records that reveal the location of historic, prehistoric, paleontological, or
biological resources that if known would jeopardize the security of those resources or of
valuable historic, scientific, educational, or cultural information;
(27) records of independent state agencies if the disclosure of the records would
conflict with the fiduciary obligations of the agency;
(28) records of an institution within the state system of higher education defined in
Section 
53B-1-102
 regarding tenure evaluations, appointments, applications for admissions,
retention decisions, and promotions, which could be properly discussed in a meeting closed in
accordance with Title 52, Chapter 4, Open and Public Meetings Act, provided that records of
the final decisions about tenure, appointments, retention, promotions, or those students
admitted, may not be classified as protected under this section;
(29) records of the governor's office, including budget recommendations, legislative
proposals, and policy statements, that if disclosed would reveal the governor's contemplated
policies or contemplated courses of action before the governor has implemented or rejected
those policies or courses of action or made them public;
(30) records of the Office of the Legislative Fiscal Analyst relating to budget analysis,
revenue estimates, and fiscal notes of proposed legislation before issuance of the final
recommendations in these areas;
(31) records provided by the United States or by a government entity outside the state
that are given to the governmental entity with a requirement that they be managed as protected
records if the providing entity certifies that the record would not be subject to public disclosure
if retained by it;
(32) transcripts, minutes, recordings, or reports of the closed portion of a meeting of a
public body except as provided in Section 
52-4-206
;
(33) records that would reveal the contents of settlement negotiations but not including
final settlements or empirical data to the extent that they are not otherwise exempt from
disclosure;
(34) memoranda prepared by staff and used in the decision-making process by an
administrative law judge, a member of the Board of Pardons and Parole, or a member of any
other body charged by law with performing a quasi-judicial function;
(35) records that would reveal negotiations regarding assistance or incentives offered
by or requested from a governmental entity for the purpose of encouraging a person to expand
or locate a business in Utah, but only if disclosure would result in actual economic harm to the
person or place the governmental entity at a competitive disadvantage, but this section may not
be used to restrict access to a record evidencing a final contract;
(36) materials to which access must be limited for purposes of securing or maintaining
the governmental entity's proprietary protection of intellectual property rights including patents,
copyrights, and trade secrets;
(37) the name of a donor or a prospective donor to a governmental entity, including an
institution within the state system of higher education defined in Section 
53B-1-102
, and other
information concerning the donation that could reasonably be expected to reveal the identity of
the donor, provided that:
(a) the donor requests anonymity in writing;
(b) any terms, conditions, restrictions, or privileges relating to the donation may not be
classified protected by the governmental entity under this Subsection (37); and
(c) except for an institution within the state system of higher education defined in
Section 
53B-1-102
, the governmental unit to which the donation is made is primarily engaged
in educational, charitable, or artistic endeavors, and has no regulatory or legislative authority
over the donor, a member of the donor's immediate family, or any entity owned or controlled
by the donor or the donor's immediate family;
(38) accident reports, except as provided in Sections 
41-6a-404
, 
41-12a-202
, and
73-18-13
;
(39) a notification of workers' compensation insurance coverage described in Section
34A-2-205
;
(40) (a) the following records of an institution within the state system of higher
education defined in Section 
53B-1-102
, which have been developed, discovered, disclosed to,
or received by or on behalf of faculty, staff, employees, or students of the institution:
(i) unpublished lecture notes;
(ii) unpublished notes, data, and information:
(A) relating to research; and
(B) of:
(I) the institution within the state system of higher education defined in Section
53B-1-102
; or
(II) a sponsor of sponsored research;
(iii) unpublished manuscripts;
(iv) creative works in process;
(v) scholarly correspondence; and
(vi) confidential information contained in research proposals;
(b) Subsection (40)(a) may not be construed to prohibit disclosure of public
information required pursuant to Subsection 
53B-16-302
(2)(a) or (b); and
(c) Subsection (40)(a) may not be construed to affect the ownership of a record;
(41) (a) records in the custody or control of the Office of the Legislative Auditor
General that would reveal the name of a particular legislator who requests a legislative audit
prior to the date that audit is completed and made public; and
(b) notwithstanding Subsection (41)(a), a request for a legislative audit submitted to the
Office of the Legislative Auditor General is a public document unless the legislator asks that
the records in the custody or control of the Office of the Legislative Auditor General that would
reveal the name of a particular legislator who requests a legislative audit be maintained as
protected records until the audit is completed and made public;
(42) records that provide detail as to the location of an explosive, including a map or
other document that indicates the location of:
(a) a production facility; or
(b) a magazine;
(43) information:
(a) contained in the statewide database of the Division of Aging and Adult Services
created by Section 
62A-3-311.1
; or
