(1) 

Terms Used In Utah Code 31A-19a-203

  • Application: means a document:
(a) 
(i) completed by an applicant to provide information about the risk to be insured; and
(ii) that contains information that is used by the insurer to evaluate risk and decide whether to:
(A) insure the risk under:
(I) the coverage as originally offered; or
(II) a modification of the coverage as originally offered; or
(B) decline to insure the risk; or
(b) used by the insurer to gather information from the applicant before issuance of an annuity contract. See Utah Code 31A-1-301
  • authorized insurer: means an insurer:
    (i) holding a valid certificate of authority to do an insurance business in this state; and
    (ii) transacting business as authorized by a valid certificate. See Utah Code 31A-1-301
  • Contract: A legal written agreement that becomes binding when signed.
  • Filed: means that a filing is:
    (i) submitted to the department as required by and in accordance with applicable statute, rule, or filing order;
    (ii) received by the department within the time period provided in applicable statute, rule, or filing order; and
    (iii) accompanied by the appropriate fee in accordance with:
    (A) Section 31A-3-103; or
    (B) rule. See Utah Code 31A-1-301
  • Filing: when used as a noun, means an item required to be filed with the department including:
    (a) a policy;
    (b) a rate;
    (c) a form;
    (d) a document;
    (e) a plan;
    (f) a manual;
    (g) an application;
    (h) a report;
    (i) a certificate;
    (j) an endorsement;
    (k) an actuarial certification;
    (l) a licensee annual statement;
    (m) a licensee renewal application;
    (n) an advertisement;
    (o) a binder; or
    (p) an outline of coverage. See Utah Code 31A-1-301
  • Insurance: includes :
    (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;
    (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
    (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
  • Policy: includes a service contract issued by:
    (i) a motor club under Chapter 11, Motor Clubs;
    (ii) a service contract provided under Chapter 6a, Service Contracts; and
    (iii) a corporation licensed under:
    (A) Chapter 7, Nonprofit Health Service Insurance Corporations; or
    (B) Chapter 8, Health Maintenance Organizations and Limited Health Plans. See Utah Code 31A-1-301
  • Policyholder: means a person who controls a policy, binder, or oral contract by ownership, premium payment, or otherwise. See Utah Code 31A-1-301
  • Premium: includes , however designated:
    (i) an assessment;
    (ii) a membership fee;
    (iii) a required contribution; or
    (iv) monetary consideration. See Utah Code 31A-1-301
  • Rate: means that cost of insurance per exposure unit either expressed as:
    (i) a single number; or
    (ii) as a pure premium rate, adjusted before any application of individual risk variations, based on loss or expense considerations to account for the treatment of:
    (A) expenses;
    (B) profit; and
    (C) individual insurer variation in loss experience. See Utah Code 31A-19a-102
  • Rate service organization: means a person who assists an insurer in rate making or filing by:
    (i) collecting, compiling, and furnishing loss or expense statistics;
    (ii) recommending, making, or filing rates or supplementary rate information; or
    (iii) advising about rate questions, except as an attorney giving legal advice. 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
  • Supplementary rate information: includes one or more of the following needed to determine the applicable rate in effect or to be in effect:
    (a) a manual or plan of rates;
    (b) a statistical plan;
    (c) a classification;
    (d) a rating schedule;
    (e) a minimum premium;
    (f) a policy fee;
    (g) a rating rule;
    (h) a rate-related underwriting rule;
    (i) a rate modification plan; or
    (j) any other similar information prescribed by rule of the commissioner as supplementary rate information. See Utah Code 31A-19a-102
  • Supporting information: includes one or more of the following:
    (a) data demonstrating actuarial justification for the basic rate factors, classifications, expenses, and profit factors used by the filer;
    (b) the experience and judgment of the filer;
    (c) the experience or data of other insurers or rate service organizations relied upon by the filer;
    (d) the interpretation of any other data relied upon by the filer;
    (e) descriptions of methods used in making the rates; or
    (f) any other information defined by rule as supporting information that is required to be filed. See Utah Code 31A-19a-102
  • Writing: includes :Utah Code 68-3-12.5
  • (a)  Except as provided in Subsections (4) and (5), every authorized insurer and every rate service organization licensed under Section 31A-19a-301 that has been designated by any insurer for the filing of pure premium rates under Subsection 31A-19a-205(2) shall file with the commissioner the following for use in this state:

    (i)  all rates;

    (ii)  all supplementary information; and

    (iii)  all changes and amendments to rates and supplementary information.

