(1)  An organization may apply for a certificate of authority at any time prior to the expiration of its organization permit. The application shall include:

Terms Used In Utah Code 31A-8-213

  • Application: means a document:
(a) 
(i) completed by an applicant to provide information about the risk to be insured; and
(ii) that contains information that is used by the insurer to evaluate risk and decide whether to:
(A) insure the risk under:
(I) the coverage as originally offered; or
(II) a modification of the coverage as originally offered; or
(B) decline to insure the risk; or
(b) used by the insurer to gather information from the applicant before issuance of an annuity contract. See Utah Code 31A-1-301
  • Business plan: means the information required to be supplied to the commissioner under Subsections 31A-5-204(2)(i) and (j), including the information required when these subsections apply by reference under:
    (a) Section 31A-8-205; or
    (b) Subsection 31A-9-205(2). See Utah Code 31A-1-301
  • Certificate: means evidence of insurance given to:
    (a) an insured under a group insurance policy; or
    (b) a third party. 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
  • Order: means an order of the commissioner. See Utah Code 31A-1-301
  • Surplus: means the excess of assets over the sum of paid-in capital and liabilities. See Utah Code 31A-1-301
  • (a)  a detailed statement by a principal officer about any material changes that have taken place or are likely to take place in the facts on which the issuance of the organization permit was based; and

    (b)  if any material changes are proposed in the business plan, the information about the changes that would be required if an organization permit were then being applied for.
  • (2)  The commissioner shall issue a certificate of authority, if the commissioner finds that:

    (a)  the organization’s capital and surplus complies with the requirements of Section 31A-8-209 as to the operations proposed under the new certificate of authority;

    (b)  there is no basis for revoking the organization permit under Section 31A-8-207;

    (c)  the deposit required by Section 31A-8-211 has been made;

    (d)  the organization satisfies the requirements of Section 31A-8-104; and

    (e)  all other applicable requirements of the law have been met.

    (3)  The certificate of authority shall specify any limits imposed by the commissioner upon the organization’s business or methods of operation, including the general types of health care services the organization is authorized to provide.

    (4)  Upon the issuance of the certificate of authority:

    (a)  the board shall authorize and direct the issuance of certificates for shares, bonds, or notes subscribed to under the organization permit, and of insurance policies upon qualifying applications obtained under the organization permit; and

    (b)  the commissioner shall authorize the release to the organization of all funds held in escrow under Section 31A-5-208, as adopted by Section 31A-8-206.

    (5) 

    (a)  An organization may at any time apply to the commissioner for a new or amended certificate of authority altering the limits on its business or methods of operation. The application shall contain or be accompanied by that information reasonably required by the commissioner under Subsections 31A-5-204(2) and 31A-8-205(2). The commissioner shall issue the new certificate as requested if the commissioner finds that the organization continues to satisfy the requirements specified under Subsection (2).

    (b)  If the commissioner issues an order under 5, against an organization, the commissioner may also revoke the organization’s certificate and issue a new one with any limitation the commissioner considers necessary.

    Amended by Chapter 309, 2007 General Session