HB 58 — Insurance Code Modifications

(c)(c)(i) (i) On demand, an examinee under Subsection (1)(a) shall make available to the commissioner for examination:

and (B)- to7 the- extentH.B. reasonably necessary for an examination, an account, record, file, document, or evidence of a transaction of a person described under Subsection (1)(b).

(ii)58 ExceptEnrolled asCopy provided(B) into Subsectionthe (1)(c)(iii),extent failurereasonably tonecessary makefor an itemexamination, describedan inaccount, Subsectionrecord, (1)(c)file, (i)document, availableor isevidence concealmentof a transaction of recordsa person described under Subsection 31A-27a-207(1)(e).(1)(b).

(ii) Except as provided in Subsection (1)(c)(iii), failure to make an item described in Subsection (1)(c)(i) available is concealment of records under Subsection 31A-27a-207(1)(e).

(d)(d)(i) (i) The commissioner or an examiner may not remove an account, record, file, document, evidence of a transaction, or other property of an examinee from the examinee's offices unless:

(2)(2)(a) (a) Subject to the other provisions of this section, the commissioner shall examine as needed and as otherwise provided by law:

and - 9 - HB0058 compared with HB0058S02 (iii) any other licensee.

(d)- (i)8 Any- 25Enrolled personsCopy whoH.B. are policyholders, shareholders, or creditors of a domestic insurer may by verified petition demand a hearing under Section 31A-2-301 to determine whether the commissioner should conduct an unscheduled examination of the insurer.

58 (d)(i) Any 25 persons who are policyholders, shareholders, or creditors of a domestic insurer may by verified petition demand a hearing under Section 31A-2-301 to determine whether the commissioner should conduct an unscheduled examination of the insurer.

(e)(e)(i) (i) If the board of directors of a domestic insurer requests that the commissioner examine the insurer, the commissioner shall examine the insurer as soon as reasonably possible.

(3)(3)(a) (a) The commissioner may order an independent audit or examination by one or more [technical[ technical experts, including a certified public accountant or actuary] independent contractors, including certified public accountants, investment specialists, and information technology specialists:

- 10 - HB0058 compared with HB0058S02 (b) The commissioner may employ one or more independent contractors who are qualified by knowledge, skill, experience, training, or education to provide specialized assistance in an examination.

(4)(4)(a) (a) In lieu of all or a part of an examination under this section, the commissioner may accept- the9 report- ofH.B. an examination made by:

58 Enrolled Copy accept the report of an examination made by:

(5)(5)(a) (a) An examination may be comprehensive or limited with respect to the examinee's affairs and condition.

- 11 - HB0058 compared with HB0058S02 (6) To effectively administer this section, the commissioner:

and (b)- in10 accordance- withEnrolled TitleCopy 63G,H.B. Chapter 3, Utah Administrative Rulemaking Act, may make rules pertaining to:

58 (b) in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, may make rules pertaining to:

31A-2-205.31A-2-205 .

(1)(1)[(a)] [(a)] Except as provided in [Subsection (3)] Subsection (7), an examinee that is one of the following shall [reimburse the department] pay for the reasonable costs of [examinations][ examinations] an examination made under Sections 31A-2-203 and 31A-2-204:

- 12 - HB0058 compared with HB0058S02 [(iv) the administration and supervisory expense of:] [(A) the department;

and (d) an expense that the independent contractor necessarily incurs that the commissioner approves.- 11 - H.B.

58 Enrolled Copy approves.

[(2)] (6)(6)(a) (a) An insurer requesting the examination of one of [its] the insurer's producers shall pay the cost of the examination to the extent described in Subsections (2) through (4).[ ] (b) [Otherwise] If an insurer does not request the examination of one of the insurer's producers as described in Subsection (6)(a), the department shall pay the cost of examining a licensee [other than those specified under] except for a licensee listed in Subsection (1).

[(3)] (7)(7)(a) (a) On the examinee's request or at the commissioner's discretion, the department may pay all or part of the costs of an examination whenever the commissioner finds that [because of] based on the frequency of examinations or the examinee's financial condition[ of the examinee, ] :

- 13 - HB0058 compared with HB0058S02 (b) The commissioner shall include in the commissioner's annual report information about any instance in which the commissioner has applied this Subsection [(3)] (7).

