Utah Code 31A-22-2006. Rulemaking
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In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, the commissioner:
(1) shall makes rules:
Terms Used In Utah Code 31A-22-2006
- Certificate: means evidence of insurance given to:(23)(a) an insured under a group insurance policy; or(23)(b) a third party. 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- Limited long-term care insurance: includes a policy or rider described in Subsection (4)(a) that provides for payment of benefits based on cognitive impairment or the loss of functional capacity. See Utah Code 31A-22-2002
- Long-term care insurance: includes :
(121)(b)(i) any of the following that provide directly or supplement long-term care insurance:(121)(b)(i)(A) a group or individual annuity or rider; or(121)(b)(i)(B) a life insurance policy or rider;(121)(b)(ii) a policy or rider that provides for payment of benefits on the basis of:(121)(b)(ii)(A) cognitive impairment; or(121)(b)(ii)(B) functional capacity; or(121)(b)(iii) a qualified long-term care insurance contract. See Utah Code 31A-1-301- Outline of coverage: means a summary that explains an accident and health insurance policy. 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- 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- producer: means a person licensed or required to be licensed under the laws of this state to sell, solicit, or negotiate insurance. See Utah Code 31A-1-301
- Rate: means :
(163)(a)(i) the cost of a given unit of insurance; or(163)(a)(ii) for property or casualty insurance, that cost of insurance per exposure unit either expressed as:(163)(a)(ii)(A) a single number; or(163)(a)(ii)(B) a pure premium rate, adjusted before the application of individual risk variations based on loss or expense considerations to account for the treatment of:(163)(a)(ii)(B)(I) expenses;(163)(a)(ii)(B)(II) profit; and(163)(a)(ii)(B)(III) individual insurer variation in loss experience. See Utah Code 31A-1-301(1)(a) in the event of a substantial rate increase, promoting premium adequacy and protecting the policy holder;(1)(b) establishing minimum standards for limited long-term care insurance marketing practices, producer compensation, producer testing, independent review of benefit determinations, penalties, and reporting practices;(1)(c) prescribing a standard format, including style, arrangement, and overall appearance of an outline of coverage;(1)(d) prescribing the content of an outline of coverage, in accordance with the requirements described in Subsection 31A-22-2004(5)(b);(1)(e) specifying the type of nonforfeiture benefits offered as part of a limited long-term care insurance policy or certificate;(1)(f) establishing the standards of nonforfeiture benefits; and(1)(g) establishing the rules regarding contingent benefits upon lapse, including:(1)(g)(i) a determination of the specified period of time during which a contingent benefit upon lapse will be available; and(1)(g)(ii) the substantial premium rate increase that triggers a contingent benefit upon lapse as described in Subsection 31A-22-2005(1); and(2) may make rules establishing loss-ratio standards for limited long-term care insurance policies. - Insurance: includes :