(b) received or maintained in relation to the Identity Theft Reporting Information
System (IRIS) established under Section 
67-5-22
;
(44) information contained in the Licensing Information System described in Title
62A, Chapter 4a, Child and Family Services;
(45) information regarding National Guard operations or activities in support of the
National Guard's federal mission;
(46) records provided by any pawn or secondhand business to a law enforcement
agency or to the central database in compliance with Title 13, Chapter 32a, Pawnshop and
Secondhand Merchandise Transaction Information Act;
(47) information regarding food security, risk, and vulnerability assessments performed
by the Department of Agriculture and Food;
(48) except to the extent that the record is exempt from this chapter pursuant to Section
63G-2-106
, records related to an emergency plan or program, a copy of which is provided to or
prepared or maintained by the Division of Emergency Management, and the disclosure of
which would jeopardize:
(a) the safety of the general public; or
(b) the security of:
(i) governmental property;
(ii) governmental programs; or
(iii) the property of a private person who provides the Division of Emergency
Management information;
(49) records of the Department of Agriculture and Food that provides for the
identification, tracing, or control of livestock diseases, including any program established under
Title 4, Chapter 24, Utah Livestock Brand and Anti-Theft Act, or Title 4, Chapter 31, Control
of Animal Disease;
(50) as provided in Section 
26-39-501
:
(a) information or records held by the Department of Health related to a complaint
regarding a child care program or residential child care which the department is unable to
substantiate; and
(b) information or records related to a complaint received by the Department of Health
from an anonymous complainant regarding a child care program or residential child care;
(51) unless otherwise classified as public under Section 
63G-2-301
 and except as
provided under Section 
41-1a-116
, an individual's home address, home telephone number, or
personal mobile phone number, if:
(a) the individual is required to provide the information in order to comply with a law,
ordinance, rule, or order of a government entity; and
(b) the subject of the record has a reasonable expectation that this information will be
kept confidential due to:
(i) the nature of the law, ordinance, rule, or order; and
(ii) the individual complying with the law, ordinance, rule, or order;
(52) the portion of the following documents that contains a candidate's residential or
mailing address, if the candidate provides to the filing officer another address or phone number
where the candidate may be contacted:
(a) a declaration of candidacy, a nomination petition, or a certificate of nomination,
described in Section 
20A-9-201
, 
20A-9-202
, 
20A-9-203
, 
20A-9-404
, 
20A-9-405
, 
20A-9-408
,
20A-9-408.5
, 
20A-9-502
, or 
20A-9-601
;
(b) an affidavit of impecuniosity, described in Section 
20A-9-201
; or
(c) a notice of intent to gather signatures for candidacy, described in Section
20A-9-408
;
(53) the name, home address, work addresses, and telephone numbers of an individual
that is engaged in, or that provides goods or services for, medical or scientific research that is:
(a) conducted within the state system of higher education, as defined in Section
53B-1-102
; and
(b) conducted using animals;
(54) in accordance with Section 
78A-12-203
, any record of the Judicial Performance
Evaluation Commission concerning an individual commissioner's vote on whether or not to
recommend that the voters retain a judge including information disclosed under Subsection
78A-12-203
(5)(e);
(55) information collected and a report prepared by the Judicial Performance
Evaluation Commission concerning a judge, unless Section 
20A-7-702
 or Title 78A, Chapter
12, Judicial Performance Evaluation Commission Act, requires disclosure of, or makes public,
the information or report;
(56) records provided or received by the Public Lands Policy Coordinating Office in
furtherance of any contract or other agreement made in accordance with Section 
63L-11-202
;
(57) information requested by and provided to the 911 Division under Section
63H-7a-302
;
(58) in accordance with Section 
73-10-33
:
(a) a management plan for a water conveyance facility in the possession of the Division
of Water Resources or the Board of Water Resources; or
(b) an outline of an emergency response plan in possession of the state or a county or
municipality;
(59) the following records in the custody or control of the Office of Inspector General
of Medicaid Services, created in Section 
63A-13-201
:
(a) records that would disclose information relating to allegations of personal
misconduct, gross mismanagement, or illegal activity of a person if the information or
allegation cannot be corroborated by the Office of Inspector General of Medicaid Services
through other documents or evidence, and the records relating to the allegation are not relied
upon by the Office of Inspector General of Medicaid Services in preparing a final investigation
report or final audit report;
(b) records and audit workpapers to the extent they would disclose the identity of a
person who, during the course of an investigation or audit, communicated the existence of any
Medicaid fraud, waste, or abuse, or a violation or suspected violation of a law, rule, or
regulation adopted under the laws of this state, a political subdivision of the state, or any
recognized entity of the United States, if the information was disclosed on the condition that
the identity of the person be protected;
(c) before the time that an investigation or audit is completed and the final
investigation or final audit report is released, records or drafts circulated to a person who is not
an employee or head of a governmental entity for the person's response or information;
(d) records that would disclose an outline or part of any investigation, audit survey
