Utah Code 31A-19a-306. Insurers and rate service organizations — Prohibited activity
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(1) An insurer or rate service organization may not:
Terms Used In Utah Code 31A-19a-306
- business of insurance: includes :(98)(a) providing health care insurance by an organization that is or is required to be licensed under this title;(98)(b) providing a benefit to an employee in the event of a contingency not within the control of the employee, in which the employee is entitled to the benefit as a right, which benefit may be provided either:(98)(b)(i) by a single employer or by multiple employer groups; or(98)(b)(ii) through one or more trusts, associations, or other entities;(98)(c) providing an annuity:(98)(c)(i) including an annuity issued in return for a gift; and(98)(c)(ii) except an annuity provided by a person specified in Subsections
31A-22-1305 (2) and (3);(98)(d) providing the characteristic services of a motor club;(98)(e) providing another person with insurance;(98)(f) making as insurer, guarantor, or surety, or proposing to make as insurer, guarantor, or surety, a contract or policy offering title insurance;(98)(g) transacting or proposing to transact any phase of title insurance, including:(98)(g)(i) solicitation;(98)(g)(ii) negotiation preliminary to execution;(98)(g)(iii) execution of a contract of title insurance;(98)(g)(iv) insuring; and(98)(g)(v) transacting matters subsequent to the execution of the contract and arising out of the contract, including reinsurance;(98)(h) transacting or proposing a life settlement; and(98)(i) doing, or proposing to do, any business in substance equivalent to Subsections (98)(a) through (h) in a manner designed to evade this title. See Utah Code 31A-1-301- classification: means the process of grouping risks with similar risk characteristics so that differences in anticipated costs may be recognized. See Utah Code 31A-19a-102
- Form: means one of the following prepared for general use:
(74)(a)(i) a policy;(74)(a)(ii) a certificate;(74)(a)(iii) an application;(74)(a)(iv) an outline of coverage; or(74)(a)(v) an endorsement. 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- Market: means the interaction between buyers and sellers consisting of a:
(8)(a)(i) product component; and(8)(a)(ii) geographic component. See Utah Code 31A-19a-102- 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- 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- Rate: means that cost of insurance per exposure unit either expressed as:
(12)(a)(i) a single number; or(12)(a)(ii) as a pure premium rate, adjusted before any application of individual risk variations, based on loss or expense considerations to account for the treatment of:(12)(a)(ii)(A) expenses;(12)(a)(ii)(B) profit; and(12)(a)(ii)(C) individual insurer variation in loss experience. See Utah Code 31A-19a-102- Rate service organization: means a person who assists an insurer in rate making or filing by:
(164)(a)(i) collecting, compiling, and furnishing loss or expense statistics;(164)(a)(ii) recommending, making, or filing rates or supplementary rate information; or(164)(a)(iii) advising about rate questions, except as an attorney giving legal advice. See Utah Code 31A-1-301- State: when applied to the different parts of the United States, includes a state, district, or territory of the United States. See Utah Code 68-3-12.5
(1)(a) attempt to monopolize, or combine or conspire with any other person to monopolize an insurance market; or(1)(b) engage in a boycott of an insurance market on a concerted basis.(2)(2)(a) Except as provided in Subsection (2)(c), an insurer may not agree with any other insurer or with a rate service organization to mandate adherence to or to mandate use of any:(2)(a)(i) rate;(2)(a)(ii) prospective loss cost;(2)(a)(iii) rating plan;(2)(a)(iv) rating schedule;(2)(a)(v) rating rule;(2)(a)(vi) policy or bond form;(2)(a)(vii) rate classification;(2)(a)(viii) rate territory;(2)(a)(ix) underwriting rule;(2)(a)(x) survey;(2)(a)(xi) inspection; or(2)(a)(xii) material similar to those described in Subsections (2)(a)(i) through (xi).(2)(b) The fact that two or more insurers, whether or not members or subscribers of a rate service organization, use consistently or intermittently the same materials described in Subsection (2)(a) is not sufficient in itself to support a finding that an agreement exists.(2)(c) An insurer may enter into an agreement prohibited by Subsection (2)(a):(2)(c)(i) to the extent needed to facilitate the reporting of statistics to:(2)(c)(i)(A) a rate service organization;(2)(c)(i)(B) a statistical agent; or(2)(c)(i)(C) the commissioner; or(2)(c)(ii) as provided in Part 4, Workers’ Compensation Rates.(3) Two or more insurers having a common ownership or operating in this state under common management or control may act in concert between or among themselves with respect to any matters pertaining to those activities authorized in this section as if they constituted a single insurer.(4) An insurer or rate service organization may not make any arrangement with any other insurer, rate service organization, or other person that has the purpose or effect of unreasonably restraining trade or unreasonably lessening competition in the business of insurance.