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Terms Used In Utah Code 31A-22-607

  • Accident and health insurance: means insurance to provide protection against economic losses resulting from:
              (1)(a)(i) a medical condition including:
                   (1)(a)(i)(A) a medical care expense; or
                   (1)(a)(i)(B) the risk of disability;
              (1)(a)(ii) accident; or
              (1)(a)(iii) sickness. See Utah Code 31A-1-301
  • Grace period: The number of days you'll have to pay your bill for purchases in full without triggering a finance charge. Source: Federal Reserve
  • Group insurance policy: means a policy covering a group of persons that is issued:
              (79)(a)(i) to a policyholder on behalf of the group; and
              (79)(a)(ii) for the benefit of a member of the group who is selected under a procedure defined in:
                   (79)(a)(ii)(A) the policy; or
                   (79)(a)(ii)(B) an agreement that is collateral to the policy. 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
  • 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
  • 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:
              (156)(b)(i) an assessment;
              (156)(b)(ii) a membership fee;
              (156)(b)(iii) a required contribution; or
              (156)(b)(iv) monetary consideration. See Utah Code 31A-1-301
  • producer: means a person licensed or required to be licensed under the laws of this state to sell, solicit, or negotiate insurance. 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
     (1)(a) An individual or franchise accident and health insurance policy shall contain one or more clauses providing for a grace period for premium payment only of:

          (1)(a)(i) at least 15 days for a weekly or monthly premium policy; and
          (1)(a)(ii) 30 days for a policy that is not a weekly or monthly premium policy, for each premium after the first premium payment.
     (1)(b) An insurer may elect to include a grace period that is longer than 15 days for a weekly or monthly policy.
     (1)(c) An individual or franchise accident and health insurance policy is not in force during a grace period.
     (1)(d) If an insurer receives payment before the day on which a grace period expires, the individual or franchise accident and health insurance policy continues in force with no gap in coverage.
     (1)(e) If an insurer does not receive payment before the day on which a grace period expires, the individual or franchise accident and health insurance policy terminates as of the last date for which the premium is paid in full.
     (1)(f) A grace period is not required if the policyholder has requested that the individual or franchise accident and health insurance policy be discontinued.
(2)

     (2)(a) A group insurance policy offering accident and health insurance or a blanket insurance policy offering accident and health insurance shall provide for a grace period of at least 30 days, unless the policyholder gives written notice of discontinuance before the day on which the policy discontinues, in accordance with the policy terms.
     (2)(b) A group insurance policy offering accident and health insurance or a blanket insurance policy offering accident and health insurance is in force during a grace period.
     (2)(c) If an insurer does not receive payment before the day on which a grace period expires, the group insurance policy offering accident and health insurance or blanket insurance policy offering accident and health insurance terminates as of the last day on which the grace period is in effect.
     (2)(d) A group insurance policy offering accident and health insurance or a blanket insurance policy offering accident and health insurance may provide for payment of a pro rata premium for the period the policy is in effect during a grace period under this Subsection (2).
(3) If an insurer has not guaranteed the insured a right to renew an accident and health insurance policy, a grace period beyond the expiration or anniversary date may, if provided in the accident and health insurance policy, be cut off by compliance with the notice provision under Subsection (4).
(4)

     (4)(a) An insurer shall send a written renewal notice to the policyholder or, if the insurer issued the policy to an employer group, the producer:

          (4)(a)(i) no sooner than 90 days before, and no later than 14 days before, the day on which an accident and health insurance policy renews; or
          (4)(a)(ii) if the renewal notice includes a change in premium, at least 45 days before the day on which an accident and health insurance policy renews.
     (4)(b) The renewal notice described in Subsection (4)(a) shall clearly state:

          (4)(b)(i) the renewal amount;
          (4)(b)(ii) how the policyholder may pay the renewal premium, including the day on which the renewal premium is due; and
          (4)(b)(iii) that failure of the policyholder to pay the renewal premium extinguishes the policyholder’s right to renew.
(5) The extinguishment of a policyholder’s right to renew for nonpayment of premium is effective no sooner than 10 days after the day on which the policyholder receives written notice that the policyholder has failed to pay the premium when due.