Title 31A, Title 31A: Insurance Code

31A-30-102. Purpose statement. The purpose of this chapter is to: (1) prevent abusive rating practices; (2) require disclosure of rating practices to purchasers; (3) establish rules regarding: a universal individual and small group application; and renewability of coverage; (4) i…

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 ex…

31A-30-104. Applicability and scope. (1) This chapter applies to any: health benefit plan that provides coverage to: individuals; small employers, except as provided in Subsection; or (3) both Subsectionsand; or (1)(a)(i) (ii) individual conversion policy for purposes of Sections…

31A-30-105. Establishment of classes of business. Effective January 1, 2014, a covered carrier may establish up to four separate classes of business: (1) one class of business for individual health benefit plans that are not grandfathered under PPACA; (2) one class of business fo…

31A-30-106. Individual premiums -- Rating restrictions -- Disclosure. (1) Premium rates for health benefit plans for individuals under this chapter are subject to this section. The index rate for a rating period for any class of business may not exceed the index rate for any othe…

31A-30-106.1. Small employer premiums -- Rating restrictions -- Disclosure. (1) Premium rates for small employer health benefit plans under this chapter are subject to this section. (2) The index rate for a rating period for any class of business may not exceed the index rate for…

31A-30-106.5. Conversion policy -- Premiums -- Rating restrictions. (1) Sectionapplies to conversion policies. 31A-30-106 (2) Conversion policy premium rates may not exceed by more than 35% the index rate for small employers with similar case characteristics for any class of busi…

31A-30-106.7. Surcharge for groups changing carriers. (1) Except as provided in Subsection, if prior notice is given, a covered carrier may impose upon a small group that changes coverage to that carrier from another carrier a one-time surcharge of up to 25% of the annualized pre…

31A-30-107.5. Preexisting condition exclusion -- Condition-specific exclusion riders -- Limitation periods. (1) A health benefit plan may impose a preexisting condition exclusion only if the provision complies with Subsection. 31A-22-605.1(4) (2) In accordance with Subsection, an…

31A-30-108. Eligibility for small employer and individual market. (1) A small employer carrier shall accept a small employer that applies for small group coverage as set forth in the Health Insurance Portability and Accountability Act, Sec. 2701(f) and 2711(a), and PPACA, Sec. 27…

31A-30-112. Employee participation levels. (1) For purposes of this section, "participation" means the same as that term is defined in Section. 31A-1-301 Except as provided in Subsection, a requirement used by a covered carrier in determining whether to provide coverage to a smal…

31A-30-114. Disclosure. (1) A covered carrier shall make the information described in Subsectionavailable: (2) to: a small employer; or an individual; and at the time of solicitation; or upon the request of: a small employer; or an individual; as part of the covered carrier's sol…

31A-30-115. Actuarial review of health benefit plans. (1) The department shall conduct an actuarial review of rates submitted by a carrier that offers a small employer plan and a carrier that offers an individual plan under this chapter: to verify the validity of the rates, risk …

31A-30-117. Patient Protection and Affordable Care Act -- Market transition. (1) The commissioner may adopt administrative rules in accordance with, that change the rating and underwriting requirements of this chapter as necessary to transition the insurance market to meet federa…

31A-30-118. Patient Protection and Affordable Care Act -- State insurance mandates -- Cost of additional benefits. (1) The commissioner shall identify a new mandated benefit that is in excess of the essential health benefits required by PPACA. The state shall quantify the cost at…

31A-31-101. Title. This chapter may be cited as the "Insurance Fraud Act."

31A-31-102. Definitions. As used in this chapter: (1) "Authorized agency" means: the attorney general; the state fire marshal; any state law enforcement agency; any criminal investigative department or agency of the United States; a district attorney; the prosecuting attorney of …

31A-31-103. Fraudulent insurance act. (1) A person commits a fraudulent insurance act if that person with intent to deceive or defraud: knowingly presents or causes to be presented to an insurer any oral or written statement or representation knowing that the statement or represe…

31A-31-104. Disclosure of information. (1) Subject to Subsection, upon written request by an insurer to an authorized agency, the authorized agency may release to the insurer information or evidence that is relevant to any suspected insurance fraud. (2) Upon written request by an…

31A-31-105. Immunity. (1) A person, insurer, or authorized agency is immune from civil action, civil penalty, or damages when in good faith that person, insurer, or authorized agency: cooperates with an agency described in Subsection; (1)(b) furnishes evidence to an agency descri…

31A-31-106. Disciplinary action. (1) If, after giving notice and a hearing conducted pursuant to, the commissioner finds by a preponderance of the evidence that a person licensed under, has committed a fraudulent insurance act, the commissioner may suspend or revoke the license i…

31A-31-107. Workers' compensation insurance fraud. (1) In any action involving workers' compensation insurance, Sectionsupersedes this chapter. 34A-2-110 (2) Nothing in this section prohibits the department from investigating and pursuing civil or criminal penalties in accordance…

31A-31-108. Assessment of insurers. (1) For purposes of this section: The commissioner shall by rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, define: "annuity consideration"; "membership fees"; "other fees"; "deposit-type contract funds"; …

