Utah Code 31A-22-719. Mastectomy coverage

(1)	A group policy subject to Section 31A-22-630 may not deny a person‘s eligibility or continued eligibility to enroll or renew coverage under the terms of the group policy plan solely for the purpose of avoiding the requirements of this section or Section 31A-22-630.

Terms Used In Utah Code 31A-22-719

Insured: means a person to whom or for whose benefit an insurer makes a promise in an insurance policy and includes:

(i)	a policyholder;

(ii)	a subscriber;

(iii)

a member; and

(iv)

a beneficiary. See Utah Code 31A-1-301

Person: includes :

(a)	an individual;

(b)	a partnership;

(c)	a corporation;

(d)	an incorporated or unincorporated association;

(e)	a joint stock company;

(f)

a trust;

(g)	a limited liability company;

(h)	a reciprocal;

(i)	a syndicate; or

(j)

another similar entity or combination of entities acting in concert. 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

(2)

A group policy subject to Section 31A-22-630 may not do any of the following to induce a provider to provide care to an insured in a manner inconsistent with this section or Section 31A-22-630:

(a)	penalize or otherwise reduce or limit the reimbursement of an attending provider; or

(b)	provide incentives to an attending provider whether or not the incentives are monetary.

Enacted by Chapter 114, 2000 General Session

Previous section

Next section

Part 7 Contents