Terms Used In Utah Code > Title 17 > Chapter 18a > Part 8 - Ethical Responsibilities

• Accident and health insurance: means insurance to provide protection against economic losses resulting from:
            (1)(a)(i) a medical condition including:

                 (1)(a)(i)(A) a medical care expense; or

                 (1)(a)(i)(B) the risk of disability;
            (1)(a)(ii) accident; or
            (1)(a)(iii) sickness. See Utah Code 31A-1-301
• Agency: means :
       (6)(a) a person other than an individual, including a sole proprietorship by which an individual does business under an assumed name; and
       (6)(b) an insurance organization licensed or required to be licensed under Section 31A-23a-301, 31A-25-207, or 31A-26-209. See Utah Code 31A-1-301
• Application: means a document:
       (10)(a)

            (10)(a)(i) completed by an applicant to provide information about the risk to be insured; and

            (10)(a)(ii) that contains information that is used by the insurer to evaluate risk and decide whether to:

                 (10)(a)(ii)(A) insure the risk under:

                      (10)(a)(ii)(A)(I) the coverage as originally offered; or

                      (10)(a)(ii)(A)(II) a modification of the coverage as originally offered; or

                 (10)(a)(ii)(B) decline to insure the risk; or
       (10)(b) used by the insurer to gather information from the applicant before issuance of an annuity contract. See Utah Code 31A-1-301
• Appropriation: The provision of funds, through an annual appropriations act or a permanent law, for federal agencies to make payments out of the Treasury for specified purposes. The formal federal spending process consists of two sequential steps: authorization
• business of insurance: includes :
       (98)(a) providing health care insurance by an organization that is or is required to be licensed under this title;
       (98)(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:

            (98)(b)(i) by a single employer or by multiple employer groups; or

            (98)(b)(ii) through one or more trusts, associations, or other entities;
       (98)(c) providing an annuity:

            (98)(c)(i) including an annuity issued in return for a gift; and

            (98)(c)(ii) except an annuity provided by a person specified in Subsections 31A-22-1305(2) and (3);
       (98)(d) providing the characteristic services of a motor club;
       (98)(e) providing another person with insurance;
       (98)(f) making as insurer, guarantor, or surety, or proposing to make as insurer, guarantor, or surety, a contract or policy offering title insurance;
       (98)(g) transacting or proposing to transact any phase of title insurance, including:

            (98)(g)(i) solicitation;

            (98)(g)(ii) negotiation preliminary to execution;

            (98)(g)(iii) execution of a contract of title insurance;

            (98)(g)(iv) insuring; and

            (98)(g)(v) transacting matters subsequent to the execution of the contract and arising out of the contract, including reinsurance;
       (98)(h) transacting or proposing a life settlement; and
       (98)(i) doing, or proposing to do, any business in substance equivalent to Subsections (98)(a) through (h) in a manner designed to evade this title. See Utah Code 31A-1-301
• center: means the Center for International Business and Diplomacy created in Section 63N-19-103. See Utah Code 63N-19-101
• Contract: A legal written agreement that becomes binding when signed.
• Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
• Department: means the Insurance Department. See Utah Code 31A-1-301
• Director: means a member of the board of directors of a corporation. See Utah Code 31A-1-301
• Disability: means a physiological or psychological condition that partially or totally limits an individual's ability to:
       (51)(a) perform the duties of:

            (51)(a)(i) that individual's occupation; or

            (51)(a)(ii) an occupation for which the individual is reasonably suited by education, training, or experience; or
       (51)(b) perform two or more of the following basic activities of daily living:

            (51)(b)(i) eating;

            (51)(b)(ii) toileting;

            (51)(b)(iii) transferring;