    (b)  An insurer shall file its rates by filing:

    (i)  its final rates; or

    (ii)  either of the following to be applied to pure premium rates that have been filed by a rate service organization on behalf of the insurer as permitted by Section 31A-19a-205:

    (A)  a multiplier; or

    (B) 

    (I)  a multiplier; and

    (II)  an expense constant adjustment.

    (c)  Every filing under this Subsection (1) shall state:

    (i)  the effective date of the rates; and

    (ii)  the character and extent of the coverage contemplated.

    (d)  Except for workers’ compensation rates filed under Sections 31A-19a-405 and 31A-19a-406, each filing shall be within 30 days after the rates and supplementary information, changes, and amendments are effective.

    (e)  A rate filing is considered filed when it has been received:

    (i)  with the applicable filing fee as prescribed under Section 31A-3-103; and

    (ii)  pursuant to procedures established by the commissioner.

    (f)  The commissioner may by rule prescribe procedures for submitting rate filings by electronic means.
  • (2) 

    (a)  To show compliance with Section 31A-19a-201, at the same time as the filing of the rate and supplementary rate information, an insurer shall file all supporting information to be used in support of or in conjunction with a rate.

    (b)  If the rate filing provides for a modification or revision of a previously filed rate, the insurer is required to file only the supporting information that supports the modification or revision.

    (c)  If the commissioner determines that the insurer did not file sufficient supporting information, the commissioner shall inform the insurer in writing of the lack of sufficient supporting information.

    (d)  If the insurer does not provide the necessary supporting information within 45 calendar days of the date on which the commissioner mailed notice under Subsection (2)(c), the rate filing may be:

    (i)  considered incomplete and unfiled; and

    (ii)  returned to the insurer as:

    (A)  not filed; and

    (B)  not available for use.

    (e)  Notwithstanding Subsection (2)(d), the commissioner may extend the time period for filing supporting information.

    (f)  If a rate filing is returned to an insurer as not filed and not available for use under Subsection (2)(d), the insurer may not use the rate filing for any policy issued or renewed on or after 60 calendar days from the date the rate filing was returned.

    (3)  At the request of the commissioner, an insurer using the services of a rate service organization shall provide a description of the rationale for using the services of the rate service organization, including the insurer’s:

    (a)  own information; and

    (b)  method of use of the rate service organization’s information.

    (4) 

    (a)  An insurer may not make or issue a contract or policy except in accordance with the rate filings that are in effect for the insurer as provided in this chapter.

    (b)  Subsection (4)(a) does not apply to contracts or policies for inland marine risks for which filings are not required.

    (5)  Subsection (1) does not apply to inland marine risks, which, by general custom, are not written according to standardized manual rules or rating plans.

    (6) 

    (a)  The insurer may file a written application, stating the insurer’s reasons for using a higher rate than that otherwise applicable to a specific risk.

    (b)  If the application described in Subsection (6)(a) is filed with and not disapproved by the commissioner within 10 days after filing, the higher rate may be applied to the specific risk.

    (c)  The rate described in this Subsection (6) may be disapproved without a hearing.

    (d)  If disapproved, the rate otherwise applicable applies from the effective date of the policy, but the insurer may cancel the policy pro rata on 10 days’ notice to the policyholder.

    (e)  If the insurer does not cancel the policy under Subsection (6)(d), the insurer shall refund any excess premium from the effective date of the policy.

    (7) 

    (a)  Agreements may be made between insurers on the use of reasonable rate modifications for insurance provided under Section 31A-22-310.

    (b)  The rate modifications described in Subsection (7)(a) shall be filed immediately upon agreement by the insurers.

    Amended by Chapter 117, 2004 General Session