Terms Used In Utah Code > Title 11 > Chapter 13a - Governmental Nonprofit Corporations Act

• Accident and health insurance: means insurance to provide protection against economic losses resulting from:

  (i)	a medical condition including: (A)  a medical care expense; or (B)  the risk of disability;

  (ii)	accident; or

  (iii)

  sickness. See Utah Code 31A-1-301 Adult: means an individual who is 18 years old or older. See Utah Code 31A-1-301 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 Bonds: means any bonds, bond anticipation notes, or other obligations authorized under this title for which the full faith, credit, and resources and ad valorem taxing power of the state have been pledged for the payment of the principal of and interest on the bonds. See Utah Code 63B-1-101 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 City: includes , depending on population, a metro township as defined in Section 10-3c-102. See Utah Code 68-3-12.5 Commission: means the State Bonding Commission created in Section 63B-1-201. See Utah Code 63B-1-101 Contract: A legal written agreement that becomes binding when signed. Controlling interest: means that one or more governmental entities collectively represent a majority of the board's voting power as outlined in the nonprofit corporation's governing documents. See Utah Code 11-13a-102 Creditable coverage: includes coverage that is offered through a public health plan such as: (i)  the Primary Care Network Program under a Medicaid primary care network demonstration waiver obtained subject to Section 26B-3-108; (ii)  the Children's Health Insurance Program under Section 26B-3-904; or (iii)  the Ryan White Program Comprehensive AIDS Resources Emergency Act, Pub. See Utah Code 31A-1-301 Dependent: A person dependent for support upon another. Disability: means a physiological or psychological condition that partially or totally limits an individual's ability to: (a)  perform the duties of: (i)  that individual's occupation; or (ii)  an occupation for which the individual is reasonably suited by education, training, or experience; or (b)  perform two or more of the following basic activities of daily living: (i)  eating; (ii)  toileting; (iii)  transferring; (iv)  bathing; or (v)  dressing. See Utah Code 31A-1-301 Division: means the Division of Facilities Construction and Management. See Utah Code 63B-1-101 Employee: means : (a)  an individual employed by an employer; or (b)  an individual who meets the requirements of Subsection (53)(b). See Utah Code 31A-1-301 Enrollee: includes an insured. See Utah Code 31A-1-301 Exclusion: means for the purposes of accident and health insurance that an insurer does not provide insurance coverage, for whatever reason, for one of the following: (a)  a specific physical condition; (b)  a specific medical procedure; (c)  a specific disease or disorder; or (d)  a specific prescription drug or class of prescription drugs. See Utah Code 31A-1-301 Fiduciary: A trustee, executor, or administrator. Form: means one of the following prepared for general use: (i)  a policy; (ii)  a certificate; (iii)  an application; (iv)  an outline of coverage; or (v)  an endorsement. See Utah Code 31A-1-301 Governing board: includes a board of directors. See Utah Code 11-13a-102 Governing body: means collectively the legislative body and the executive of any municipality. See Utah Code 10-1-104 Governmental entity: means the state, a county, a municipality, a special district, a special service district, a school district, a state institution of higher education, or any other political subdivision or administrative unit of the state. See Utah Code 11-13a-102 Governmental nonprofit corporation: means : (i)  a nonprofit corporation that is wholly owned or wholly controlled by one or more governmental entities, unless the nonprofit corporation receives no operating funding or other financial support from any governmental entity; or (ii)  a nonprofit corporation in which one or more governmental entities exercise a controlling interest and: (A)  that exercises taxing authority; (B)  that imposes a mandatory fee for association or participation with the nonprofit corporation where that association or participation is mandated by law; or (C)  that receives a majority of the nonprofit corporation's operating funding from one or more governmental entities under the nonprofit corporation's governing documents, except where voluntary membership fees, dues, or assessments compose the operating funding. See Utah Code 11-13a-102 Grace period: The number of days you'll have to pay your bill for purchases in full without triggering a finance charge. Source: Federal Reserve Group health plan: means an employee welfare benefit plan to the extent that the plan provides medical care: (a)  (i)  to an employee; or (ii)  to a dependent of an employee; and (b)  (i)  directly; (ii)  through insurance reimbursement; or (iii)  through another method. See Utah Code 31A-1-301 Group insurance policy: means a policy covering a group of persons that is issued: (i)  to a policyholder on behalf of the group; and (ii)  for the benefit of a member of the group who is selected under a procedure defined in: (A)  the policy; or (B)  an agreement that is collateral to the policy. See Utah Code 31A-1-301 Health benefit plan: means a policy, contract, certificate, or agreement offered or issued by an insurer to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care, including major medical expense coverage. 