Terms Used In Utah Code > Title 63G > Chapter 21 - Agreements to Provide State Services

• Affiliate: means a person who controls, is controlled by, or is under common control with, another person. See Utah Code 31A-1-301
• Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. ^{Source: OCC}
• Contract: A legal written agreement that becomes binding when signed.
• Dependent: A person dependent for support upon another.
• Designated agency: means :
       (1)(a) the Governor's Office of Economic Opportunity;
       (1)(b) the Division of Wildlife Resources;
       (1)(c) the Department of Public Safety;
       (1)(d) the Division of Technology Services; or
       (1)(e) the Department of Workforce Services. See Utah Code 63G-21-102
• Eligible employee: includes :
            (55)(b)(i) an owner, sole proprietor, or partner who:

                 (55)(b)(i)(A) works on a full-time basis;

                 (55)(b)(i)(B) has a normal work week of 30 or more hours; and

                 (55)(b)(i)(C) employs at least one common employee; and
            (55)(b)(ii) an independent contractor if the individual is included under a health benefit plan of a small employer. See Utah Code 31A-1-301
• Emergency medical condition: means a medical condition that:
       (56)(a) manifests itself by acute symptoms, including severe pain; and
       (56)(b) would cause a prudent layperson possessing an average knowledge of medicine and health to reasonably expect the absence of immediate medical attention through a hospital emergency department to result in:

            (56)(b)(i) placing the layperson's health or the layperson's unborn child's health in serious jeopardy;

            (56)(b)(ii) serious impairment to bodily functions; or

            (56)(b)(iii) serious dysfunction of any bodily organ or part. See Utah Code 31A-1-301
• Employee: means :
       (57)(a) an individual employed by an employer; or
       (57)(b) an individual who meets the requirements of Subsection (55)(b). See Utah Code 31A-1-301
• Enrollee: includes an insured. See Utah Code 31A-1-301
• Fraud: Intentional deception resulting in injury to another.
• Health benefit plan: means a policy, contract, certificate, or agreement offered or issued by an insurer to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care, including major medical expense coverage. 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
• Indemnity: means the payment of an amount to offset all or part of an insured loss. 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
• 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
• Member: means a person having membership rights in an insurance corporation. See Utah Code 31A-1-301
• Plan sponsor: means the same as that term is defined in Utah Code 31A-1-301
• Plan year: means :
       (149)(a) the year that is designated as the plan year in:

            (149)(a)(i) the plan document of a group health plan; or

            (149)(a)(ii) a summary plan description of a group health plan;
       (149)(b) if the plan document or summary plan description does not designate a plan year or there is no plan document or summary plan description:

            (149)(b)(i) the year used to determine deductibles or limits;

            (149)(b)(ii) the policy year, if the plan does not impose deductibles or limits on a yearly basis; or

            (149)(b)(iii) the employer's taxable year if:

                 (149)(b)(iii)(A) the plan does not impose deductibles or limits on a yearly basis; and

                 (149)(b)(iii)(B)

                      (149)(b)(iii)(B)(I) the plan is not insured; or

                      (149)(b)(iii)(B)(II) the insurance policy is not renewed on an annual basis; or
       (149)(c) in a case not described in Subsection (149)(a) or (b), the calendar year. See Utah Code 31A-1-301
• Property: includes both real and personal property. See Utah Code 68-3-12.5
• Small employer: means , in connection with a health benefit plan and with respect to a calendar year and to a plan year, an employer who:
            (182)(a)(i)

                 (182)(a)(i)(A) employed at least one but not more than 50 eligible employees on business days during the preceding calendar year; or

                 (182)(a)(i)(B) if the employer did not exist for the entirety of the preceding calendar year, reasonably expects to employ an average of at least one but not more than 50 eligible employees on business days during the current calendar year;
            (182)(a)(ii) employs at least one employee on the first day of the plan year; and
            (182)(a)(iii) for an employer who has common ownership with one or more other employers, is treated as a single employer under 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
• State service: includes :
            (2)(b)(i) for the Governor's Office of Economic Opportunity or the Division of Technology Services, public high-speed Internet access;
            (2)(b)(ii) for the Division of Wildlife Resources, fishing, hunting, and trapping licenses;
            (2)(b)(iii) for the Department of Public Safety, fingerprinting, an online driver license renewal, online appointment scheduling, an online motor vehicle record request, and an online change of address with the Driver License Division; and
            (2)(b)(iv) for the Department of Workforce Services, online job searches, verification of submission for benefits administered by the Department of Workforce Services, online unemployment applications, online food stamp applications, and online appointment scheduling. See Utah Code 63G-21-102
• United States: includes each state, district, and territory of the United States of America. See Utah Code 68-3-12.5
• USPS: means the United States Postal Service. See Utah Code 63G-21-102
• 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