Terms Used In Utah Code 31A-22-618.5

• Emergency medical condition: means a medical condition that:
       (56)(a) manifests itself by acute symptoms, including severe pain; and
       (56)(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:

            (56)(b)(i) placing the layperson's health or the layperson's unborn child's health in serious jeopardy;

            (56)(b)(ii) serious impairment to bodily functions; or

            (56)(b)(iii) serious dysfunction of any bodily organ or part. See Utah Code 31A-1-301
• Health benefit plan: means a policy, contract, certificate, or agreement offered or issued by an insurer to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care, including major medical expense coverage. See Utah Code 31A-1-301
• Health care: means any of the following intended for use in the diagnosis, treatment, mitigation, or prevention of a human ailment or impairment:
       (83)(a) a professional service;
       (83)(b) a personal service;
       (83)(c) a facility;
       (83)(d) equipment;
       (83)(e) a device;
       (83)(f) supplies; or
       (83)(g) medicine. See Utah Code 31A-1-301
• Indemnity: means the payment of an amount to offset all or part of an insured loss. 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
• Insured: means a person to whom or for whose benefit an insurer makes a promise in an insurance policy and includes:
            (103)(a)(i) a policyholder;
            (103)(a)(ii) a subscriber;
            (103)(a)(iii) a member; and
            (103)(a)(iv) a beneficiary. See Utah Code 31A-1-301
• 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