Utah Code 31A-22-633. Exemptions from standards
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Notwithstanding the provisions of this title, any accident and health insurer or health maintenance organization may offer a choice of coverage that is less or different than is otherwise required by applicable state law if:
(1) the Department of Health and Human Services offers a choice of coverage as part of a Medicaid waiver under Title 26B, Chapter 3, Health Care – Administration and Assistance, which includes:
Terms Used In Utah Code 31A-22-633
- Contract: A legal written agreement that becomes binding when signed.
- Department: means the Insurance Department. 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
- 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- 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- 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) less or different coverage than the basic coverage;(1)(b) less or different coverage than is otherwise required in an insurance policy or health maintenance organization contract under applicable state law; or(1)(c) less or different coverage than required by Subsection 31A-22-605(4)(b); and(2) the choice of coverage offered by the carrier:(2)(a) is the same or similar coverage as the coverage offered by the Department of Health and Human Services under Subsection (1);(2)(b) is offered to the same or similar population as the coverage offered by the Department of Health and Human Services under Subsection (1); and(2)(c) contains an explanation for each insured of coverage exclusions and limitations. - Insurance: includes :