(1) A stop-loss insurer shall file the stop-loss insurance contract form and rate methodology with the commissioner pursuant to Sections 31A-2-201 and 31A-2-201.1 before the stop-loss insurance contract may be issued or delivered in the state.

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Terms Used In Utah Code 31A-43-302

  • Contract: A legal written agreement that becomes binding when signed.
  • Filing: when used as a noun, means an item required to be filed with the department including:
         (70)(a) a policy;
         (70)(b) a rate;
         (70)(c) a form;
         (70)(d) a document;
         (70)(e) a plan;
         (70)(f) a manual;
         (70)(g) an application;
         (70)(h) a report;
         (70)(i) a certificate;
         (70)(j) an endorsement;
         (70)(k) an actuarial certification;
         (70)(l) a licensee annual statement;
         (70)(m) a licensee renewal application;
         (70)(n) an advertisement;
         (70)(o) a binder; or
         (70)(p) an outline of coverage. See Utah Code 31A-1-301
  • Form: means one of the following prepared for general use:
              (74)(a)(i) a policy;
              (74)(a)(ii) a certificate;
              (74)(a)(iii) an application;
              (74)(a)(iv) an outline of coverage; or
              (74)(a)(v) an endorsement. 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
  • 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
  • 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) A stop-loss insurer shall file with the commissioner, annually on or before April 1, in a form and manner required by the commissioner by administrative rule adopted by the commissioner:

     (2)(a) an actuarial memorandum and certification which demonstrates that the insurer is in compliance with this chapter; and
     (2)(b) the stop-loss insurer’s stop-loss experience.
(3) An insurer shall maintain at its principal place of business:

     (3)(a) a complete and detailed description of its rating practices and renewal underwriting practices, including information and documentation that demonstrate the rating methods and practices are:

          (3)(a)(i) based upon commonly accepted actuarial assumptions; and
          (3)(a)(ii) in accordance with sound actuarial principles; and
     (3)(b) a copy of the annual filing required by Subsection (2).