(1) The commissioner shall establishan Office of Consumer Health Assistance before July 1, 1999.

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Terms Used In Utah Code 31A-2-216

  • 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 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
  • Proceeding: includes an action or special statutory proceeding. 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
(2) The office shall:

     (2)(a) be a resource for health insurance consumers concerning health insurance coverage or the need for such coverage;
     (2)(b) help health insurance consumers understand:

          (2)(b)(i) contractual rights and responsibilities;
          (2)(b)(ii) statutory protections; and
          (2)(b)(iii) available remedies, including adverse benefit determination processes;
     (2)(c) educate health insurance consumers:

          (2)(c)(i) by producing or collecting and disseminating educational materials to consumersand health insurers; and
          (2)(c)(ii) through outreach and other educational activities;
     (2)(d) for health insurance consumers that have difficulty in accessing their health insurance policies because of language, disability, age, or ethnicity, provide information and services, directly or through referral;
     (2)(e) analyze and monitor federal and state consumer health insurance statutes, rules, and regulations; and
     (2)(f) summarize information gathered under this section and make the summaries available to the public, government agencies, and the Legislature.
(3) The office may:

     (3)(a) obtain data from health insurance consumers as necessary to further the office’s duties under this section;
     (3)(b) investigate complaints and attempt to resolve complaints at the lowest possible level; and
     (3)(c) assist, but not testify or represent, a consumer in an adverse benefit determination, arbitration, judicial, or related proceeding, unless the proceeding is in connection with an enforcement action under Section 31A-2-308.
(4) The commissioner may adopt rules necessary to implement the requirements of this section.