[(4)] (8)(8)(a) (a) [A technical expert employed] An independent contractor the commissioner employs under Subsection 31A-2-203(3) shall present to the commissioner [a statement of all expenses incurred by the technical expert in conjunction with an examination] an invoice for each cost described in Subsection (3).

[(i)[(i)(A) (A) actual travel expenses;] [(B)- reasonable12 living- expenses;Enrolled Copy H.B.

58 [(B) reasonable living expenses;

and] [(ii) the compensation of department examiners involved in the examination.] [(d)[(d)(i) (i) The examined insurer shall certify the consolidated account of all charges and expenses for the examination.] [(ii) The examined insurer shall:] [(A) retain a copy of the consolidated account;

and] [(B) file a copy of the consolidated account with the department as a public record.] - 14 - HB0058 compared with HB0058S02 [(e) An annual report of examination charges paid by examined insurers directly to persons employed under Subsection 31A-2-203(3) or to department examiners shall be included with the department's budget request.] [(f)] (9) [Amounts paid directly by examined insurers to persons employed] An amount an examinee pays to an independent contractor the commissioner employs under Subsection 31A-2-203(3) or to a department [examiners] examiner may not be deducted from the department's appropriation.

[(5)] (10)(10)(a) (a) The amount payable under [Subsection (1) ] Subsections (1) through (3) is due 10 days after the day on which [the examinee is served with a detailed account of the costs] the commissioner directs the examinee to pay the invoice.

[(6)] (11)(11)(a) (a) The commissioner may require an examinee under Subsection (1), or an insurer requesting an examination under Subsection [(2)] (6), either before or during an examination, to make deposits with the state treasurer to pay the costs of examination.

(b) [Any ] The state treasurer shall hold a deposit [made] an examinee or an insurer makes under this Subsection [(6) shall be held] (11) in trust [by the state treasurer ]until [applied][ applied] the state treasurer applies the deposit to pay the department the costs payable under- this13 section.- H.B.

58 Enrolled Copy under this section.

31A-2-206.31A-2-206 .

and - 15 - HB0058 compared with HB0058S02 (ii) [is approved by ]the commissioner approves to have custody of deposited securities, whether physically, through the Federal Reserve book-entry system, or through a clearing corporation as defined under Subsection 70A-8-101(1).

(a)- first,14 for- anEnrolled examinationCopy costH.B. that an insurer has not paid in under Section 31A-2-205;

58 (a) first, for an examination cost that an insurer has not paid in under Section 31A-2-205;

or (b) delivering to the commissioner, on a form adopted by rule, a signed certificate of a custodian institution, describing securities qualifying for deposit under Subsection (7) that are on deposit - 16 - HB0058 compared with HB0058S02 with a clearing corporation or held in the Federal Reserve book-entry system in the name of the custodian institution, in trust for the purposes stated under this section, and that these securities are subject to the exclusive direction of the commissioner and [may not be withdrawn or transferred by any person] a person may not withdraw or transfer the securities, including the insurer owning the securities, without the commissioner's written approval.

(7)(7)(a) (a) [Deposits ] A deposit may consist of [any securities] a security authorized in Subsection (7)(b) for which there is a ready market if [they] the deposit:

(iii) tax anticipation bonds or notes, general obligation bonds, or revenue bonds of this- state15 or- ofH.B. any county, incorporated city or town, school district, or other political subdivision of this state, if the bonds or notes are rated AAA by Standard and Poor's or an equivalent nationally recognized rating agency;

58 Enrolled Copy this state or of any county, incorporated city or town, school district, or other political subdivision of this state, if the bonds or notes are rated AAA by Standard and Poor's or an equivalent nationally recognized rating agency;

and (v) any other security [approved by ]the commissioner approves that the commissioner considers an equivalent grade investment to [those] an authorized security enumerated under Subsections (7)(b)(7)(b)(i) (i) through (iv) based on tests of the safety of principal and liquidity.

(8)(8)(a) (a) Securities held on deposit shall be valued under Section 31A-17-401 as those investments are valued for life insurers, or at market, whichever is lower.

-(9)(a) 17 - HB0058 compared with HB0058S02 (9) (a) The state treasurer or custodian institution shall:

(c)(c)(i) (i) Depositors, the state treasurer, [any] a custodian institution, and the commissioner shall each keep a permanent record of securities deposited or held under this section and of any substitutions or withdrawals.

