§ 31A-23b-301 Unfair practices — Compensation — Limit of scope of practice

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Terms Used In Utah Code > Title 31A > Chapter 23b > Part 3 - Unlawful Conduct and Limitation of Scope of Practice

  • 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
  • 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
  • Department: means the Insurance Department. 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
  • 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
  • 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
  • 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
  • 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.
  • 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
  • PPACA: means the Patient Protection and Affordable Care Act, Pub. See Utah Code 31A-1-301
  • 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
  • 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