Terms Used In Utah Code > Title 31A > Chapter 25 > Part 2 - Licensing of Third Party Administrators

• Administrator: means the same as that term is defined in Subsection (182). See Utah Code 31A-1-301
• Affiliate: means a person who controls, is controlled by, or is under common control with, another person. See Utah Code 31A-1-301
• Agency: includes :

  (A)	executive branch entities;

  (B)	judicial branch entities; and

  (C)

  the State Board of Education. See Utah Code 63J-5-102 Agency: includes executive branch entities and judicial branch entities. See Utah Code 63J-7-101 Agency: means : (a)  a person other than an individual, including a sole proprietorship by which an individual does business under an assumed name; and (b)  an insurance organization licensed or required to be licensed under Section 31A-23a-301, 31A-25-207, or 31A-26-209. See Utah Code 31A-1-301 American Rescue Plan Act: means the American Rescue Plan Act, Pub. See Utah Code 63J-4-801 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 Appropriation: The provision of funds, through an annual appropriations act or a permanent law, for federal agencies to make payments out of the Treasury for specified purposes. The formal federal spending process consists of two sequential steps: authorization authorized insurer: means an insurer: (i)  holding a valid certificate of authority to do an insurance business in this state; and (ii)  transacting business as authorized by a valid certificate. See Utah Code 31A-1-301 business of insurance: includes : (a)  providing health care insurance by an organization that is or is required to be licensed under this title; (b)  providing a benefit to an employee in the event of a contingency not within the control of the employee, in which the employee is entitled to the benefit as a right, which benefit may be provided either: (i)  by a single employer or by multiple employer groups; or (ii)  through one or more trusts, associations, or other entities; (c)  providing an annuity: (i)  including an annuity issued in return for a gift; and (ii)  except an annuity provided by a person specified in Subsections 31A-22-1305(2) and (3); (d)  providing the characteristic services of a motor club; (e)  providing another person with insurance; (f)  making as insurer, guarantor, or surety, or proposing to make as insurer, guarantor, or surety, a contract or policy offering title insurance; (g)  transacting or proposing to transact any phase of title insurance, including: (i)  solicitation; (ii)  negotiation preliminary to execution; (iii)  execution of a contract of title insurance; (iv)  insuring; and (v)  transacting matters subsequent to the execution of the contract and arising out of the contract, including reinsurance; (h)  transacting or proposing a life settlement; and (i)  doing, or proposing to do, any business in substance equivalent to Subsections (95)(a) through (h) in a manner designed to evade this title. 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 Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant. Contract: A legal written agreement that becomes binding when signed. Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name. Department: means the Insurance Department. See Utah Code 31A-1-301 Director: means a member of the board of directors of a corporation. See Utah Code 31A-1-301 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 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 Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other. Executive director: means the chief administrative officer of the office, appointed under Section 63J-4-202. See Utah Code 63J-4-102 Federal funds: includes federal assistance and federal assistance programs, however described. See Utah Code 63J-5-102 Federal funds reauthorization: means : (i)  the formal submission from an agency to the federal government applying for or seeking reauthorization of federal funds which the state is currently receiving; (ii)  the formal submission from an agency to the federal government applying for or seeking reauthorization to participate in a federal program in which the state is currently participating that will result in federal funds being transferred to an agency; or (iii)  that period after the first year of a previously authorized and awarded grant or funding award, during which federal funds are disbursed or are scheduled to be disbursed after the first year because the term of the grant or financial award extends for more than one year. See Utah Code 63J-5-102 Federal funds request summary: includes , if available: (A)  the letter awarding an agency a grant of federal funds or other official documentation awarding an agency a grant of federal funds; and (B)  a document detailing federal maintenance of effort requirements. See Utah Code 63J-5-102 Federal maintenance of effort requirements: means any matching, level of effort, or earmarking requirements, as defined in Office of Management and Budget requirements, that are imposed on an agency as a condition of receiving federal funds. See Utah Code 63J-5-102 Fiduciary: A trustee, executor, or administrator. Filed: means that a filing is: (i)  submitted to the department as required by and in accordance with applicable statute, rule, or filing order; (ii)  received by the department within the time period provided in applicable statute, rule, or filing order; and (iii)  accompanied by the appropriate fee in accordance with: (A)  Section 31A-3-103; or (B)  rule. See Utah Code 31A-1-301 Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006. 