(10) A transfer of a deposited security, whether voluntary or by operation of law, is valid only [if approved in writing by ] if the commissioner approves the transfer in writing and [countersigned[ countersigned by ]the state treasurer or custodian institution countersigns the transfer.

(a)- receive16 interest- andEnrolled cashCopy dividendsH.B. accruing on the securities held for [its] the depositor's account;

58 (a) receive interest and cash dividends accruing on the securities held for [its] the depositor's account;

-(15)(a) 18 - HB0058 compared with HB0058S02 (15) (a) Upon the depositor's request and upon approval of the commissioner, any deposit or part of a deposit shall be released to, or on order of, the depositor to the extent not needed to satisfy requirements of this title.

31A-2-207.31A-2-207 .

or (d)- the17 needs- ofH.B. the public.

58 Enrolled Copy (d) the needs of the public.

and - 19 - HB0058 compared with HB0058S02 (b) a record of all certificates of authority and licenses issued by the commissioner.

(5)(5)(a) (a) [Prior to] Before October 1 of each year, the commissioner shall prepare an annual report to the governor which shall include, for the preceding calendar year, the information concerning the department and the insurance industry which the commissioner believes will be useful to the governor and the public.

(b) The report required by this Subsection (5) shall include the information required under Chapter 27a, Insurer Receivership Act, and Subsections 31A-2-106(2), [31A-2-205(3)][ 31A-2-205(3)] 31A-2-205(7), and 31A-2-208(3).

31A-2-310.31A-2-310 .

(1)- Service18 upon- theEnrolled commissionerCopy orH.B. lieutenant governor under Section 31A-2-309 is service on the principal, if:

58 (1) Service upon the commissioner or lieutenant governor under Section 31A-2-309 is service on the principal, if:

and] - 20 - HB0058 compared with HB0058S02 [(ii) a certificate of proof of service that meets the requirements of Subsection (3), dated and signed by the official designated in Section 31A-2-309;

and] (b) that official mails a copy of the process to the person to be served according to [Subsection[ (2)Subsection (b)](2)(b)] Subsection (2)(c)(i).

(2)(2)(a) (a) [The ] Upon request, the commissioner [and] or the lieutenant governor shall give [receipts][ receipts] a receipt for [and keep records of ]all process served through [them] the commissioner or the lieutenant governor.

[(b)] (c)(c)(i) (i) The commissioner or the lieutenant governor shall [immediately ]send by certified mail [one] a copy of the process [received] the commissioner or the lieutenant governor receives to the person to be served at that person's last known principal place of business, residence, or post-office address.

(3)(3)(a) (a) [Proof] The official designated in Section 31A-2-309 shall evidence proof of service [shall be evidenced ]by a certificate:

(i) [ by the official designated in Section 31A-2-309, ]showing service made upon [him][ him] the official and mailing by [him{][him,] {the official}[} ,] the official;

(4)- When19 process- isH.B. served under this section, the words "twenty days" in the first sentence of Rule 12(a) of the Utah Rules of Civil Procedure shall be changed to read "forty days." Section 7.

58 Enrolled Copy (4) When process is served under this section, the words "twenty days" in the first sentence of Rule 12(a) of the Utah Rules of Civil Procedure shall be changed to read "forty days." Section 7.

-31A-2-404 21. - HB0058 compared with HB0058S02 31A-2-404.

(1)(1)(a) (a) Notwithstanding the other provisions of this chapter, to the extent provided in this part, the commissioner shall administer and enforce the provisions in this title related to a title insurance matter.

(b)(b)(i) (i) The commissioner may impose a penalty:

(c)(c)(i) (i) Unless a provision of this title grants specific authority to the commission, the commissioner has authority over the implementation of this title related to a title insurance matter.

- 22 - HB0058 compared with HB0058S02 (i) the commission shall report to and update the commissioner on a regular basis related- to20 that- titleEnrolled insuranceCopy matter;H.B.

58 related to that title insurance matter;

(4)(4)(a) (a) The commission may make a rule under this title only:

- 23 - HB0058 compared with HB0058S02 (i) in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act;

and (iii)- if21 at- theH.B. time the commission files the commission's proposed rule and rule analysis with the Office of Administrative Rules in accordance with Section 63G-3-301, the commission provides the Real Estate Commission that same information.

58 Enrolled Copy (iii) if at the time the commission files the commission's proposed rule and rule analysis with the Office of Administrative Rules in accordance with Section 63G-3-301, the commission provides the Real Estate Commission that same information.

