Terms Used In Utah Code > Title 63G > Chapter 24 - Board Vacancies and Conflicts Act

• Advice and consent: Under the Constitution, presidential nominations for executive and judicial posts take effect only when confirmed by the Senate, and international treaties become effective only when the Senate approves them by a two-thirds vote.
• Affiliation: means association with an entity, including association in the form of employment, ownership, shareholdership, or financial interest. See Utah Code 63G-24-102
• Agency: means the same as that term is defined in Section 63G-4-103. See Utah Code 63G-24-102
• Appointed board member: means an individual appointed by the governor, with the consent of the Senate, to serve on a rulemaking board. See Utah Code 63G-24-102
• Contract: A legal written agreement that becomes binding when signed.
• Department: means the Insurance Department. See Utah Code 31A-1-301
• Disability: means a physiological or psychological condition that partially or totally limits an individual's ability to:
       (51)(a) perform the duties of:

            (51)(a)(i) that individual's occupation; or

            (51)(a)(ii) an occupation for which the individual is reasonably suited by education, training, or experience; or
       (51)(b) perform two or more of the following basic activities of daily living:

            (51)(b)(i) eating;

            (51)(b)(ii) toileting;

            (51)(b)(iii) transferring;

            (51)(b)(iv) bathing; or

            (51)(b)(v) dressing. 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
• Enrollee: includes an insured. See Utah Code 31A-1-301
• Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. ^{Source: U.S. Courts}
• 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
• 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
• 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
• 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
• Intellectual disability: means a significant, subaverage general intellectual functioning that:
       (16)(a) exists concurrently with deficits in adaptive behavior; and
       (16)(b) is manifested during the developmental period as defined in the current edition of the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association. See Utah Code 68-3-12.5
• Managed care organization: means a person:
       (122)(a) licensed as a health maintenance organization under Chapter 8, Health Maintenance Organizations and Limited Health Plans; or
       (122)(b)

            (122)(b)(i) licensed under:

                 (122)(b)(i)(A) Chapter 5, Domestic Stock and Mutual Insurance Corporations;

                 (122)(b)(i)(B) Chapter 7, Nonprofit Health Service Insurance Corporations; or

                 (122)(b)(i)(C) Chapter 14, Foreign Insurers; and

            (122)(b)(ii) that requires an enrollee to use, or offers incentives, including financial incentives, for an enrollee to use, network providers. See Utah Code 31A-1-301
• Medicare: means the "Health Insurance for the Aged Act" Title XVIII of the federal Social Security Act, as then constituted or later amended. See Utah Code 31A-1-301
• Nominee: means a person selected by the governor to fill a rulemaking board vacancy subject to the advice and consent of the Senate. See Utah Code 63G-24-102
• Person: means :
       (24)(a) an individual;
       (24)(b) an association;
       (24)(c) an institution;
       (24)(d) a corporation;
       (24)(e) a company;
       (24)(f) a trust;
       (24)(g) a limited liability company;
       (24)(h) a partnership;
       (24)(i) a political subdivision;
       (24)(j) a government office, department, division, bureau, or other body of government; and
       (24)(k) any other organization or entity. See Utah Code 68-3-12.5
• 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
• Process: means a writ or summons issued in the course of a judicial proceeding. See Utah Code 68-3-12.5
• Rulemaking board: means a board, committee, commission, or council:
            (5)(a)(i) that has rulemaking authority; and
            (5)(a)(ii) at least part of whose membership is appointed by the governor subject to the advice and consent of the Senate. See Utah Code 63G-24-102
• 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
• Substantial interest: means the same as that term is defined in Section 67-16-3. See Utah Code 63G-24-102
• 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