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 Fraud: Intentional deception resulting in injury to another. Grant: includes : (A)  a reauthorization of an existing grant; and (B)  a donation, regardless of whether it is subject to a formal grant agreement. See Utah Code 63J-7-101 Grant program: means the COVID-19 Local Assistance Matching Grant Program established in Section 63J-4-802. See Utah Code 63J-4-801 Grant summary: means a document detailing: (i)  the amount of money that is being requested or is available to be received by the agency from a grant; (ii)  the duration of the grant and provisions for its reauthorization or extension, if any; (iii)  the name of the grantor; (iv)  the purpose of the grant, including, in detail, any programs, resources, and positions required to be funded by the grant; (v)  any requirements that the agency must meet as a condition to receive or participate in the grant; and (vi)  the amount of state money, if any, that will be required in order to obtain the grant. See Utah Code 63J-7-101 Grantor: means the individual, group of individuals, foundation, corporation, or public or private organization making the grant. See Utah Code 63J-7-101 Grantor: The person who establishes a trust and places property into it. Highway: includes :Utah Code 68-3-12.5 Individual: means a natural person. See Utah Code 31A-1-301 Injunction: An order of the court prohibiting (or compelling) the performance of a specific act to prevent irreparable damage or injury. insolvent: means that: (a)  an insurer is unable to pay the insurer's obligations as the obligations are due; (b)  an insurer's total adjusted capital is less than the insurer's mandatory control level RBC under Subsection 31A-17-601(8)(c); or (c)  an insurer's admitted assets are less than the insurer's liabilities. 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 Intergovernmental transfer program: means an existing reimbursement program or category that is authorized by the Medicaid state plan or waiver authority for intergovernmental transfers. See Utah Code 63J-5-102 Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases. Land: includes :Utah Code 68-3-12.5 Legislative session: That part of a chamber's daily session in which it considers legislative business (bills, resolutions, and actions related thereto). License: includes a certificate of authority issued to an insurer. See Utah Code 31A-1-301 Local government: means a county, city, town, metro township, special district, or special service district. See Utah Code 63J-4-801 New federal funds: means : (i)  federal assistance or other federal funds that are available from the federal government that: (A)  the state is not currently receiving; or (B)  exceed the federal funds amount most recently approved by the Legislature by more than 25% for a federal grant or program in which the state is currently participating; (ii)  a federal assistance program or other federal program in which the state is not currently participating; or (iii)  a one-time TANF request. See Utah Code 63J-5-102 New federal funds request: means : (i)  the formal submission from an agency to the federal government: (A)  applying for or otherwise seeking to obtain new federal funds; or (B)  applying for or seeking to participate in a new federal program that will result in federal funds being transferred to an agency; or (ii)  a one-time TANF request. See Utah Code 63J-5-102 New state money: includes money expended to meet federal maintenance of effort requirements. See Utah Code 63J-5-102 New state money: means money, whether specifically appropriated by the Legislature or not, that the grantor requires Utah to expend as a condition for receiving the grant. See Utah Code 63J-7-101 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. Office: means the Governor's Office of Planning and Budget created in Section 63J-4-201. See Utah Code 63J-4-102 Order: means an order of the commissioner. See Utah Code 31A-1-301 Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses. 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 Planning coordinator: means the individual appointed as the planning coordinator under Section 63J-4-401. See Utah Code 63J-4-102 Plea: In a criminal case, the defendant's statement pleading "guilty" or "not guilty" in answer to the charges, a declaration made in open court. 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 Political subdivision: means : (a)  a county, municipality, special district, special service district, school district, or interlocal entity, as defined in Section 11-13-103; or (b)  an administrative subunit of an entity listed in Subsection (4)(a). See Utah Code 63J-4-102 Probation: A sentencing alternative to imprisonment in which the court releases convicted defendants under supervision as long as certain conditions are observed. Proceeding: includes an action or special statutory proceeding. See Utah Code 31A-1-301 Process: means a writ or summons issued in the course of a judicial proceeding. See Utah Code 68-3-12.5 Review committee: means the COVID-19 Local Assistance Matching Grant Program Review Committee established in Section 63J-4-803. See Utah Code 63J-4-801 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. State: means the state of Utah and all of its agencies, and any administrative subunits of those agencies. See Utah Code 63J-5-102 State: means the state of Utah and all of its agencies, and any administrative subunits of those agencies. See Utah Code 63J-7-101 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 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 United States: includes each state, district, and territory of the United States of America. See Utah Code 68-3-12.5