Utah Code 31A-22-2002. Definitions
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As used in this part:
(1) “Applicant” means:
Terms Used In Utah Code 31A-22-2002
- 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
- Contract: A legal written agreement that becomes binding when signed.
- 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- Endorsement: means a written agreement attached to a policy or certificate to modify the policy or certificate coverage. See Utah Code 31A-1-301
- Health care: means any of the following intended for use in the diagnosis, treatment, mitigation, or prevention of a human ailment or impairment:
(83)(a) a professional service;(83)(b) a personal service;(83)(c) a facility;(83)(d) equipment;(83)(e) a device;(83)(f) supplies; or(83)(g) medicine. See Utah Code 31A-1-301- Indemnity: means the payment of an amount to offset all or part of an insured loss. See Utah Code 31A-1-301
- Individual: means a natural person. 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- 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- 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- Medicare: means the "Health Insurance for the Aged Act" Title XVIII of the federal Social Security Act, as then constituted or later amended. See Utah Code 31A-1-301
- 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- Rider: means an endorsement to:
(173)(a) an insurance policy; or(173)(b) an insurance certificate. 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) when referring to an individual limited long-term care insurance policy, the person who seeks to contract for benefits; and(1)(b) when referring to a group limited long-term care insurance policy, the proposed certificate holder.(2) “Elimination period” means the length of time between meeting the eligibility for benefit payment and receiving benefit payments from an insurer.(3) “Group limited long-term care insurance” means a limited long-term care insurance policy that is delivered or issued for delivery:(3)(a) in this state; and(3)(b) to an eligible group, as described under Subsection31A-22-701 (1).(4)(4)(a) “Limited long-term care insurance” means an insurance policy, endorsement, or rider that is advertised, marketed, offered, or designed to provide coverage:(4)(a)(i) for less than 12 consecutive months for each covered person;(4)(a)(ii) on an expense-incurred, indemnity, prepaid or other basis; and(4)(a)(iii) for one or more necessary or medically necessary diagnostic, preventative, therapeutic, rehabilitative, maintenance, or personal care services that is provided in a setting other than an acute care unit of a hospital.(4)(b) “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.(4)(c) “Limited long-term care insurance” does not include an insurance policy that is offered primarily to provide:(4)(c)(i) basic Medicare supplement insurance coverage;(4)(c)(ii) basic hospital expense coverage;(4)(c)(iii) basic medical-surgical expense coverage;(4)(c)(iv) hospital confinement indemnity coverage;(4)(c)(v) major medical expense coverage;(4)(c)(vi) disability income or related asset-protection coverage;(4)(c)(vii) accidental only coverage;(4)(c)(viii) specified disease or specified accident coverage; or(4)(c)(ix) limited benefit health coverage.(5) “Preexisting condition” means a condition for which medical advice or treatment is recommended:(5)(a) by, or received from, a provider of health care services; and(5)(b) within six months before the day on which the coverage of an insured person becomes effective.(6) “Waiting period” means the time an insured waits before some or all of the insured’s coverage becomes effective.