Title 31A, Insurance Code

31A-7-306. Continuity of management in emergencies. Section 31A-5-411 applies to continuity of management in emergencies in corporations organized and operating under this chapter.

31A-7-307. Committees of directors. (1) If provided by the articles or bylaws of a corporation, the board of directors may, by a resolution adopted by a majority of the full board, designate one or more committees, each consisting of three or more directors, to serve at the pleas…

31A-7-308. Interlocking directorates and other relationships. Section 31A-5-413 applies to interlocking directorates and other relationships in corporations organized and operating under this chapter.

31A-7-309. Transactions in which directors and others are interested. Section 31A-5-414 applies to corporations organized and operating under this chapter, except that, for purposes of this chapter, Section 31A-5-414 does not preclude standard contracts for the provision of healt…

31A-7-310. Officers', directors', and employees' liability and indemnification. Section 31A-5-415 applies to officers', directors', and employees' liability and indemnification in corporations organized and operating under this chapter.

31A-7-311. Executive compensation. Subsections 31A-5-416(4), (5), (6), and (7) apply to executive compensation in corporations organized and operating under this chapter.

31A-7-312. Exclusive management and exclusive agency contracts. Section 31A-5-417 applies to exclusive management and exclusive agency contracts in corporations organized and operating under this chapter, except that in this chapter, Subsection 31A-5-417(2) does not preclude excl…

31A-7-313. Books and records. Section 16-6a-1602 applies to the books and records of corporations organized and operating under this chapter.

31A-7-401. Mergers and consolidations. Sections 31A-5-501 and 31A-5-503 apply to mergers and consolidations of corporations organized and operating under this chapter.

31A-7-402. Voluntary dissolution. Section 31A-5-504 applies to the voluntary dissolution of corporations organized and operating under this chapter.

31A-7-403. Conversion to a Title 31A, Chapter 5, mutual insurer. (1) An insurer organized and operating under this chapter may be converted into a mutual insurer under Chapter 5, Domestic Stock and Mutual Insurance Corporations, as provided in this section. (2)(a) The board shall…

31A-7-404. Transfer of business or assets. Section 31A-5-508 applies to the transfer of business or assets of corporations organized and operating under this chapter.

31A-7-501. Duties of officers, directors, agents, and employees. Section 31A-5-601 applies to the duties of officers, directors, agents, and employees of corporations organized and operating under this chapter.

31A-7-502. Doing business in other states. Section 31A-5-602 applies to corporations organized and operating under this chapter doing business in other states.

31A-8-101. Definitions. As used in this chapter: (1)(a) "Ambulance membership organization" means a person that offers an ambulance membership plan. (b) "Ambulance membership organization" does not include a person that offers ambulance services. (2) "Ambulance membership plan" m…

31A-8-102. Scope and purposes. (1) No person may operate an organization in this state without complying with and obtaining a certificate of authority under this chapter. (2) The purposes of this chapter include to: (a) provide for the establishment of health maintenance organiza…

31A-8-103. Applicability to other provisions of law. (1)(a) Except for exemptions specifically granted under this title, an organization is subject to regulation under all of the provisions of this title. (b) Notwithstanding any provision of this title, an organization licensed u…

31A-8-104. Determination of ability to provide services. (1) The commissioner may not issue a certificate of authority to an applicant for a certificate of authority under this chapter unless the applicant demonstrates to the commissioner that the applicant has: (a) the willingne…

31A-8-105. General powers of organizations. (1) Except as provided in Subsection (2), an organization may: (a) buy, sell, lease, encumber, construct, renovate, operate, or maintain hospitals, health care clinics, other health care facilities, and other real and personal property …

31A-8-105.5. Primary care physicians. With regard to participating providers who are physicians who are members of the American College of Obstetrics and Gynecology, organizations operating under this chapter shall: (1) permit a female enrollee to receive at least one outpatient …

31A-8-106. Other business. No organization may engage, directly or indirectly, in any business other than that of an organization and business reasonably incidental to that business.

31A-8-107. Documents as evidence. Section 31A-5-105 applies to documents as evidence in organizations.

31A-8-108. Unauthorized assumption of corporate power. Section 31A-5-106 applies to the unauthorized assumption of corporate power in organizations.

31A-8-201. Scope of part. This part applies to all organizations doing business in this state.

31A-8-202. Corporate name -- Office -- Registered agent. (1)(a) Sections 16-1a-304, 16-10a-403, and 42-2-201 apply to the reservation and registration of the corporate name in domestic health maintenance organizations. (b) Reservation and registration fees under Section 31A-3-103…

31A-8-203. Incorporators. One or more adult natural persons may organize and act as the incorporators of a domestic health maintenance organization under this part.