(5)(5)(a) (a) The commissioner shall annually report the information described in Subsection (5)(b) in writing to the commission.

{Section 8.

Section 31A-3-102 is amended to read:

} 31A-3-102.

Exclusive fees and taxes.

(1) The following are in place of any other license fee or license assessment that might otherwise be levied against a licensee by the state or a political subdivision of the state:

(a) subject to Subsection (4), taxes and fees under this chapter;

- 24 - HB0058 compared with HB0058S02 (b) the premium taxes under Title 59, Chapter 9, Taxation of Admitted Insurers;

(c) the fees under Section 31A-31-108;

and (d) the examination costs under Section 31A-2-205.

(2) The following are not subject to Title 59, Chapter 7, Corporate Franchise and Income Taxes:

(a) an insurer that is subject to premium taxes under Title 59, Chapter 9, Taxation of Admitted Insurers, regardless of whether the insurance company has a tax liability under that chapter;

(b) an insurance company that engages in a transaction that is subject to taxes under Section 31A-3-301 or 31A-3-302, regardless of whether the insurance company has a tax liability under that section;

and (c) a captive insurance company, except for a risk retention group, as provided in Section 31A-3-304 that pays a fee imposed under Section 31A-3-304.

(3) Unless otherwise exempt, a licensee under this title is subject to real and personal property taxes.

(4) A tax or fee under this chapter is not in place of a tax or fee a municipality or county imposes in accordance with Section 10-1-203 or 17-64-505.

31A-3-304.31A-3-304 .

(1)(1)(a) (a) A captive insurance company, other than a risk retention group, shall pay an annual fee imposed under this section to obtain or renew a certificate of authority.

(c) The annual fee for a captive insurance company organized as a risk retention group formed- in22 this- stateEnrolled asCopy aH.B. corporation or other limited liability entity under the Liability Risk Retention Act of 1986, U.S.C.

58 formed in this state as a corporation or other limited liability entity under the Liability Risk Retention Act of 1986, 15 U.S.C.

-(3)(a) 25 - HB0058 compared with HB0058S02 (3) (a) A captive insurance company that pays one of the following fees is exempt from Title 59, Chapter 7, Corporate Franchise and Income Taxes, and Title 59, Chapter 9, Taxation of Admitted Insurers:

(4) A captive insurance company shall pay the fee imposed by this section to the commissioner by June 1 of each year.

(5)(5)(a) (a) The commissioner shall deposit money received from a fee described in Subsection (3)(a) into the Captive Insurance Restricted Account.

(d)(d)(i) (i) The commissioner shall administer the Captive Insurance Restricted Account.

and- [(ii)]23 (B)- promoteH.B. the captive insurance industry in Utah.

58 Enrolled Copy and [(ii)] (B) promote the captive insurance industry in Utah.

and] - 26 - HB0058 compared with HB0058S02 [(ii)] (i) for fiscal year 2026[ and subsequent fiscal years], in excess of $1,668,500[.] ;

31A-4-113.31A-4-113 .

(1)(1)(a) (a) Each authorized insurer shall annually, on or before March 1, file with the commissioner and the NAIC a true statement of the authorized insurer's financial condition, transactions, and affairs as of December 31 of the preceding year.

[(c) The commissioner may, for good cause shown, extend the date for filing the statement required by Subsection (1)(a).] (2)(2)(a) (a) Each authorized insurer shall file with the commissioner and the NAIC a true statement of the insurer's financial condition, transactions, and affairs within 45 days after the close of the first, second, and third quarters of a calendar year.

(4)- The24 commissioner- may,Enrolled forCopy goodH.B. cause shown, extend the date for filing a statement required by this section.

58 (4) The commissioner may, for good cause shown, extend the date for filing a statement required by this section.

31A-4-113.5.31A-4-113.5 .

(1)(1)(a) - 27 - HB0058 compared with HB0058S02 (a) Each domestic, foreign, and alien insurer who is authorized to transact insurance business in this state shall annually file with the NAIC:

(b)(b)(i) (i) The information [filed] an insurer files with the NAIC under Subsection [(1)(a)(i)][ (1)(a)(i)] (1)(a)(i)(A) shall:

(c) [The ] An insurer shall prepare the information [filed] an insurer files with the NAIC under [Subsection{][Subsection Subsections}(1)(a)(ii) {[} (1)(a)(ii){] (1)(a)(i)(B) and (C)} {[} shall be prepared] Subsections (1)(a)(i)(B) and (C){(C) ]} in accordance with the NAIC's Market Conduct Annual Statement Industry User Guide.