plan, or audit program; or
(e) requests for an investigation or audit, if disclosure would risk circumvention of an
investigation or audit;
(60) records that reveal methods used by the Office of Inspector General of Medicaid
Services, the fraud unit, or the Department of Health, to discover Medicaid fraud, waste, or
abuse;
(61) information provided to the Department of Health or the Division of Occupational
and Professional Licensing under Subsections 
58-67-304
(3) and (4) and Subsections
58-68-304
(3) and (4);
(62) a record described in Section 
63G-12-210
;
(63) captured plate data that is obtained through an automatic license plate reader
system used by a governmental entity as authorized in Section 
41-6a-2003
;
(64) any record in the custody of the Utah Office for Victims of Crime relating to a
victim, including:
(a) a victim's application or request for benefits;
(b) a victim's receipt or denial of benefits; and
(c) any administrative notes or records made or created for the purpose of, or used to,
evaluate or communicate a victim's eligibility for or denial of benefits from the Crime Victim
Reparations Fund;
(65) an audio or video recording created by a body-worn camera, as that term is
defined in Section 
77-7a-103
, that records sound or images inside a hospital or health care
facility as those terms are defined in Section 
78B-3-403
, inside a clinic of a health care
provider, as that term is defined in Section 
78B-3-403
, or inside a human service program as
that term is defined in Section 
62A-2-101
, except for recordings that:
(a) depict the commission of an alleged crime;
(b) record any encounter between a law enforcement officer and a person that results in
death or bodily injury, or includes an instance when an officer fires a weapon;
(c) record any encounter that is the subject of a complaint or a legal proceeding against
a law enforcement officer or law enforcement agency;
(d) contain an officer involved critical incident as defined in Subsection
76-2-408
(1)(f); or
(e) have been requested for reclassification as a public record by a subject or
authorized agent of a subject featured in the recording; 
(66) a record pertaining to the search process for a president of an institution of higher
education described in Section 
53B-2-102
, except for application materials for a publicly
announced finalist;
(67) an audio recording that is:
(a) produced by an audio recording device that is used in conjunction with a device or
piece of equipment designed or intended for resuscitating an individual or for treating an
individual with a life-threatening condition;
(b) produced during an emergency event when an individual employed to provide law
enforcement, fire protection, paramedic, emergency medical, or other first responder service:
(i) is responding to an individual needing resuscitation or with a life-threatening
condition; and
(ii) uses a device or piece of equipment designed or intended for resuscitating an
individual or for treating an individual with a life-threatening condition; and
(c) intended and used for purposes of training emergency responders how to improve
their response to an emergency situation; 
(68) records submitted by or prepared in relation to an applicant seeking a
recommendation by the Research and General Counsel Subcommittee, the Budget
Subcommittee, or the Audit Subcommittee, established under Section 
36-12-8
, for an
employment position with the Legislature;
(69) work papers as defined in Section 
31A-2-204
;
(70) a record made available to Adult Protective Services or a law enforcement agency
under Section 
61-1-206
;
(71) a record submitted to the Insurance Department in accordance with Section
31A-37-201
;
(72) a record described in Section 
31A-37-503
;
(73) any record created by the Division of Occupational and Professional Licensing as
a result of Subsection 
58-37f-304
(5) or 
58-37f-702
(2)(a)(ii);
(74) a record described in Section 
72-16-306
 that relates to the reporting of an injury
involving an amusement ride;
(75) except as provided in Subsection 
63G-2-305.5
(1), the signature of an individual
on a political petition, or on a request to withdraw a signature from a political petition,
including a petition or request described in the following titles:
(a) Title 10, Utah Municipal Code;
(b) Title 17, Counties;
(c) Title 17B, Limited Purpose Local Government Entities - Local Districts;
(d) Title 17D, Limited Purpose Local Government Entities - Other Entities; and
(e) Title 20A, Election Code;
(76) except as provided in Subsection 
63G-2-305.5
(2), the signature of an individual in
a voter registration record;
(77) except as provided in Subsection 
63G-2-305.5
(3), any signature, other than a
signature described in Subsection (75) or (76), in the custody of the lieutenant governor or a
local political subdivision collected or held under, or in relation to, Title 20A, Election Code;
(78) a Form I-918 Supplement B certification as described in Title 77, Chapter 38, Part
5, Victims Guidelines for Prosecutors Act;
(79) a record submitted to the Insurance Department under [
Subsection
] 
Section
31A-48-103
[
(1)(b)
];
(80) personal information, as defined in Section 
63G-26-102
, to the extent disclosure is
prohibited under Section 
63G-26-103
;
(81) (a) an image taken of an individual during the process of booking the individual
into jail, unless:
(i) the individual is convicted of a criminal offense based upon the conduct for which
the individual was incarcerated at the time the image was taken;
(ii) a law enforcement agency releases or disseminates the image after determining
that:
(A) the individual is a fugitive or an imminent threat to an individual or to public
safety; and
(B) releasing or disseminating the image will assist in apprehending the individual or
reducing or eliminating the threat; or
(iii) a judge orders the release or dissemination of the image based on a finding that the
release or dissemination is in furtherance of a legitimate law enforcement interest[
.
