(1) For purposes of this section:

Ask an insurance law question, get an answer ASAP!
Click here to chat with a lawyer about your rights.

Terms Used In Utah Code 31A-4-106.5

  • Contract: A legal written agreement that becomes binding when signed.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • Corporation: means an insurance corporation, except when referring to:
              (34)(a)(i) a corporation doing business:
                   (34)(a)(i)(A) as:
                        (34)(a)(i)(A)(I) an insurance producer;
                        (34)(a)(i)(A)(II) a surplus lines producer;
                        (34)(a)(i)(A)(III) a limited line producer;
                        (34)(a)(i)(A)(IV) a consultant;
                        (34)(a)(i)(A)(V) a managing general agent;
                        (34)(a)(i)(A)(VI) a reinsurance intermediary;
                        (34)(a)(i)(A)(VII) a third party administrator; or
                        (34)(a)(i)(A)(VIII) an adjuster; and
                   (34)(a)(i)(B) under:
                        (34)(a)(i)(B)(I) Chapter 23a, Insurance Marketing - Licensing Producers, Consultants, and Reinsurance Intermediaries;
                        (34)(a)(i)(B)(II) Chapter 25, Third Party Administrators; or
                        (34)(a)(i)(B)(III) Chapter 26, Insurance Adjusters; or
              (34)(a)(ii) a noninsurer that is part of a holding company system under Chapter 16, Insurance Holding Companies. 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
  • Health care provider: means the same as that term is defined in Section 78B-3-403. 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
  • 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
  • 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
  • Writing: includes :
         (48)(a) printing;
         (48)(b) handwriting; and
         (48)(c) information stored in an electronic or other medium if the information is retrievable in a perceivable format. See Utah Code 68-3-12.5
     (1)(a) “Medical retainer agreement” means a written contract:

          (1)(a)(i) between:

               (1)(a)(i)(A) except as provided in Subsection (1)(b)(iii)(B), a natural person or a professional corporation, alone or with others professionally associated with the natural person or professional corporation; and
               (1)(a)(i)(B) an individual patient or a patient’s representative; and
          (1)(a)(ii) in which:

               (1)(a)(ii)(A) the person described in Subsection (1)(a)(i)(A) agrees to provide routine health care services to the individual patient for an agreed upon fee and period of time; and
               (1)(a)(ii)(B) either party to the contract may terminate the agreement upon written notice to the other party.
     (1)(b) “Routine health care services” include:

          (1)(b)(i) screening, assessment, diagnosis, and treatment for the purpose of promotion of health, and detection and management of disease or injury;
          (1)(b)(ii) supplies and prescription drugs that are dispensed in a health care provider‘s office; and
          (1)(b)(iii) laboratory work, such as routine blood screening or routine pathology screening performed by a laboratory that:

               (1)(b)(iii)(A) is associated with the health care provider entering into the medical retainer agreement; or
               (1)(b)(iii)(B) if not associated with the health care provider, has entered into an agreement with the health care provider to provide the laboratory work without charging a fee to the patient for the laboratory work.
(2) A medical retainer agreement exempt from the provisions of Subsection 31A-4-106(2) shall:

     (2)(a) describe the specific routine health care services that are included in the contract;
     (2)(b) prominently state in writing that the retainer agreement is not health insurance; and
     (2)(c) prohibit the health care provider, but not the patient, from billing an insurer for the services provided under the medical retainer agreement.