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Terms Used In Utah Code 31A-16-106

  • Affiliate: means a person who controls, is controlled by, or is under common control with, another person. 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
  • Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
  • board of directors: means the group of persons with responsibility over, or management of, a corporation, however designated. See Utah Code 31A-1-301
  • Business entity: means :
         (17)(a) a corporation;
         (17)(b) an association;
         (17)(c) a partnership;
         (17)(d) a limited liability company;
         (17)(e) a limited liability partnership; or
         (17)(f) another legal entity. See Utah Code 31A-1-301
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • Corporation: means an insurance corporation, except when referring to:
              (34)(a)(i) a corporation doing business:
                   (34)(a)(i)(A) as:
                        (34)(a)(i)(A)(I) an insurance producer;
                        (34)(a)(i)(A)(II) a surplus lines producer;
                        (34)(a)(i)(A)(III) a limited line producer;
                        (34)(a)(i)(A)(IV) a consultant;
                        (34)(a)(i)(A)(V) a managing general agent;
                        (34)(a)(i)(A)(VI) a reinsurance intermediary;
                        (34)(a)(i)(A)(VII) a third party administrator; or
                        (34)(a)(i)(A)(VIII) an adjuster; and
                   (34)(a)(i)(B) under:
                        (34)(a)(i)(B)(I) Chapter 23a, Insurance Marketing - Licensing Producers, Consultants, and Reinsurance Intermediaries;
                        (34)(a)(i)(B)(II) Chapter 25, Third Party Administrators; or
                        (34)(a)(i)(B)(III) Chapter 26, Insurance Adjusters; or
              (34)(a)(ii) a noninsurer that is part of a holding company system under Chapter 16, Insurance Holding Companies. See Utah Code 31A-1-301
  • Crop insurance: includes multiperil crop insurance. See Utah Code 31A-1-301
  • Domestic insurer: means an insurer organized under the laws of this state. See Utah Code 31A-1-301
  • Equal: means , with respect to biological sex, of the same value. See Utah Code 68-3-12.5
  • Fair market value: The price at which an asset would change hands in a transaction between a willing, informed buyer and a willing, informed seller.
  • Filed: means that a filing is:
              (69)(a)(i) submitted to the department as required by and in accordance with applicable statute, rule, or filing order;
              (69)(a)(ii) received by the department within the time period provided in applicable statute, rule, or filing order; and
              (69)(a)(iii) accompanied by the appropriate fee in accordance with:
                   (69)(a)(iii)(A) Section 31A-3-103; or
                   (69)(a)(iii)(B) rule. 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
  • 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
  • Insurance holding company system: means a group of two or more affiliated persons, at least one of whom is an insurer. 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
  • Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
  • Member: means a person having membership rights in an insurance corporation. See Utah Code 31A-1-301
  • Month: means a calendar month, unless otherwise expressed. See Utah Code 68-3-12.5
  • Mutual: means a mutual insurance corporation. 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
  • 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
  • Proceeding: includes an action or special statutory proceeding. See Utah Code 31A-1-301
  • Property: includes both real and personal property. See Utah Code 68-3-12.5
  • Quorum: The number of legislators that must be present to do business.
  • Reinsurance: means an insurance transaction where an insurer, for consideration, transfers any portion of the risk it has assumed to another insurer. See Utah Code 31A-1-301
  • Reinsurer: means a person licensed in this state as an insurer with the authority to assume reinsurance. See Utah Code 31A-1-301
  • Right of offset: Banks' legal right to seize funds that a guarantor or debtor may have on deposit to cover a loan in default. It is also known as the right of set-off. Source: OCC
  • Surplus: means the excess of assets over the sum of paid-in capital and liabilities. See Utah Code 31A-1-301
  • under common control: means the direct or indirect possession of the power to direct or cause the direction of the management and policies of a person. 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) Transactions within an insurance holding company system to which an insurer subject to registration is a party are subject to the following standards:

          (1)(a)(i) the terms shall be fair and reasonable;
          (1)(a)(ii) agreements for cost sharing services and management shall include the provisions required by rule made by the commissioner in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act;
          (1)(a)(iii) charges or fees for services performed shall be reasonable;
          (1)(a)(iv) expenses incurred and payment received shall be allocated to the insurer in conformity with customary insurance accounting practices consistently applied;
          (1)(a)(v) the books, accounts, and records of each party to all transactions shall be so maintained as to clearly and accurately disclose the nature and details of the transactions, including the accounting information necessary to support the reasonableness of the charges or fees to the respective parties;
          (1)(a)(vi) the insurer’s surplus held for policyholders, following any dividends or distributions to shareholder affiliates, shall be reasonable in relation to the insurer’s outstanding liabilities and shall be adequate to its financial needs;
          (1)(a)(vii) the commissioner may require the insurer to secure and maintain a deposit held by the commissioner or a bond, as determined by the insurer at the insurer’s discretion, in an amount determined by the commissioner not to exceed the value of the agreement in any one year, if the commissioner:

               (1)(a)(vii)(A) determines that the insurer is in a hazardous financial condition under Title 31A, Chapter 27a, Insurer Receivership Act, or a condition that would warrant a delinquency proceeding under Title 31A, Chapter 27a, Insurer Receivership Act; and
               (1)(a)(vii)(B) believes that the insurers’ affiliate may be unable to fulfill an agreement with the insurer if the insurer were put into liquidation;
          (1)(a)(viii) all insurer records and data held by an affiliate:

               (1)(a)(viii)(A) are the insurer’s property;
               (1)(a)(viii)(B) are subject to the insurer’s control;
               (1)(a)(viii)(C) are identifiable;
               (1)(a)(viii)(D) are segregated or readily capable of segregation, at no additional cost to the insurer, from all other records and data;
               (1)(a)(viii)(E) shall be provided to a receiver, at the insurer’s request, including any information, software, licensing agreement, release, waiver, or any other thing required to access the records and data; and
               (1)(a)(viii)(F) may be restricted in use by the affiliate if the affiliate is not operating the insurer’s business; and
          (1)(a)(ix)

               (1)(a)(ix)(A) all funds belonging to the insurer that an affiliate collects or holds are the exclusive property of the insurer and subject to the control of the insurer; and
               (1)(a)(ix)(B) if the insurer is placed into receivership, any right of offset against the funds is subject to Title 31A, Chapter 27a, Insurance Receivership Act.
     (1)(b) The following transactions involving a domestic insurer and any person in its insurance holding company system, including amendments or modifications of affiliate agreements previously filed pursuant to this section, which are subject to any materiality standards contained in Subsections (1)(a)(i) through (vi), may not be entered into unless the insurer has notified the commissioner in writing of its intention to enter into the transaction at least 30 days before entering into the transaction, or within any shorter period the commissioner may permit, if the commissioner has not disapproved the transaction within the period. The notice for an amendment or modification shall include the reasons for the change and financial impact on the domestic insurer. Informal notice shall be reported, within 30 days after a termination of a previously filed agreement, to the commissioner for determination of the type of filing required, if any:

          (1)(b)(i) sales, purchases, exchanges, loans or extensions of credit, guarantees, or investments if the transactions are equal to, or exceed as of the next preceding December 31:

               (1)(b)(i)(A) for nonlife insurers, the lesser of 3% of the insurer’s admitted assets or 25% of surplus held for policyholders;
               (1)(b)(i)(B) for life insurers, 3% of the insurer’s admitted assets;
          (1)(b)(ii) loans or extensions of credit made to any person who is not an affiliate, if the insurer makes the loans or extensions of credit with the agreement or understanding that the proceeds of the transactions, in whole or in substantial part, are to be used to make loans or extensions of credit to, to purchase assets of, or to make investments in, any affiliate of the insurer making the loans or extensions of credit if the transactions are equal to, or exceed as of the next preceding December 31:

               (1)(b)(ii)(A) for nonlife insurers, the lesser of 3% of the insurer’s admitted assets or 25% of surplus held for policyholders;
               (1)(b)(ii)(B) for life insurers, 3% of the insurer’s admitted assets;
          (1)(b)(iii) reinsurance agreements or modifications to reinsurance agreements, including an agreement in which the reinsurance premium, a change in the insurer’s liabilities, or the projected reinsurance premium or a change in the insurer’s liabilities in any of the current and succeeding three years, equals or exceeds 5% of the insurer’s surplus held for policyholders, as of the next preceding December 31, including those agreements that may require as consideration the transfer of assets from an insurer to a non-affiliate, if an agreement or understanding exists between the insurer and the non-affiliate that any portion of the assets will be transferred to one or more affiliates of the reinsurer;
          (1)(b)(iv) all management agreements, service contracts, tax allocation agreements, and all cost-sharing arrangements;
          (1)(b)(v) guarantees when made by a domestic insurer, except that:

               (1)(b)(v)(A) a guarantee that is quantifiable as to amount is not subject to the notice requirements of this Subsection (1) unless it exceeds the lesser of .5% of the insurer’s admitted assets or 10% of surplus held for policyholders, as of the next preceding December 31; and
               (1)(b)(v)(B) a guarantee that is not quantifiable as to amount is subject to the notice requirements of this Subsection (1);
          (1)(b)(vi) direct or indirect acquisitions or investments in a person that controls the insurer or in an affiliate of the insurer in an amount that, together with its present holdings in the investments, exceeds 2.5% of the insurer’s surplus to policyholders, except that a direct or indirect acquisition or investment in a subsidiary acquired pursuant to Section 31A-16-102.5, or in a non-subsidiary insurance affiliate that is subject to this chapter, is exempt from this Subsection (1)(b)(vi);
          (1)(b)(vii) any material transactions, specified by rule, which the commissioner determines may adversely affect the interests of the insurer’s policyholders; and
          (1)(b)(viii) this Subsection (1) may not be interpreted to authorize or permit any transactions which would be otherwise contrary to law in the case of an insurer not a member of the same holding company system.
     (1)(c) A domestic insurer may not enter into transactions which are part of a plan or series of like transactions with persons within the holding company system if the purpose of the separate transactions is to avoid the statutory threshold amount and thus to avoid the review by the commissioner that would occur otherwise. If the commissioner determines that the separate transactions were entered into over any 12 month period for such a purpose, the commissioner may exercise the commissioner’s authority under Section 31A-16-110.
     (1)(d) The commissioner, in reviewing transactions pursuant to Subsection (1)(b), shall consider whether the transactions comply with the standards set forth in Subsection (1)(a) and whether they may adversely affect the interests of policyholders.
     (1)(e) The commissioner shall be notified within 30 days of any investment of the domestic insurer in any one corporation, if the total investment in the corporation by the insurance holding company system exceeds 10% of the corporation’s voting securities.
(2)

     (2)(a) A domestic insurer may not pay any extraordinary dividend or make any other extraordinary distribution to its shareholders until:

          (2)(a)(i) 30 days after the commissioner has received notice of the declaration of the dividend and has not within the 30-day period disapproved the payment; or
          (2)(a)(ii) the commissioner has approved the payment within the 30-day period.
     (2)(b) For purposes of this Subsection (2), an extraordinary dividend or distribution includes any dividend or distribution of cash or other property, fair market value of which, together with that of other dividends or distributions made within the preceding 12 months, exceeds the lesser of:

          (2)(b)(i) 10% of the insurer’s surplus held for policyholders as of the next preceding December 31;
          (2)(b)(ii) the net gain from operations of the insurer, if the insurer is a life insurer, or the net income, if the insurer is not a life insurer, not including realized capital gains, for the 12-month period ending the next preceding December 31; or
          (2)(b)(iii) an extraordinary dividend does not include pro rata distributions of any class of the insurer’s own securities.
     (2)(c) In determining whether a dividend or distribution is extraordinary, an insurer other than a life insurer may carry forward net income from the previous two calendar years that has not already been paid out as dividends. This carry-forward shall be computed by taking the net income from the second and third preceding calendar years, not including realized capital gains, less dividends paid in the second and immediate preceding calendar years.
     (2)(d) Notwithstanding any other provision of law, an insurer may declare an extraordinary dividend or distribution, which is conditioned upon the commissioner’s approval of the dividend or distribution, and the declaration shall confer no rights upon shareholders until:

          (2)(d)(i) the commissioner has approved the payment of the dividend or distribution; or
          (2)(d)(ii) the commissioner has not disapproved the payment within the 30-day period referred to in Subsection (2)(a).
(3)

     (3)(a) Notwithstanding the control of a domestic insurer by any person, the officers and directors of the insurer may not be relieved of any obligation or liability to which they would otherwise be subject by law, and the insurer shall be managed so as to assure its separate operating identity consistent with this chapter.
     (3)(b) Nothing in this section precludes a domestic insurer from having or sharing a common management or cooperative or joint use of personnel, property, or services with one or more other persons under arrangements meeting the standards of Subsection (1)(a).
     (3)(c)

          (3)(c)(i) Not less than one-third of the directors of a domestic insurer, and not less than one-third of the members of each committee of the board of directors of a domestic insurer, shall be persons who are not officers or employees of the insurer or of any entity controlling, controlled by, or under common control with the insurer and who are not beneficial owners of a controlling interest in the voting stock of the insurer or entity.
          (3)(c)(ii) At least one person described in Subsection (3)(c)(i) shall be included in a quorum for the transaction of business at a meeting of the board of directors or a committee of the board of directors.
     (3)(d) Subsection (3)(c) does not apply to a domestic insurer if the person controlling the insurer, such as an insurer, a mutual insurance holding company, or a publicly held corporation, has a board of directors and committees of the board of directors that meet the requirements of Subsection (3)(c) with respect to the controlling entity.
     (3)(e) An insurer may make application to the commissioner for a waiver from the requirements of this Subsection (3) if the insurer’s annual direct written and assumed premium, excluding premiums reinsured with the Federal Crop Insurance Corporation and Federal Flood Program, is less than $300,000,000. An insurer may also make application to the commissioner for a waiver from the requirements of this Subsection (3) based upon unique circumstances. The commissioner may consider various factors, including:

          (3)(e)(i) the type of business entity;
          (3)(e)(ii) the volume of business written;
          (3)(e)(iii) the availability of qualified board members; or
          (3)(e)(iv) the ownership or organizational structure of the entity.
(4)

     (4)(a) For purposes of this chapter, in determining whether an insurer’s surplus as regards policyholders is reasonable in relation to the insurer’s outstanding liabilities and adequate to meet its financial needs, the following factors, among others, shall be considered:

          (4)(a)(i) the size of the insurer as measured by its assets, capital and surplus, reserves, premium writings, insurance in force, and other appropriate criteria;
          (4)(a)(ii) the extent to which the insurer’s business is diversified among several lines of insurance;
          (4)(a)(iii) the number and size of risks insured in each line of business;
          (4)(a)(iv) the extent of the geographical dispersion of the insurer’s insured risks;
          (4)(a)(v) the nature and extent of the insurer’s reinsurance program;
          (4)(a)(vi) the quality, diversification, and liquidity of the insurer’s investment portfolio;
          (4)(a)(vii) the recent past and projected future trend in the size of the insurer’s investment portfolio;
          (4)(a)(viii) the surplus as regards policyholders maintained by other comparable insurers;
          (4)(a)(ix) the adequacy of the insurer’s reserves; and
          (4)(a)(x) the quality and liquidity of investments in affiliates.
     (4)(b) The commissioner may treat an investment described in Subsection (4)(a)(x) as a disallowed asset for purposes of determining the adequacy of surplus as regards policyholders whenever in the judgment of the commissioner the investment so warrants.
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