]
;
(82) a record:
(a) concerning an interstate claim to the use of waters in the Colorado River system;
(b) relating to a judicial proceeding, administrative proceeding, or negotiation with a
representative from another state or the federal government as provided in Section
63M-14-205
; and
(c) the disclosure of which would:
(i) reveal a legal strategy relating to the state's claim to the use of the water in the
Colorado River system;
(ii) harm the ability of the Colorado River Authority of Utah or river commissioner to
negotiate the best terms and conditions regarding the use of water in the Colorado River
system; or
(iii) give an advantage to another state or to the federal government in negotiations
regarding the use of water in the Colorado River system; and
(83) any part of an application described in Section 
63N-16-201
 that the Governor's
Office of Economic Opportunity determines is nonpublic, confidential information that if
disclosed would result in actual economic harm to the applicant, but this Subsection (83) may
not be used to restrict access to a record evidencing a final contract or approval decision.
Section 35. Section 
76-6-521
 is amended to read:
76-6-521.
Fraudulent insurance act.
(1) A person commits a fraudulent insurance act if that person with intent to 
deceive or
defraud:
(a) presents or causes to be presented any oral or written statement or representation
knowing that the statement or representation contains false or fraudulent information
concerning any fact material to an application for the issuance or renewal of an insurance
policy, certificate, or contract, as part of or in support of:
(i) obtaining an insurance policy the insurer would otherwise not issue on the basis of
underwriting criteria applicable to the person;
(ii) a scheme or artifice to avoid paying the premium that an insurer charges on the
basis of underwriting criteria applicable to the person; or
(iii) a scheme or artifice to file an insurance claim for a loss that has already occurred;
(b) presents, or causes to be presented, any oral or written statement or representation:
(i) (A) as part of or in support of a claim for payment or other benefit pursuant to an
insurance policy, certificate, or contract; or
(B) in connection with any civil claim asserted for recovery of damages for personal or
bodily injuries or property damage; and
(ii) knowing that the statement or representation contains false, incomplete, or
fraudulent information concerning any fact or thing material to the claim;
(c) knowingly accepts a benefit from proceeds derived from a fraudulent insurance act;
(d) intentionally, knowingly, or recklessly devises a scheme or artifice to obtain fees
for professional services, or anything of value by means of false or fraudulent pretenses,
representations, promises, or material omissions;
(e) knowingly employs, uses, or acts as a runner, as defined in Section 
31A-31-102
, for
the purpose of committing a fraudulent insurance act;
(f) knowingly assists, abets, solicits, or conspires with another to commit a fraudulent
insurance act;
(g) knowingly supplies false or fraudulent material information in any document or
statement required by the Department of Insurance; or
(h) knowingly fails to forward a premium to an insurer in violation of Section
31A-23a-411.1
.
(2) (a) A violation of Subsection (1)(a) (i) is a class A misdemeanor.
(b) A violation of Subsections (1)(a)(ii) or (1)(b) through (1) (h) is punishable as in the
manner prescribed by Section 
76-10-1801
 for communication fraud for property of like value.
(c) A violation of Subsection (1)(a)(iii):
(i) is a class A misdemeanor if the value of the loss is less than $1,500 or unable to be
determined; or
(ii) if the value of the loss is $1,500 or more, is punishable as in the manner prescribed
by Section 
76-10-1801
 for communication fraud for property of like value.
(3) A corporation or association is guilty of the offense of insurance fraud under the
same conditions as those set forth in Section 
76-2-204
.
(4) The determination of the degree of any offense under Subsections (1)(a)(ii) and
(1)(b) through (1)(h) shall be measured by the total value of all property, money, or other things
obtained or sought to be obtained by the fraudulent insurance act or acts described in
Subsections (1)(a)(ii) and (1)(b) through (1)(h).
Section 36. 
Repealer.
This bill repeals:
Section 
31A-17-519
,
Small company exemption.