31A-21-201.  Filing of forms.

(1) 

Terms Used In Utah Code 31A-21-201

  • Accident and health insurance: means insurance to provide protection against economic losses resulting from:
(i) a medical condition including:
(A) a medical care expense; or
(B) the risk of disability;
(ii) accident; or
(iii) sickness. See Utah Code 31A-1-301
  • 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
  • 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
  • Form: means one of the following prepared for general use:
    (i) a policy;
    (ii) a certificate;
    (iii) an application;
    (iv) an outline of coverage; or
    (v) an endorsement. 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
  • Life insurance: means :
    (i) insurance on a human life; and
    (ii) insurance pertaining to or connected with human life. See Utah Code 31A-1-301
  • Order: means an order of the commissioner. 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
  • 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
  • Statute: A law passed by a legislature.
  • Writing: includes :Utah Code 68-3-12.5
  • (a)  Except as exempted under Subsections 31A-21-101(2) through (6), a form may not be used, sold, or offered for sale until the form is filed with the commissioner.

    (b)  A form is considered filed with the commissioner when the commissioner receives:

    (i)  the form;

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

    (iii)  the applicable transmittal forms as required by the commissioner.

    (2)  In filing a form for use in this state the insurer is responsible for assuring that the form is in compliance with this title and rules adopted by the commissioner.

    (3) 

    (a)  The commissioner may prohibit the use of a form at any time upon a finding that:

    (i)  the form:

    (A)  is inequitable;

    (B)  is unfairly discriminatory;

    (C)  is misleading;

    (D)  is deceptive;

    (E)  is obscure;

    (F)  is unfair;

    (G)  encourages misrepresentation; or

    (H)  is not in the public interest;

    (ii)  the form provides benefits or contains another provision that endangers the solidity of the insurer;

    (iii)  except for a life or accident and health insurance policy form, the form is an insurance policy or application for an insurance policy, that fails to conspicuously provide:

    (A)  the exact name of the insurer; and

    (B)  the state of domicile of the insurer filing the insurance policy or application for the insurance policy;

    (iv)  except an application required by Section 31A-22-635, the form is a life or accident and health insurance form that fails to conspicuously provide:

    (A)  the exact name of the insurer;

    (B)  the state of domicile of the insurer; and

    (C)  for a life insurance policy only, the address of the administrative office of the insurer filing the form;

    (v)  the form violates a statute or a rule adopted by the commissioner; or

    (vi)  the form is otherwise contrary to law.

    (b) 

    (i)  When the commissioner prohibits the use of a form under Subsection (3)(a), the commissioner may order that, on or before a date not less than 15 days after the day on which the commissioner issues the order, the use of the form be discontinued.

    (ii)  Once use of a form is prohibited, the form may not be used until appropriate changes are filed with and reviewed by the commissioner.

    (iii)  When the commissioner prohibits the use of a form under Subsection (3)(a), the commissioner may require the insurer to disclose contract deficiencies to the existing policyholders.

    (c)  If the commissioner prohibits use of a form under this Subsection (3), the prohibition shall:

    (i)  be in writing;

    (ii)  constitute an order; and

    (iii)  state the reasons for the prohibition.

    (4) 

    (a)  If, after a hearing, the commissioner determines that it is in the public interest, the commissioner may require by rule or order that a form be subject to the commissioner’s approval before an insurer uses the form.

    (b)  The rule or order described in Subsection (4)(a) shall prescribe the filing procedures for a form if the procedures are different from the procedures stated in this section.

    (c)  The type of form that under Subsection (4)(a) the commissioner may require approval of before use includes:

    (i)  a form for a particular class of insurance;

    (ii)  a form for a specific line of insurance;

    (iii)  a specific type of form; or

    (iv)  a form for a specific market segment.

    (5) 

    (a)  An insurer shall maintain a complete and accurate record of the following for the time period described in Subsection (5)(b):

    (i)  a form:

    (A)  filed under this section for use; or

    (B)  that is in use; and

    (ii)  a document filed under this section with a form described in Subsection (5)(a)(i).

    (b)  The insurer shall maintain a record required under Subsection (5)(a) for the balance of the current year, plus five years from:

    (i)  the last day on which the form is used; or

    (ii)  the last day an insurance policy that is issued using the form is in effect.

    Amended by Chapter 198, 2022 General Session