(1)  For purposes of this section:

Terms Used In Utah Code 31A-4-106.5

  • Contract: A legal written agreement that becomes binding when signed.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • Corporation: means an insurance corporation, except when referring to:
(i) a corporation doing business:
(A) as:
(I) an insurance producer;
(II) a surplus lines producer;
(III) a limited line producer;
(IV) a consultant;
(V) a managing general agent;
(VI) a reinsurance intermediary;
(VII) a third party administrator; or
(VIII) an adjuster; and
(B) under:
(I) Chapter 23a, Insurance Marketing - Licensing Producers, Consultants, and Reinsurance Intermediaries;
(II) Chapter 25, Third Party Administrators; or
(III) Chapter 26, Insurance Adjusters; or
(ii) a noninsurer that is part of a holding company system under Chapter 16, Insurance Holding Companies. See Utah Code 31A-1-301
  • Health care: means any of the following intended for use in the diagnosis, treatment, mitigation, or prevention of a human ailment or impairment:
    (a) a professional service;
    (b) a personal service;
    (c) a facility;
    (d) equipment;
    (e) a device;
    (f) supplies; or
    (g) medicine. See Utah Code 31A-1-301
  • Health care provider: means the same as that term is defined in Section 78B-3-403. See Utah Code 31A-1-301
  • Individual: means a natural person. 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
  • 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
  • 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
  • Writing: includes :Utah Code 68-3-12.5
  • (a)  “Medical retainer agreement” means a written contract:

    (i)  between:

    (A)  except as provided in Subsection (1)(b)(iii)(B), a natural person or a professional corporation, alone or with others professionally associated with the natural person or professional corporation; and

    (B)  an individual patient or a patient’s representative; and

    (ii)  in which:

    (A)  the person described in Subsection (1)(a)(i)(A) agrees to provide routine health care services to the individual patient for an agreed upon fee and period of time; and

    (B)  either party to the contract may terminate the agreement upon written notice to the other party.

    (b)  “Routine health care services” include:

    (i)  screening, assessment, diagnosis, and treatment for the purpose of promotion of health, and detection and management of disease or injury;

    (ii)  supplies and prescription drugs that are dispensed in a health care provider‘s office; and

    (iii)  laboratory work, such as routine blood screening or routine pathology screening performed by a laboratory that:

    (A)  is associated with the health care provider entering into the medical retainer agreement; or

    (B)  if not associated with the health care provider, has entered into an agreement with the health care provider to provide the laboratory work without charging a fee to the patient for the laboratory work.
  • (2)  A medical retainer agreement exempt from the provisions of Subsection 31A-4-106(2) shall:

    (a)  describe the specific routine health care services that are included in the contract;

    (b)  prominently state in writing that the retainer agreement is not health insurance; and

    (c)  prohibit the health care provider, but not the patient, from billing an insurer for the services provided under the medical retainer agreement.

    Enacted by Chapter 50, 2012 General Session