- 2825 - HB0058H.B. compared with HB0058S02 (3) The commissioner may suspend, revoke, or refuse to renew the certificate of authority of [any] an insurer [failing] that fails to:

58 Enrolled Copy (3) The commissioner may suspend, revoke, or refuse to renew the certificate of authority of [any] an insurer [failing] that fails to:

31A-5-420.31A-5-420 .

(2)(2)(a) (a) The mutual insurer or mutual insurance holding company shall make a reasonable classification of [its] the mutual insurer's or the mutual insurance holding company's participating policies and [its] the mutual insurer's or the mutual insurance holding company's assumed risks.

(5)(5)(a) - 29 - HB0058 compared with HB0058S02 (a) At least 30 days before the day on which a dividend distribution occurs, a mutual insurer or mutual insurance holding company shall file with the commissioner a schedule explaining the basis for the dividend distribution.

(b)- The26 commissioner- shallEnrolled keepCopy aH.B. schedule a mutual insurer or mutual insurance holding company files in accordance with this Subsection (5) confidential unless the commissioner finds that the interests of insureds and the public require that the commissioner make the schedule public.

58 (b) The commissioner shall keep a schedule a mutual insurer or mutual insurance holding company files in accordance with this Subsection (5) confidential unless the commissioner finds that the interests of insureds and the public require that the commissioner make the schedule public.

31A-8-101.31A-8-101 .

(1)(1)(a) (a) "Ambulance membership organization" means a person that offers an ambulance membership plan.

- 30 - HB0058 compared with HB0058S02 (i) an insurer licensed under Chapter 7, Nonprofit Health Service Insurance Corporations;

or (ii)- an27 individual- whoH.B. contracts to render professional or personal services that the individual directly performs;

58 Enrolled Copy (ii) an individual who contracts to render professional or personal services that the individual directly performs;

[(3)] (7)(7)(a) (a) "Limited health plan" means, except as [limited under ] provided in Subsection [(3)(b),] (7)(b):

and [(iii)] (C) for which the person is obligated to the enrollee to arrange for or directly provide the available and accessible services described in this Subsection [(3)(a).][ (3)(a).] (7)(a);

[(4)] (9)(9)(a) (a) "Nonprofit organization" or "nonprofit corporation" means an organization no part of the income of which is distributable to its members, trustees, or officers, or a nonprofit cooperative association, except in a manner allowed under Section 31A-8-406.

[(5)]- (10)28 "Organization"- meansEnrolled aCopy healthH.B. maintenance organization and limited health plan, unless used in the context of:

-58 31[(5)] -(10) HB0058"Organization" comparedmeans witha HB0058S02health (a)maintenance "organizationorganization expenses,"and whichlimited ishealth describedplan, unless used in Sectionthe 31A-8-208[.]context ;of:

(a) "organization expenses," which is described in Section 31A-8-208[.] ;

31A-8-102.31A-8-102 .

31A-8-103.31A-8-103 .

(1)(1)(a) (a) Except for exemptions specifically granted under this title, an organization is subject to regulation under all of the provisions of this title.

(D)- Chapter29 11,- MotorH.B. Clubs;

58 Enrolled Copy (D) Chapter 11, Motor Clubs;

and - 32 - HB0058 compared with HB0058S02 (F) Chapter 19a, Utah Rate Regulation Act;

(4)(4)(a) (a) Whenever in this chapter, Chapter 5, Domestic Stock and Mutual Insurance Corporations,- or30 Chapter- 14,Enrolled ForeignCopy Insurers,H.B. is made applicable to an organization, the application is:

-58 33Corporations, -or HB0058Chapter compared14, withForeign HB0058S02Insurers, (i)is ofmade thoseapplicable provisions that apply to aan mutualorganization, corporation if the organizationapplication isis: nonprofit;

(i) of those provisions that apply to a mutual corporation if the organization is nonprofit;

31A-8-105.31A-8-105 .

