31A-22-633. Exemptions from standards. Notwithstanding the provisions of this title, any accident and health insurer or health maintenance organization may offer a choice of coverage that is less or different than is otherwise required by applicable state law if:
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
Insured: means a person to whom or for whose benefit an insurer makes a promise in an insurance policy and includes:
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
(a)
less or different coverage than the basic coverage;
(b)
less or different coverage than is otherwise required in an insurancepolicy or health maintenance organization contract under applicable state law; or
(c)
less or different coverage than required by Subsection 31A-22-605(4)(b); and
(2)
the choice of coverage offered by the carrier:
(a)
is the same or similar coverage as the coverage offered by the Department of Health and Human Services under Subsection (1);
(b)
is offered to the same or similar population as the coverage offered by the Department of Health and Human Services under Subsection (1); and
(c)
contains an explanation for each insured of coverage exclusions and limitations.
