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[Utah Code Table of Contents]
[TITLE 31a. Table of Contents]
31A-4-101 Solicitation permit.
(1) No person may advertise for or solicit or receive any funds, subscriptions for securities, or membership fees, dues, or contributions in Utah or from any person present in Utah for the purpose of forming or financing the formation or enlargement of an insurer, holding company to form or acquire one or more insurers, or any corporation or unincorporated association to do or facilitate the doing of an insurance business in Utah or elsewhere, unless the person has obtained the appropriate organization or solicitation permit under Chapter 5, 6, 7, 8, or 9, and filed any required statement under Chapter 16.
(2) Any person obtaining the appropriate organization
or solicitation permit under this code is exempt from compliance
with Title 61.
1985
31A-4-102 Qualified insurers.
(1) A person may not conduct an insurance business in Utah, either in person, through agents or brokers, or through the mail or any other method of communication, except:
(a) an insurer authorized to do business in Utah under Title 31A, Chapter 5, 7, 8, 9, 10, 11, 13, or 14, within the limits of its certificate of authority;
(b) a joint underwriting group under Section 31A-2-214 or 31A-20-102 ;
(c) an insurer doing business under Section 31A-15-103 ;
(d) a person who, pursuant to Section 31A-1-105 , submits to the commissioner a certificate from the United States Department of Labor, or such other evidence as satisfies the commissioner, that the laws of Utah are preempted with respect to specified activities of that person by Section 514 of the Employee Retirement Income Security Act of 1974 or other federal law; or
(e) a person exempt from the application of the Insurance Code under Section 31A-1-103 and all other applicable statutes.
(2) As used in this section, "insurer" includes a bail
bond surety company, as defined in Section
31A-35-102
.
1998
31A-4-103 Certificate of authority.
(1) Each certificate of authority issued by the commissioner shall specify:
(a) the name of the insurer;
(b) the kinds of insurance the insurer is authorized to transact in Utah; and
(c) any other information the commissioner requires.
(2) A certificate of authority issued under this chapter remains in force until:
(a) the certificate is not renewed; or
(b) under Subsection (3), the certificate of authority is:
(i) revoked; or
(ii) suspended.
(3) (a) After an adjudicative proceeding under Title 63, Chapter 46b, Administrative Procedures Act, if the commissioner makes a finding described in Subsection (3)(b), the commissioner may:
(i) revoke a certificate of authority;
(ii) suspend a certificate of authority for a period not to exceed 12 months; or
(iii) limit a certificate of authority.
(b) The commissioner may take any action described in Subsection (3)(a) if the commissioner finds the insurer has:
(i) failed to pay when due any fee due under Section 31A-3-103 ;
(ii) violated or failed to comply with:
(A) this title;
(B) a rule made under Subsection 31A-2-201 (3); or
(C) an order issued under Subsection 31A-2-201 (4); or
(iii) engaged in methods and practices in the conduct of business that endanger the legitimate interests of customers and the public.
(c) An order suspending a certificate of authority shall specify:
(i) the conditions and terms imposed on the insurer during the suspension; and
(ii) the conditions and procedures for reinstatement from suspension.
(d) The commissioner may place limitations on a certificate of authority at the time the certificate of authority is issued based on information contained in the application for the certificate of authority.
(e) An order limiting a certificate of authority that is issued under Subsection (3)(a) or (3)(d) shall specify:
(i) the period of the limitation;
(ii) the conditions of the limitation; and
(iii) the procedures for removing the limitation.
(4) Subject to the requirements of this section and in accordance with Title 63, Chapter 46a, Utah Administrative Rulemaking Act, the commissioner may by rule prescribe procedures to renew or reinstate a certificate of authority.
(5) An insurer under this chapter whose certificate of authority is suspended or revoked, but that continues to act as an authorized insurer, is subject to the penalties for acting as an insurer without a certificate of authority.
(6) Any insurer holding a certificate of authority in this state shall immediately report to the commissioner a suspension or revocation of that insurer's certificate of authority in any:
(a) state;
(b) the District of Columbia; or
(c) a territory of the United States.
(7) (a) An order revoking a certificate of authority under Subsection (3) may specify a time within which the former authorized insurer may not apply for a new certificate of authority, except that the time may not exceed five years from the date on which the certificate of authority is revoked.
(b) If no time is specified in an order revoking a certificate of authority under Subsection (3), the former authorized insurer may not apply for a new certificate of authority for five years from the date on which the certificate of authority is revoked without express approval by the commissioner.