            (51)(b)(iv) bathing; or

            (51)(b)(v) dressing. See Utah Code 31A-1-301
• Employee: means :
       (57)(a) an individual employed by an employer; or
       (57)(b) an individual who meets the requirements of Subsection (55)(b). See Utah Code 31A-1-301
• Executive: when used to describe the powers, duties, or functions of a person or body elected as the county executive or a person appointed as the county manager or administrative officer, refers to:
       (2)(a) the power and duty to carry laws and ordinances into effect and secure their due observance; and
       (2)(b) those powers, duties, and functions that, under constitutional and statutory provisions and through long usage and accepted practice and custom at the federal and state level, have come to be regarded as belonging to the executive branch of government. See Utah Code 17-50-101
• Filing: when used as a noun, means an item required to be filed with the department including:
       (70)(a) a policy;
       (70)(b) a rate;
       (70)(c) a form;
       (70)(d) a document;
       (70)(e) a plan;
       (70)(f) a manual;
       (70)(g) an application;
       (70)(h) a report;
       (70)(i) a certificate;
       (70)(j) an endorsement;
       (70)(k) an actuarial certification;
       (70)(l) a licensee annual statement;
       (70)(m) a licensee renewal application;
       (70)(n) an advertisement;
       (70)(o) a binder; or
       (70)(p) an outline of coverage. See Utah Code 31A-1-301
• Fraud: Intentional deception resulting in injury to another.
• health insurance: means insurance providing:
            (84)(a)(i) a health care benefit; or
            (84)(a)(ii) payment of an incurred health care expense. See Utah Code 31A-1-301
• Individual: means a natural person. See Utah Code 31A-1-301
• Injunction: An order of the court prohibiting (or compelling) the performance of a specific act to prevent irreparable damage or injury.
• insolvent: means that:
       (95)(a) an insurer is unable to pay the insurer's obligations as the obligations are due;
       (95)(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
       (95)(c) an insurer's admitted assets are less than the insurer's liabilities. See Utah Code 31A-1-301
• Insurance: includes :
            (96)(b)(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;
            (96)(b)(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
            (96)(b)(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. See Utah Code 31A-1-301
• Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
• License: includes a certificate of authority issued to an insurer. See Utah Code 31A-1-301
• Litigation: A case, controversy, or lawsuit. Participants (plaintiffs and defendants) in lawsuits are called litigants.
• Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
• Order: means an order of the commissioner. See Utah Code 31A-1-301
• Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
• Person: includes :
       (146)(a) an individual;
       (146)(b) a partnership;
       (146)(c) a corporation;
       (146)(d) an incorporated or unincorporated association;
       (146)(e) a joint stock company;
       (146)(f) a trust;
       (146)(g) a limited liability company;
       (146)(h) a reciprocal;
       (146)(i) a syndicate; or
       (146)(j) another similar entity or combination of entities acting in concert. See Utah Code 31A-1-301
• Plea: In a criminal case, the defendant's statement pleading "guilty" or "not guilty" in answer to the charges, a declaration made in open court.
• Policyholder: means a person who controls a policy, binder, or oral contract by ownership, premium payment, or otherwise. See Utah Code 31A-1-301
• PPACA: means the Patient Protection and Affordable Care Act, Pub. See Utah Code 31A-1-301
• Premium: includes , however designated:
            (156)(b)(i) an assessment;
            (156)(b)(ii) a membership fee;
            (156)(b)(iii) a required contribution; or
            (156)(b)(iv) monetary consideration. See Utah Code 31A-1-301
• Probation: A sentencing alternative to imprisonment in which the court releases convicted defendants under supervision as long as certain conditions are observed.
• Proceeding: includes an action or special statutory proceeding. See Utah Code 31A-1-301
• Process: means a writ or summons issued in the course of a judicial proceeding. See Utah Code 68-3-12.5
• Property: includes both real and personal property. See Utah Code 68-3-12.5
• Public programs: means the state Medicaid program in Title 26B, Chapter 3, Health Care - Administration and Assistance, and Title 26B, Chapter 3, Part 9, Utah Children's Health Insurance Program. See Utah Code 31A-23b-102
• Resident: is a s defined by rule made by the commissioner in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act. See Utah Code 31A-23b-102
• 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:
            (182)(a)(i)

                 (182)(a)(i)(A) employed at least one but not more than 50 eligible employees on business days during the preceding calendar year; or

                 (182)(a)(i)(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;
            (182)(a)(ii) employs at least one employee on the first day of the plan year; and
            (182)(a)(iii) for an employer who has common ownership with one or more other employers, is treated as a single employer under Utah Code 31A-1-301
• State: when applied to the different parts of the United States, includes a state, district, or territory of the United States. See Utah Code 68-3-12.5
• Statute: A law passed by a legislature.
• Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.
• United States: includes each state, district, and territory of the United States of America. See Utah Code 68-3-12.5