31A-31-108.5. Insurance Fraud Victim Restitution Fund. (1) There is created an expendable special revenue fund known as the "Insurance Fraud Victim Restitution Fund." (2) The Insurance Fraud Victim Restitution Fund shall consist of money ordered paid under Subsectionsand. 31A-31-…

31A-31-109. Civil penalties. (1) In addition to other penalties provided by law, a person who violates this chapter: is subject to the following civil penalties: the person shall make full restitution; and the person shall pay the costs of enforcement of this chapter for the case…

31A-31-110. Mandatory reporting of fraudulent insurance acts. (1) A person shall report a fraudulent insurance act to the department if: the person has a good faith belief on the basis of a preponderance of the evidence that a fraudulent insurance act is being, will be, or has be…

31A-31-111. Health discount program fraud. (1) In addition to any other fraudulent acts prohibited by this chapter, a person commits a fraudulent insurance act if that person with intent to deceive or defraud: accepts fees, dues, charges, or other consideration for providing a he…

31A-31-112. Insurance antifraud plan. (1) An insurer, as defined in Section, shall prepare, implement, and maintain an insurance antifraud plan for its operations in this state. 31A-31-102 (2) The insurance antifraud plan required by Subsectionshall outline specific procedures, a…

31A-32a-101. Title. This chapter is known as the "Medical Care Savings Account Act."

31A-32a-102. Definitions. As used in this chapter: (1) "Account administrator" means any of the following: a depository institution as defined in Section; 7-1-103 a trust company as defined in Section; 7-1-103 an insurance company authorized to do business in this state under thi…

31A-32a-103. Establishing medical care savings accounts. (1) An employer, except as otherwise provided by contract or a collective bargaining agreement, may offer a medical care savings account program to the employer's employees. A resident individual may establish a medical car…

31A-32a-104. Administration of medical care savings account. (1) An account administrator shall administer the medical care savings account from which the payment of claims is made and has a fiduciary duty to the person for whose benefit the account administrator administers an a…

31A-32a-105. Withdrawals -- Termination -- Transfers. (1) Subject to Subsection, if the employee or account holder withdraws money for any purpose other than a medical expense at any time in which the balance in the account is below $4,000: (3) the amount of the withdrawal shall …

31A-32a-106. Regulation of account administrators -- Administration of addition to adjusted gross income and tax credit -- Rulemaking authority. (1) The department shall regulate account administrators and may adopt rules necessary to administer this chapter. (2) The State Tax Co…

31A-32a-107. Penalties for noncompliance with tax provisions. (1) An account administrator who fails to comply with a provision described in Subsectionis subject to: (2) the civil penalties provided in Section; and 59-1-401 interest at the rate and in the manner provided in Secti…

31A-35-101. Title. This chapter is known as the "Bail Bond Act."

31A-35-102. Definitions. As used in this chapter: (1) "Bail bond" means a bail bond insurance product for a specified monetary amount that is: executed by a bail bond producer licensed in accordance with Section; and 31A-35-401 issued to a court, magistrate, or authorized officer…

31A-35-103. Exemption from other provisions of this title. Bail bond agencies are exempted from: (1) , except Section; Chapter 3, Department Funding, Fees, and Taxes 31A-3-103 (2) , except Sections,,, and; Chapter 4, Insurers in General 31A-4-102 31A-4-103 31A-4-104 31A-4-107 (3)…

31A-35-104. Rulemaking authority. The commissioner shall by rule establish specific licensure and certification guidelines and standards of conduct for the business of bail bond insurance under this chapter.

31A-35-201. Bail Bond Oversight Board. (1) There is created a Bail Bond Oversight Board within the department, consisting of: the following seven voting members who shall be appointed by the commissioner: one representative each from four licensed bail bond agencies; two members …

31A-35-202. Board responsibilities. (1) The board shall: meet: at least quarterly; and at the call of the chair; make written recommendations to the commissioner for rules governing the following aspects of the bail bond insurance business: qualifications, applications, and fees …

31A-35-301. The commissioner's authority. (1) The commissioner shall: make rules as necessary for the administration of this chapter; with information as provided by the board, issue or deny licensure under this chapter; take action regarding a license, including suspension or re…

31A-35-401. Requirement for license or certificate of authority -- Process -- Fees -- Limitations. (1) A person may not engage in the bail bond insurance business unless that person: is a bail bond agency licensed under this chapter; is a surety insurer that is granted a certific…

31A-35-401.5. Additional licensure requirements for a bail bond agency. (1) A person applying for licensure or the reinstatement of a license as a bail bond agency shall, in addition to the requirements of Section, provide proof that at least one principal of the bail bond agency…

31A-35-402. Authority related to bail bonds. (1) A bail bond agency may only sell bail bonds. (2) In accordance with Section, a bail bond producer may not execute or issue a bail bond in this state without holding a current appointment from a surety insurer or a current designati…

31A-35-403. Exemptions to licensing requirements. This chapter does not affect the negotiation through a licensed producer for, or the execution or delivery of, an undertaking of bail executed by an insurer for its insured under a policy of automobile insurance or of liability in…