(8) (a) Subject to Subsection (8)(b), the insurer shall pay all fees under Section 31A-3-103 that would have been payable if the certificate of authority had not been suspended or revoked, unless the commissioner, in accordance with rule, waives the payment of the fees by no later than the day on which:
(i) a suspension under Subsection (3) of an insurer's certificate of authority ends; or
(ii) a new certificate of authority is issued to an insurer whose certificate of authority is revoked under Subsection (3).
(b) If a new certificate of authority is issued more than
three years after the day on which a similar certificate
of authority was revoked, this Subsection (8) applies only
to the fees that would have accrued during the three years
immediately following the revocation.
2003
31A-4-104 Bar on local activity by persons not authorized.
A person not qualified under Section
31A-4-102
to do an insurance business may not, from offices
or by personnel or facilities located in Utah, solicit insurance
applications or transact insurance business in another jurisdiction.
1985
31A-4-105 Deposit required from domestic insurers.
Domestic insurers organized or operating under Chapter
5, 7, or 9 shall maintain a deposit under Section
31A-2-206
in the amount of the insurer's required capital
for stock insurers, or minimum permanent surplus for mutuals.
The commissioner may not issue a certificate of authority
to an insurer operating under one of these chapters until
the insurer complies with this section.
1995
31A-4-105.5 Deposit required from foreign insurers.
(1) (a) Foreign insurers operating under Chapter 14 shall maintain a deposit in the amount of the insurer's minimum required capital for stock insurers, or minimum required permanent surplus for mutual insurers.
(b) The deposit shall be held for the benefit of all policyholders and may be maintained with an official of some other state designated by law to accept the deposit.
(2) The commissioner may not issue or renew a certificate
of authority to an insurer until the insurer complies with
this section.
1994
31A-4-106 Provision of health care.
(1) As used in this section, "health care provider" has the same definition as in Section 78-14-3 .
(2) Except under Subsection (3) or (4), a person may not directly or indirectly provide health care, or arrange for, manage, or administer the provision or arrangement of, collect advance payments for, or compensate providers of health care unless authorized to do so or employed by someone authorized to do so under Chapter 5, 7, 8, 9, or 14.
(3) Subsection (2) does not apply to:
(a) a natural person or professional corporation that alone or with others professionally associated with the natural person or professional corporation, and without receiving consideration for services in advance of the need for a particular service, provides the service personally with the aid of nonprofessional assistants;
(b) a health care facility as defined in Section 26-21-2 which:
(i) is licensed or exempt from licensing under Title 26, Chapter 21; and
(ii) does not engage in health care insurance as defined under Section 31A-1-301 ;
(c) a person who files with the commissioner under Section 31A-1-105 a certificate from the United States Department of Labor, or other evidence satisfactory to the commissioner, showing that the laws of Utah are preempted under Section 514 of the Employee Retirement Income Security Act of 1974 or other federal law;
(d) a person licensed under Chapter 23a, Insurance Marketing - Licensing Producers, Consultants, and Reinsurance Intermediaries, who has arranged for the insurance of all services under:
(i) Subsection (2) by an insurer authorized to do business in Utah;
(ii) Section 31A-15-103 ; or
(iii) works for an uninsured employer that complies with Chapter 13; or
(e) an employer that self-funds its obligations to provide health care services or indemnity for its employees if the employer complies with Chapter 13.
(4) A person may not provide administrative or management services for any other person subject to Subsection (2) and not exempt under Subsection (3) unless the person is an authorized insurer under Chapter 5, 7, 8, 9, or 14, or complies with Chapter 25.
(5) It is unlawful for any insurer or person providing,
administering, or managing health care insurance under Chapter
5, 7, 8, 9, or 14 to enter into a contract that limits a
health care provider's ability to advise the health care
provider's patients or clients fully about treatment options
or other issues that affect the health care of the health
care provider's patients or clients.
2003
31A-4-107 Other business.
(1) As used in this section, "business reasonably incidental to insurance business" includes:
(a) in the case of an insurer authorized to transact title insurance:
(i) preparing or selling abstracts of title and related documents; and
(ii) providing escrow services in connection with real estate transactions, or other services incidental to the sale or transfer of insurance related to the sale or transfer of real property, except the sale of other kinds of insurance related to the sale or transfer of real property; and
(b) the business that could be done through subsidiaries authorized under Subsection 31A-5-218 (3) or, in the case of a nondomestic insurer, through corporations that would be authorized under Subsection 31A-5-218 (3) if the insurer were a domestic insurer.
