A person shall comply with the provisions of this chapter if the person operates a health discount program in this state.
Terms Used In Utah Code 31A-8a-103
Bail: Security given for the release of a criminal defendant or witness from legal custody (usually in the form of money) to secure his/her appearance on the day and time appointed.
Health care: means any of the following intended for use in the diagnosis, treatment, mitigation, or prevention of a human ailment or impairment:
Health discount program: means a business arrangement or contract in which a person pays fees, dues, charges, or other consideration in exchange for a program that provides access to health care providers who agree to provide a discount for health care services. See Utah Code 31A-8a-102
Health discount program marketer: means a person, including a private label entity, that markets, promotes, sells, or distributes a health discount program but does not operate a health discount program. See Utah Code 31A-8a-102
Health discount program operator: means a person that provides a health discount program by entering into a contract or agreement, directly or indirectly, with a person or persons in this state who agree to provide discounts for health care services to enrollees of the health discount program and determines the charge to members. See Utah Code 31A-8a-102
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
License: includes a certificate of authority issued to an insurer. See Utah Code 31A-1-301
Marketing: means making or causing to be made any communication that contains information that relates to a product or contract regulated under this chapter. See Utah Code 31A-8a-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
Rate: means :
(i)
the cost of a given unit of insurance; or
(ii)
for property or casualty insurance, that cost of insurance per exposure unit either expressed as:
(A)
a single number; or
(B)
a pure premium rate, adjusted before the application of individual risk variations based on loss or expense considerations to account for the treatment of:
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
(2)
Notwithstanding any provision in this title, a person who only operates or markets a health discount program is exempt from:
A person licensed under this title as an accident and health insurer or health maintenance organization:
(a)
is not required to obtain a license as required by Section 31A-8a-201 to operate a health discount program; and
(b)
is required to comply with all other provisions of this chapter.
(4)
The purposes of this chapter include:
(a)
full disclosure in the sale of health discount programs;
(b)
reasonable regulation of the marketing and disclosure practices of health discount program operators; and
(c)
licensing standards for health discount programs.
(5)
Nothing in this chapter prohibits a health discount program operator from marketing a health discount program operator’s own services without a health discount program marketer license.
