(1) Except as provided in Section 31A-22-618.6, for a group insurance policy offering accident and health insurance or a blanket insurance policy offering accident and health insurance, an insurer may:

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Terms Used In Utah Code 31A-22-727

  • 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
  • Endorsement: means a written agreement attached to a policy or certificate to modify the policy or certificate 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
  • 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
  • Policy: includes a service contract issued by:
              (150)(b)(i) a motor club under Chapter 11, Motor Clubs;
              (150)(b)(ii) a service contract provided under Chapter 6a, Service Contracts; and
              (150)(b)(iii) a corporation licensed under:
                   (150)(b)(iii)(A) Chapter 7, Nonprofit Health Service Insurance Corporations; or
                   (150)(b)(iii)(B) Chapter 8, Health Maintenance Organizations and Limited Health Plans. See Utah Code 31A-1-301
  • Policyholder: means a person who controls a policy, binder, or oral contract by ownership, premium payment, or otherwise. 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
  • Writing: includes :
         (48)(a) printing;
         (48)(b) handwriting; and
         (48)(c) information stored in an electronic or other medium if the information is retrievable in a perceivable format. See Utah Code 68-3-12.5
     (1)(a) decline to renew the policy on the date the policy term expires for a reason stated in the policy; or
     (1)(b) cancel the policy at any time for:

          (1)(b)(i) nonpayment of a premium when due;
          (1)(b)(ii) intentional misrepresentation of a material fact in connection with the coverage;
          (1)(b)(iii) performance of an act or practice that constitutes fraud in connection with the coverage; or
          (1)(b)(iv) noncompliance with an employer eligibility provision.
(2) Except for a modification required by law, an insurer may only modify a policy at renewal.
(3) Subsection (2) does not apply to an endorsement by which the insurer:

     (3)(a) effectuates a request the policyholder made in writing; or
     (3)(b) exercises a specifically reserved right under the policy.