(2) No domestic insurer may engage, directly or indirectly, in any business other than insurance and business reasonably incidental to its insurance business, except as specifically authorized by Section 31A-5-218 or other law in this state.
(3) No nondomestic insurer may engage in this state in
any business forbidden to a domestic insurer, nor may the
insurer engage in that type of business elsewhere if the
commissioner orders the nondomestic insurer to cease doing
that type of business upon finding that doing that business
is not consistent with the interests of its insureds, creditors,
or the public in this state.
2002
31A-4-108 Power to hold property in other than own name.
(1) An insurer shall hold all investments and deposits of its funds in its own name except:
(a) securities kept under a custodial agreement or trust arrangement with a bank, securities firm's trust company, or trust company approved by the commissioner, which may be issued in the name of a nominee of the bank, securities firm's trust company, or trust company; and
(b) securities that may be acquired and held in bearer form.
(2) The insurer shall take steps which the commissioner
reasonably prescribes by rule or order to safeguard the securities
and to ensure that they are not loaned to other insurers,
affiliated or not, to mislead the commissioner about the
true financial condition of either the lending or the borrowing
insurer.
1995
31A-4-109 Insurers as fundholders.
All of an insurer's assets shall be held, invested, and
disbursed for the use and benefit of the insurer. No policyholder,
member, or beneficiary may have or acquire individual rights
in these assets or become entitled to an apportionment or
the surrender of any part of these assets, except as provided
in this title or by contract. An insurer may create, maintain,
invest, disburse, and apply any special funds necessary to
carry out any purpose permitted by the laws of this state
and the articles and bylaws of the insurer.
1986
31A-4-110 Duty of insurers to report abandoned property.
All insurers doing business in Utah shall report under
Section
67-4a-301
any property presumed abandoned under Title
67, Chapter 4a, Part 2.
1995
31A-4-111 Authority to insure with certain insurers.
A person, government, governmental agency, state, political
subdivision of the state, public or private corporation,
board, association, estate, trustee, or fiduciary may purchase
nonassessable policies of insurance issued by an insurer
under Chapter 5, 7, 8, or 14, which is authorized to write
that type of insurance under this code. These authorized
insurers may issue that type of insurance to any of the persons
named above.
1995
31A-4-112 Political activities.
(1) Title 36, Chapter 11, Lobbyist Disclosure and Regulation Act, applies to the lobbying efforts of every person subject to regulation under this title.
(2) Except insurers with excess surplus, an insurer doing business in Utah may not directly or indirectly pay or use, or offer or agree to pay or use any money or thing of value:
(a) for or in aid of any political office;
(b) for the nomination for the political office; or
(c) for reimbursement or indemnification of any person
for money or property used to aid any political office.
1996
31A-4-113 Annual statements.
(1) (a) Each authorized insurer shall annually, on or before March 1, file with the commissioner a true statement of its financial condition, transactions, and affairs as of December 31 of the preceding year.
(b) The statement required by Subsection (1)(a) shall be:
(i) verified by the oaths of at least two of the insurer's principal officers; and
(ii) in the general form and provide the information as prescribed by the commissioner by rule.
(c) The commissioner may, for good cause shown, extend the date for filing the statement required by Subsection (1)(a), except that the deadline for filing fee payment may not be extended.
(2) The annual statement of an alien insurer shall:
(a) relate only to its transactions and affairs in the United States unless the commissioner requires otherwise; and
(b) be verified by:
(i) the insurer's United States manager; or
(ii) the insurer's authorized officers.
2001
31A-4-113.5 Filing requirements - National Association of Insurance Commissioners.
(1) (a) Each domestic, foreign, and alien insurer who is authorized to transact insurance business in this state shall annually, on or before March 1, file with the National Association of Insurance Commissioners a copy of the insurer's:
(i) annual statement convention blank; and
(ii) any additional filings required by the commissioner for the preceding year.
(b) The information filed with the National Association of Insurance Commissioners under Subsection (1)(a) shall:
(i) be in the format and scope required by the commissioner; and
(ii) include:
(A) the signed jurat page; and
(B) the actuarial certification.
(c) Any amendments and addendums to an annual statement that are filed with the commissioner shall be filed by the insurer with the National Association of Insurance Commissioners.
(d) At the time an insurer makes a filing under this Subsection (1), the insurer shall pay any filing fees assessed by the National Association of Insurance Commissioners.
(e) A foreign insurer that is domiciled in a state that has a law substantially similar to this section shall be considered to be in compliance with this section.