[(2)]- (b)31 furnish- healthH.B. care through providers which are under contract with the organization;

-58 34Enrolled -Copy HB0058[(2)] compared(b) withfurnish HB0058S02 [(3)] (c) contract with insurance companies licensed in this state or with health servicecare corporationsthrough authorizedproviders towhich doare businessunder incontract thiswith state for insurance, indemnity, or reimbursement for the cost of health care furnished by the organization;

[(3)] (c) contract with insurance companies licensed in this state or with health service corporations authorized to do business in this state for insurance, indemnity, or reimbursement for the cost of health care furnished by the organization;

31A-8-209.31A-8-209 .

(1)(1)(a) (a) A health maintenance organization being organized or operating under this chapter shall have and maintain a minimum capital or minimum permanent surplus of $100,000.

(2) - 3532 - HB0058Enrolled comparedCopy withH.B. HB0058S02 (a) [The] Except as provided in Subsection (3), the minimum required capital or minimum permanent surplus for a limited health plan may not:

58 (2)(a) [The] Except as provided in Subsection (3), the minimum required capital or minimum permanent surplus for a limited health plan may not:

(3)(3)(a) (a) An ambulance membership organization organized under this chapter shall:

- 36 - HB0058 compared with HB0058S02 (ii) post a surety bond with one or more surety companies that the commissioner approves in an amount of at least $5,000 for every 100 members of the ambulance membership- organization33 who- areH.B. residents of this state;

58 Enrolled Copy membership organization who are residents of this state;

31A-8-211.31A-8-211 .

(2)(2)(a) - 37 - HB0058 compared with HB0058S02 (a) The commissioner may exempt a health maintenance organization from the deposit requirement of Subsection (1) if:

and (iii) the health maintenance organization has $5,000,000 surplus in excess of the health- maintenance34 organization's- companyEnrolled actionCopy levelH.B. RBC as defined in Subsection 31A-17-601(8) (b).

58 health maintenance organization's company action level RBC as defined in Subsection 31A-17-601(8)(b).

(3)(3)(a) (a) [Each] Subject to Subsection (3)(c), each limited health plan authorized in this state shall maintain a deposit with the commissioner under Section 31A-2-206 in an amount equal to the minimum capital or permanent surplus plus 50% of the greater of:

or (ii)(ii)(A) (A) during the first year of operation, 10% of the limited health plan's projected uncovered expenditures for the first year of operation;

-31A-8-301 38. - HB0058 compared with HB0058S02 31A-8-301.

(2)(2)(a) (a) To do business in this state as an organization, a foreign corporation doing a similar business in other states shall incorporate a subsidiary and license [it] the subsidiary under Part 2, Domestic Organizations, for [its] the foreign organization's Utah business.

(3)- A35 foreign- ambulanceH.B. membership organization with a limited health plan certificate of authority that complies with Part 2, Domestic Organizations, is exempt from this part.

58 Enrolled Copy (3) A foreign ambulance membership organization with a limited health plan certificate of authority that complies with Part 2, Domestic Organizations, is exempt from this part.

Section 1931A-8-303 is enacted to read:

31A-8-303.31A-8-303 .

31A-8-404.31A-8-404 .

- 39 - HB0058 compared with HB0058S02 (3) [ ]The commissioner may at any time require an audit of an organization's quality control system.

(7) [ ]All information, interviews, reports, statements, memoranda, or other data furnished by reason of the audit and any findings or conclusions of the auditors are privileged and are not subject to discovery, use, or receipt in evidence in [any] a legal proceeding except hearings before the commissioner [or the director of the Department of Health ]concerning] concerning alleged violations of the provisions of this chapter.

Section- 21.36 - Enrolled Copy H.B.

58 Section 2121. is enacted to read:

Section 31A-8-601 is enacted to read:

Ambulance Membership Plans 31A-8-601.31A-8-601 .

Section 2231A-8-602 is enacted to read:

31A-8-602.31A-8-602 .

- 40 - HB0058 compared with HB0058S02 (6) An ambulance membership plan described in Subsection (5) shall:

(iii)- the37 services- theH.B. ambulance membership organization shall provide under the ambulance membership plan, and any limitation, exception, or exclusion;

58 Enrolled Copy (iii) the services the ambulance membership organization shall provide under the ambulance membership plan, and any limitation, exception, or exclusion;

Section 2331A-8-603 is enacted to read:

31A-8-603.31A-8-603 .

