Utah Code 31A-4-107.5. Penalty for failure of a regulated health insurance entity to fulfill duties related to state claims for Medicaid payment or recovery
For purposes of this section, “regulated health insurance entity” means a health insurance entity, as defined in Section 26B-3-1001, that is subject to regulation by the department.
Terms Used In Utah Code 31A-4-107.5
Certificate: means evidence of insurance given to:
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
License: includes a certificate of authority issued to an insurer. See Utah Code 31A-1-301
(2)
If a regulated health insurance entity fails to comply with the provisions of Section 26B-3-1004:
(a)
the commissioner may revoke or suspend, in whole or in part, a license, certificate of authority, registration, or other authority that is granted by the commissioner to the regulated health insurance entity; and
(b)
the regulated health insurance entity is subject to the penalties and procedures provided for in Section 31A-2-308.
