Utah Code 31A-8a-202.5. Reporting of administrative actions and criminal prosecution
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(1) A health discount program operator or health discount program marketer shall report to the commissioner any administrative action or criminal prosecution brought against the health discount program operator, health discount program marketer, or an owner, officer, or principal of the health discount program operator or health discount program marketer, other than an administrative action brought by the department.
Terms Used In Utah Code 31A-8a-202.5
- Application: means a document:(10)(a)(10)(a)(i) completed by an applicant to provide information about the risk to be insured; and(10)(a)(ii) that contains information that is used by the insurer to evaluate risk and decide whether to:(10)(a)(ii)(A) insure the risk under:(10)(a)(ii)(A)(I) the coverage as originally offered; or(10)(a)(ii)(A)(II) a modification of the coverage as originally offered; or(10)(a)(ii)(B) decline to insure the risk; or(10)(b) used by the insurer to gather information from the applicant before issuance of an annuity contract. See Utah Code 31A-1-301
- Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
- Department: means the Insurance Department. See Utah Code 31A-1-301
- Health discount program: means a business arrangement or contract in which a person pays fees, dues, charges, or other consideration in exchange for a program that provides access to health care providers who agree to provide a discount for health care services. See Utah Code 31A-8a-102
- Health discount program marketer: means a person, including a private label entity, that markets, promotes, sells, or distributes a health discount program but does not operate a health discount program. See Utah Code 31A-8a-102
- Health discount program operator: means a person that provides a health discount program by entering into a contract or agreement, directly or indirectly, with a person or persons in this state who agree to provide discounts for health care services to enrollees of the health discount program and determines the charge to members. See Utah Code 31A-8a-102
(2) The health discount program operator or health discount program marketer shall file the report described in Subsection (1):(2)(a) at the time the health discount program operator or health discount program marketer files an application for licensure or renewal; and(2)(b)(2)(b)(i) for an administrative action that occurs on or after the day on which the health discount program operator or health discount program marketer files an application for licensure or renewal, within 30 days after the day on which the final disposition of the administrative action is issued; or(2)(b)(ii) for a criminal prosecution, within 30 days after the health discount program operator’s or health discount program marketer’s initial appearance before a court.(3) The report described in Subsection (1) shall include:(3)(a) a copy of the complaint or other relevant legal documents related to the administrative action or criminal prosecution; and(3)(b) an explanation or other information that the health discount program operator or health discount program marketer desires to submit in relation to the action or charge.