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 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
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
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
use any form of words or terms that may confuse health discount programs with other types of health insurance in advertising or marketing such as “health plan,” “health benefit plan,” “coverage,” “copay,” “copayments,” “preexisting conditions,” “guaranteed issue,” “premium,” and “preferred provider”;
(b)
use other terms as designated by the commissioner by administrative rule in advertisement or marketing that could reasonably mislead a consumer to believe that a discount health program is any other form of health insurance; or
(c)
refer to sales representatives as “agents,” “producers,” or “consultants.”
(2)
A health discount program operator:
(a)
shall have a written agreement with any marketer of the health discount program prior to marketing, selling, promoting, or distributing the health discount programs;
(b)
shall file with the commissioner all advertisement, marketing materials, brochures, and discount programs prior to their use or distribution; and
(c)
shall make the following disclosures:
(i)
in writing in at least 10-point type and bolded; and
(ii)
with any marketing or advertising to the public and with any enrollment forms given to an enrollee:
(A)
the program is not a health insurance policy;
(B)
the program provides discounts only at certain health care providers for health care services;
(C)
the program holder is obligated to pay for all health care services but will receive a discount from those health care providers who have contracted with the health discount program; and
(D)
the corporate name and the location of the health discount program operator.
(3)
A health discount program operator or marketer who sells the health discount program with another product shall provide the consumer a written itemization of the fees of the health discount program separate from any fees or charges for the other product, which can be purchased separately.
