As used in this part:

(1) “Adjusted RBC report” means an RBC report that has been adjusted by the commissioner in accordance with Subsection 31A-17-602(5).
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Terms Used In Utah Code 31A-17-601

  • 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
  • Disability: means a physiological or psychological condition that partially or totally limits an individual's ability to:
         (51)(a) perform the duties of:
              (51)(a)(i) that individual's occupation; or
              (51)(a)(ii) an occupation for which the individual is reasonably suited by education, training, or experience; or
         (51)(b) perform two or more of the following basic activities of daily living:
              (51)(b)(i) eating;
              (51)(b)(ii) toileting;
              (51)(b)(iii) transferring;
              (51)(b)(iv) bathing; or
              (51)(b)(v) dressing. See Utah Code 31A-1-301
  • Health organization: means :
         (3)(b) that is:
              (3)(b)(i) a health maintenance organization;
              (3)(b)(ii) a limited health service organization;
              (3)(b)(iii) a dental or vision plan;
              (3)(b)(iv) a hospital, medical, and dental indemnity or service corporation; or
              (3)(b)(v) other managed care organization. See Utah Code 31A-17-601
  • Indemnity: means the payment of an amount to offset all or part of an insured loss. 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 company: means a person doing an insurance business as a principal including:
              (104)(a)(i) a fraternal benefit society;
              (104)(a)(ii) an issuer of a gift annuity other than an annuity specified in Subsections 31A-22-1305(2) and (3);
              (104)(a)(iii) a motor club;
              (104)(a)(iv) an employee welfare plan;
              (104)(a)(v) a person purporting or intending to do an insurance business as a principal on that person's own account; and
              (104)(a)(vi) a health maintenance organization. See Utah Code 31A-1-301
  • Life insurance: means :
              (114)(a)(i) insurance on a human life; and
              (114)(a)(ii) insurance pertaining to or connected with human life. See Utah Code 31A-1-301
  • Managed care organization: means a person:
         (122)(a) licensed as a health maintenance organization under Chapter 8, Health Maintenance Organizations and Limited Health Plans; or
         (122)(b)
              (122)(b)(i) licensed under:
                   (122)(b)(i)(A) Chapter 5, Domestic Stock and Mutual Insurance Corporations;
                   (122)(b)(i)(B) Chapter 7, Nonprofit Health Service Insurance Corporations; or
                   (122)(b)(i)(C) Chapter 14, Foreign Insurers; and
              (122)(b)(ii) that requires an enrollee to use, or offers incentives, including financial incentives, for an enrollee to use, network providers. See Utah Code 31A-1-301
  • Mortgage: The written agreement pledging property to a creditor as collateral for a loan.
  • Order: means an order of the commissioner. See Utah Code 31A-1-301
  • Property: includes both real and personal property. See Utah Code 68-3-12.5
  • RBC: means risk-based capital. See Utah Code 31A-17-601
  • RBC instructions: means the RBC report including the National Association of Insurance Commissioner's risk-based capital instructions that govern the year for which an RBC report is prepared. See Utah Code 31A-17-601
  • RBC plan: means a comprehensive financial plan containing the elements specified in Subsection 31A-17-603(2). See Utah Code 31A-17-601
  • RBC report: means the report required in Section 31A-17-602. See Utah Code 31A-17-601
  • 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
(2) “Corrective order” means an order issued by the commissioner specifying corrective action that the commissioner determines is required.
(3) “Health organization” means:

     (3)(b) that is:

          (3)(b)(i) a health maintenance organization;
          (3)(b)(ii) a limited health service organization;
          (3)(b)(iii) a dental or vision plan;
          (3)(b)(iv) a hospital, medical, and dental indemnity or service corporation; or
          (3)(b)(v) other managed care organization.
(4) “Life or accident and health insurer” means:

     (4)(a) an insurance company licensed to write life insurance, accident and health insurance, or both; or
     (4)(b) a licensed property casualty insurer writing only disability insurance.
(5) “Property and casualty insurer” means any insurance company licensed to write lines of insurance other than life but does not include a monoline mortgage guaranty insurer, financial guaranty insurer, or title insurer.
(6) “RBC” means risk-based capital.
(7) “RBC instructions” means the RBC report including the National Association of Insurance Commissioner’s risk-based capital instructions that govern the year for which an RBC report is prepared.
(8) “RBC level” means an insurer’s or health organization‘s authorized control level RBC, company action level RBC, mandatory control level RBC, or regulatory action level RBC.

     (8)(a) “Authorized control level RBC” means the number determined under the risk-based capital formula in accordance with the RBC instructions;
     (8)(b) “Company action level RBC” means the product of 2.0 and its authorized control level RBC;
     (8)(c) “Mandatory control level RBC” means the product of .70 and the authorized control level RBC; and
     (8)(d) “Regulatory action level RBC” means the product of 1.5 and its authorized control level RBC.
(9)

     (9)(a) “RBC plan” means a comprehensive financial plan containing the elements specified in Subsection 31A-17-603(2).
     (9)(b) Notwithstanding Subsection (9)(a), the plan is a “revised RBC plan” if:

          (9)(b)(i) the commissioner rejects the RBC plan; and
          (9)(b)(ii) the plan is revised by the insurer or health organization, with or without the commissioner’s recommendation.
(10) “RBC report” means the report required in Section 31A-17-602.

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