Utah Code 31A-45-102. Definitions

31A-45-102. Definitions.
As used in this chapter:

(1)	“Covered benefit” or “benefit” means the health care services to which a covered person is entitled under the terms of a health care insurance plan offered by a managed care organization.

Terms Used In Utah Code 31A-45-102

Administrator: means the same as that term is defined in Subsection (182). 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

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

Managed care organization: means :

(a)	a managed care organization as that term is defined in Section 31A-1-301; and

(b)

a third party administrator as that term is defined in Section 31A-1-301. See Utah Code 31A-45-102

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

(2)

“Managed care organization” means:

(a)	a managed care organization as that term is defined in Section 31A-1-301; and

(b)	a third party administrator as that term is defined in Section 31A-1-301.

Amended by Chapter 193, 2019 General Session

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