(2) All financial analysis ratios and examination synopses concerning insurance companies that are submitted to the department by the Insurance Regulatory Information System are confidential and may not be disclosed by the department.
(3) The commissioner may suspend, revoke, or refuse to renew the certificate of authority of any insurer failing to:
(a) file the annual statement as required by Subsection (1)(a) when due or within any extension of time granted for good cause by:
(i) the commissioner; or
(ii) the National Association of Insurance Commissioners; or
(b) pay by the time specified in Subsection (3)(a) a fee the insurer is required to pay under this section to:
(i) the commissioner; or
(ii) the National Association of Insurance Commissioners.
2003
31A-4-114 Powers of a reciprocal insurer and interinsurance exchange.
(1) Every reciprocal insurer or interinsurance exchange may:
(a) purchase, receive, own, hold, and lease its property;
(b) mortgage, pledge, or encumber its property by deed of trust or otherwise; and
(c) manage and sell real property to fulfill its purposes, including:
(i) making investments for the production of income; or
(ii) transacting its business in a convenient manner.
(2) The attorney-in-fact designated by the subscribers
of the reciprocal or interinsurance exchange shall execute
any contract, which includes deeds, leases, mortgages, deeds
of trust, purchase or sale agreements, or any other contract,
in the name of the reciprocal insurer or interinsurance exchange.
1990
31A-4-115 Plan of orderly withdrawal.
(1) (a) When an insurer intends to withdraw from writing a line of insurance in this state or to reduce its total annual premium volume by 75% or more, the insurer shall file with the commissioner a plan of orderly withdrawal.
(b) For purposes of this section, a discontinuance of a health benefit plan pursuant to one of the following provisions is a withdrawal from a line of insurance:
(i) Subsection 31A-30-107 (3)(e); or
(ii) Subsection 31A-30-107.1 (3)(e).
(2) An insurer's plan of orderly withdrawal shall:
(a) indicate the date the insurer intends to begin and complete its withdrawal plan; and
(b) include provisions for:
(i) meeting the insurer's contractual obligations;
(ii) providing services to its Utah policyholders and claimants;
(iii) meeting any applicable statutory obligations; and
(iv) (A) the payment of a withdrawal fee of $50,000 to the Utah Comprehensive Health Insurance Pool if:
(I) the insurer is an accident and health insurer; and
(II) the insurer's line of business is not assumed or placed with another insurer approved by the commissioner; or
(B) the payment of a withdrawal fee of $50,000 to the department if:
(I) the insurer is not an accident and health insurer; and
(II) the insurer's line of business is not assumed or placed with another insurer approved by the commissioner.
(3) The commissioner shall approve a plan of orderly withdrawal if the plan adequately demonstrates that the insurer will:
(a) protect the interests of the people of the state;
(b) meet the insurer's contractual obligations;
(c) provide service to the insurer's Utah policyholders and claimants; and
(d) meet any applicable statutory obligations.
(4) Section 31A-2-302 governs the commissioner's approval or disapproval of a plan for orderly withdrawal.
(5) The commissioner may require an insurer to increase the deposit maintained in accordance with Section 31A-4-105 or Section 31A-4-105.5 and place the deposit in trust in the name of the commissioner upon finding, after an adjudicative proceeding that:
(a) there is reasonable cause to conclude that the interests of the people of the state are best served by such action; and
(b) the insurer:
(i) has filed a plan of orderly withdrawal; or
(ii) intends to:
(A) withdraw from writing a line of insurance in this state; or
(B) reduce the insurer's total annual premium volume by 75% or more.
(6) An insurer is subject to the civil penalties under Section 31A-2-308 , if the insurer:
(a) withdraws from writing insurance in this state; or
(b) reduces its total annual premium volume by 75% or more in any year without having submitted a plan or receiving the commissioner's approval.
(7) An insurer that withdraws from writing all lines of insurance in this state may not resume writing insurance in this state for five years unless:
(a) the commissioner finds that the prohibition should be waived because the waiver is:
(i) in the public interest to promote competition; or
(ii) to resolve inequity in the marketplace; and
(b) the insurer complies with Subsection 31A-30-108 (5), if applicable.
(8) The commissioner shall adopt rules necessary to implement
this section.
2002
31A-4-116 Adverse benefit determination procedures.
(1) If an insurer has established a complaint resolution body or grievance appeal board, the body or board shall include at least one consumer representative.
(2) Adverse benefit determination procedures for health
insurance policies and health maintenance organization contracts
shall be established in accordance Section
31A-22-629
.
2002