31A-8-204. Articles and bylaws. (1) The articles of a nonprofit organization shall conform to Subsections 16-6a-202(1)(a) through (e). The articles of other organizations shall conform to Section 16-10a-202. In addition: (a) the powers of the corporation shall be limited to those…

31A-8-205. Organization permit and certificate of incorporation. (1) Section 31A-5-204 applies to the formation of organizations, except that "Section 31A-5-211" in Subsection 31A-5-204(5) shall be read "Section 31A-8-209." (2) In addition to the requirements of Section 31A-5-204…

31A-8-206. Powers under organization permit -- Deposit of proceeds of subscriptions. Sections 31A-5-207 and 31A-5-208 apply to the powers of an organization under an organization permit and the deposit of proceeds of subscriptions, except that there are no qualifying insurance po…

31A-8-207. Termination of organization permit -- Payment of organization expenses. Section 31A-5-209, other than Subsection 31A-5-209(3)(c), applies to the termination of the organization permit and the payment of organization expenses of organizations, except that "Section 31A-5…

31A-8-208. Incorporators' liability and organization expenses. Section 31A-5-210 applies to incorporators' liability and organization expenses in organizations.

31A-8-209. Minimum capital or minimum permanent surplus. (1)(a) A health maintenance organization being organized or operating under this chapter shall have and maintain a minimum capital or minimum permanent surplus of $100,000. (b) Each health maintenance organization authorize…

31A-8-211. Deposit. (1) Except as provided in Subsection (2), each health maintenance organization authorized in this state shall maintain a deposit with the commissioner under Section 31A-2-206 in an amount equal to the sum of: (a) $100,000; and (b) 50% of the greater of: (i) $9…

31A-8-213. Certificate of authority. (1) An organization may apply for a certificate of authority at any time prior to the expiration of its organization permit. The application shall include: (a) a detailed statement by a principal officer about any material changes that have ta…

31A-8-214. Securities. Chapter 5, Part 3, Securities of Domestic Insurance Corporations, applies to securities of organizations, except that the amount "$150,000" in Subsection 31A-5-304(1) shall be read "one-half of the minimum capital required of the organization."

31A-8-215. Management. Chapter 5, Part 4, Management of Insurance Corporations, applies to organizations, except that for purposes of this chapter, Subsections 31A-5-412(3)(a)(vi) through (ix) shall be read: "corporate reorganizations under Section 31A-8-216."

31A-8-216. Corporate reorganizations. Sections 31A-5-501 through 31A-5-506 and Section 31A-5-508 apply to corporate reorganizations of organizations.

31A-8-217. Material transactions by insurers which are part of holding company system. (1) This section applies to an insurer licensed under this chapter that is part of a holding company system, for purposes of: (a) the reporting requirements of Section 31A-16-105; and (b) the m…

31A-8-301. Requirements for doing business in state. (1) Only a corporation incorporated and licensed under Part 2, Domestic Organizations, may do business in this state as an organization. (2)(a) To do business in this state as an organization, a foreign corporation doing a simi…

31A-8-303. Foreign ambulance membership organizations. A foreign ambulance membership organization limited health plan is exempt from: (1) Section 31A-8-204; (2) Section 31A-8-205; (3) Section 31A-8-206; (4) Section 31A-8-211; (5) Section 31A-8-214; (6) Section 31A-8-215; (7) Sec…

31A-8-401. Enrollee participation. Every organization shall provide a reasonable procedure, consistent with Section 31A-4-116, for allowing enrollees to participate in matters of policy of the organization and for resolving complaints and adverse benefit determinations initiated …

31A-8-403. Examination of organization and providers. Examinations of a health maintenance organization and its providers shall be conducted according to the provisions of Chapter 2, Administration of the Insurance Laws. Except during an audit of the internal quality control syst…

31A-8-404. Annual audit of internal quality control. (1) Each organization shall prepare an annual report of the effectiveness of the organization's internal quality control. (2) The annual report shall be: (a) in a form the commissioner approves; and (b) certified and signed by …

31A-8-405. Confidentiality of medical records and audits. Unless a court orders otherwise, the department shall treat the following records and information as confidential and prevent their disclosure to the public: (1) the medical records of enrollees of an organization; and (2)…

31A-8-406. Distribution by nonprofit organizations. A nonprofit organization may pay compensation in a reasonable amount to its members, trustees, or officers for services rendered, may make reasonable incentive payments to its providers, may confer benefits upon its members in c…

31A-8-407. Written contracts -- Limited liability of enrollee -- Provider claim disputes -- Leased networks. (1)(a) Every contract between an organization and a participating provider of health care services shall be in writing and shall set forth that if the organization: (i) fa…