In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, the commissioner:

(1) shall makes rules:

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Terms Used In Utah Code 31A-22-2006

  • 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
  • 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
  • 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
  • Outline of coverage: means a summary that explains an accident and health insurance policy. 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
  • 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
  • producer: means a person licensed or required to be licensed under the laws of this state to sell, solicit, or negotiate insurance. See Utah Code 31A-1-301
  • Rate: means :
              (163)(a)(i) the cost of a given unit of insurance; or
              (163)(a)(ii) for property or casualty insurance, that cost of insurance per exposure unit either expressed as:
                   (163)(a)(ii)(A) a single number; or
                   (163)(a)(ii)(B) a pure premium rate, adjusted before the application of individual risk variations based on loss or expense considerations to account for the treatment of:
                        (163)(a)(ii)(B)(I) expenses;
                        (163)(a)(ii)(B)(II) profit; and
                        (163)(a)(ii)(B)(III) individual insurer variation in loss experience. See Utah Code 31A-1-301
     (1)(a) in the event of a substantial rate increase, promoting premium adequacy and protecting the policy holder;
     (1)(b) establishing minimum standards for limited long-term care insurance marketing practices, producer compensation, producer testing, independent review of benefit determinations, penalties, and reporting practices;
     (1)(c) prescribing a standard format, including style, arrangement, and overall appearance of an outline of coverage;
     (1)(d) prescribing the content of an outline of coverage, in accordance with the requirements described in Subsection 31A-22-2004(5)(b);
     (1)(e) specifying the type of nonforfeiture benefits offered as part of a limited long-term care insurance policy or certificate;
     (1)(f) establishing the standards of nonforfeiture benefits; and
     (1)(g) establishing the rules regarding contingent benefits upon lapse, including:

          (1)(g)(i) a determination of the specified period of time during which a contingent benefit upon lapse will be available; and
          (1)(g)(ii) the substantial premium rate increase that triggers a contingent benefit upon lapse as described in Subsection 31A-22-2005(1); and
(2) may make rules establishing loss-ratio standards for limited long-term care insurance policies.