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 health insurance: means insurance providing: (i)  a health care benefit; or (ii)  payment of an incurred health care expense. See Utah Code 31A-1-301 Indemnity: means the payment of an amount to offset all or part of an insured loss. See Utah Code 31A-1-301 Individual: means a natural person. 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 Insured: means a person to whom or for whose benefit an insurer makes a promise in an insurance policy and includes: (i)  a policyholder; (ii)  a subscriber; (iii)  a member; and (iv)  a beneficiary. See Utah Code 31A-1-301 Month: means a calendar month, unless otherwise expressed. See Utah Code 68-3-12.5 Municipal: means of or relating to a municipality. See Utah Code 10-1-104 Municipality: means a city, town, or metro township. See Utah Code 11-13a-102 Municipality: means : (a)  a city of the first class, city of the second class, city of the third class, city of the fourth class, city of the fifth class; (b)  a town, as classified in Section 10-2-301; or (c)  a metro township as that term is defined in Section 10-2a-403 unless the term is used in the context of authorizing, governing, or otherwise regulating the provision of municipal services. See Utah Code 10-1-104 Network provider: means a health care provider who has an agreement with a managed care organization to provide health care services to an enrollee with an expectation of receiving payment, other than coinsurance, copayments, or deductibles, directly from the managed care organization. See Utah Code 31A-1-301 Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period. Outline of coverage: means a summary that explains an accident and health insurance policy. See Utah Code 31A-1-301 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 Policy: includes a service contract issued by: (i)  a motor club under Chapter 11, Motor Clubs; (ii)  a service contract provided under Chapter 6a, Service Contracts; and (iii)  a corporation licensed under: (A)  Chapter 7, Nonprofit Health Service Insurance Corporations; or (B)  Chapter 8, Health Maintenance Organizations and Limited Health Plans. See Utah Code 31A-1-301 Policyholder: means a person who controls a policy, binder, or oral contract by ownership, premium payment, or otherwise. See Utah Code 31A-1-301 Premium: includes , however designated: (i)  an assessment; (ii)  a membership fee; (iii)  a required contribution; or (iv)  monetary consideration. See Utah Code 31A-1-301 producer: means a person licensed or required to be licensed under the laws of this state to sell, solicit, or negotiate insurance. See Utah Code 31A-1-301 Security: means a: (i)  note; (ii)  stock; (iii)  bond; (iv)  debenture; (v)  evidence of indebtedness; (vi)  certificate of interest or participation in a profit-sharing agreement; (vii)  collateral-trust certificate; (viii)  preorganization certificate or subscription; (ix)  transferable share; (x)  investment contract; (xi)  voting trust certificate; (xii)  certificate of deposit for a security; (xiii)  certificate of interest of participation in an oil, gas, or mining title or lease or in payments out of production under such a title or lease; (xiv)  commodity contract or commodity option; (xv)  certificate of interest or participation in, temporary or interim certificate for, receipt for, guarantee of, or warrant or right to subscribe to or purchase any of the items listed in Subsections (171)(a)(i) through (xiv); or (xvi)  another interest or instrument commonly known as a security. See Utah Code 31A-1-301 Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims. Signature: includes a name, mark, or sign written with the intent to authenticate an instrument or writing. See Utah Code 68-3-12.5 Significant break in coverage: means a period of 63 consecutive days during each of which an individual does not have creditable coverage. See Utah Code 31A-1-301 Statute: A law passed by a legislature. Town: includes , depending on population, a metro township as defined in Section 10-3c-102. See Utah Code 68-3-12.5