§ 31A-45-501 Access to health care providers

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Terms Used In Utah Code > Title 31A > Chapter 45 > Part 5 - Network Adequacy

  • board of directors: means the group of persons with responsibility over, or management of, a corporation, however designated. See Utah Code 31A-1-301
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • Contract: A legal written agreement that becomes binding when signed.
  • Department: means the Insurance Department. See Utah Code 31A-1-301
  • Employee: means a person who performs a service for wages or other remuneration under a contract of hire, written or oral, express or implied. See Utah Code 67-21-2
  • Employer: includes an agent of an employer. See Utah Code 67-21-2
  • Enrollee: includes an insured. 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
  • health insurance: means insurance providing:
              (84)(a)(i) a health care benefit; or
              (84)(a)(ii) payment of an incurred health care expense. 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
  • Managed care organization: means :
         (2)(a) a managed care organization as that term is defined in Section 31A-1-301; and
         (2)(b) a third party administrator as that term is defined in Section 31A-1-301. See Utah Code 31A-45-102
  • Member: means a person having membership rights in an insurance corporation. 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
  • 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
  • Public body: means any of the following:
         (11)(a) a state officer, employee, agency, department, division, bureau, board, commission, council, authority, educational institution, or any other body in the executive branch of state government;
         (11)(b) an agency, board, commission, council, institution member, or employee of the legislative branch of state government;
         (11)(c) a county, city, town, regional governing body, council, school district, special district, special service district, or municipal corporation, board, department, commission, council, agency, or any member or employee of them;
         (11)(d) any other body that is created by state or local authority, or that is primarily funded by or through state or local authority, or any member or employee of that body;
         (11)(e) a law enforcement agency or any member or employee of a law enforcement agency; and
         (11)(f) the judiciary and any member or employee of the judiciary. See Utah Code 67-21-2
  • Road: includes :
         (33)(a) a public bridge;
         (33)(b) a county way;
         (33)(c) a county road;
         (33)(d) a common road; and
         (33)(e) a state road. See Utah Code 68-3-12.5
  • Security: means a:
              (176)(a)(i) note;
              (176)(a)(ii) stock;
              (176)(a)(iii) bond;
              (176)(a)(iv) debenture;
              (176)(a)(v) evidence of indebtedness;
              (176)(a)(vi) certificate of interest or participation in a profit-sharing agreement;
              (176)(a)(vii) collateral-trust certificate;
              (176)(a)(viii) preorganization certificate or subscription;
              (176)(a)(ix) transferable share;
              (176)(a)(x) investment contract;
              (176)(a)(xi) voting trust certificate;
              (176)(a)(xii) certificate of deposit for a security;
              (176)(a)(xiii) certificate of interest of participation in an oil, gas, or mining title or lease or in payments out of production under such a title or lease;
              (176)(a)(xiv) commodity contract or commodity option;
              (176)(a)(xv) certificate of interest or participation in, temporary or interim certificate for, receipt for, guarantee of, or warrant or right to subscribe to or purchase any of the items listed in Subsections (176)(a)(i) through (xiv); or
              (176)(a)(xvi) another interest or instrument commonly known as a security. 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