- 41 - HB0058 compared with HB0058S02 (2) The report described in Subsection (1) shall include:

and (d) any other information related to the ambulance membership organization that the commissioner- requires38 to- ensureEnrolled complianceCopy withH.B. this chapter.

(3)58 (a) The commissioner mayrequires not renew an ambulance membership organization's certificate of authority if the ambulance membership organization fails to fileensure acompliance complete annual report in accordance with Subsectionthis (1).chapter.

(3)(a) The commissioner may not renew an ambulance membership organization's certificate of authority if the ambulance membership organization fails to file a complete annual report in accordance with Subsection (1).

Section 2431A-8-604 is enacted to read:

31A-8-604.31A-8-604 .

(2)(2)(a) (a) If an individual who enters into an ambulance membership plan subsequently enrolls in the Medicaid program during the term of the ambulance membership plan, the individual shall notify the ambulance membership organization of the enrollment within 30 days of the day on which the individual enrolls in the Medicaid program.

- 42 - HB0058 compared with HB0058S02 (b) If the individual notifies the ambulance membership organization in accordance with Subsection (2)(2)(a), (a), the ambulance membership organization shall provide the individual a prorated refund of any consideration the individual pays for the period from the effective date of the Medicaid program enrollment through the day on which the ambulance membership plan expires.

Section 2531A-8-605 is enacted to read:

31A-8-605.31A-8-605 .

(1)- Each39 advertisement,- marketingH.B. material, brochure, ambulance membership card, presentation, and any other communication of an ambulance membership organization shall be truthful and not misleading in fact or in implication.

58 Enrolled Copy (1) Each advertisement, marketing material, brochure, ambulance membership card, presentation, and any other communication of an ambulance membership organization shall be truthful and not misleading in fact or in implication.

- 43 - HB0058 compared with HB0058S02 (3) An ambulance membership organization shall make the following general disclosures in writing, in bold, and in at least 12-point font on the first content page of an advertisement, marketing material, or brochure the ambulance membership organization makes available to prospective members or the public:

(5)- Before40 a- personEnrolled entersCopy intoH.B. an ambulance membership plan with an ambulance membership organization, the ambulance membership organization shall mail, give, or, with consent of the person, email to the person a separate document that, in bold and in at least 12-point font, states the following disclosures:

58 (5) Before a person enters into an ambulance membership plan with an ambulance membership organization, the ambulance membership organization shall mail, give, or, with consent of the person, email to the person a separate document that, in bold and in at least 12-point font, states the following disclosures:

and - 44 - HB0058 compared with HB0058S02 (f) if an enrollee cancels the ambulance membership plan before 30 days after the day on which the enrollee purchases the ambulance membership plan, the ambulance membership organization shall refund to the member:

31A-11-104.31A-11-104 .

(c)- Chapter41 23a,- PartH.B. 1, General Provisions, Part 4, Marketing Practices, and Part 5, Compensation of Producers and Consultants;

58 Enrolled Copy (c) Chapter 23a, Part 1, General Provisions, Part 4, Marketing Practices, and Part 5, Compensation of Producers and Consultants;

31A-14-206.31A-14-206 .

or - 45 - HB0058 compared with HB0058S02 (b) during the same three-year period, the foreign insurer's gross premiums written in this state constituted 15% or more of the insurer's total gross premiums written in the United States.

(2)(2)(a) (a) Subject to Subsection (3), an insurer determined by the commissioner to be commercially domiciled in this state may be subjected to Chapter 16, Insurance Holding Companies, Chapter 17, Determination of Financial Condition, Chapter 18, Investments, [Chapter 27, Delinquency Administrative Action Provisions] Chapter 27, Administrative Supervision of Insurers, and Chapter 27a, Insurer Receivership Act, and Chapter 27a, Part 4, Liquidation, Part 5, Asset Recovery, and Part 6, Claims, in the same manner and to the same extent as domestic insurers.

(3) The commissioner may exempt from the provisions of this section any commercially domiciled insurer if the commissioner determines that the insurer has assets physically located in this state or an asset to liability ratio sufficient to justify the conclusion that there is no reasonable danger that the operations or conduct of the business of the insurer could- present42 a- dangerEnrolled ofCopy lossH.B. to Utah policyholders.

58 could present a danger of loss to Utah policyholders.

31A-16-111.31A-16-111 .

(2)(2)(a) (a) The commissioner shall effect the sale required by Subsection (1) in the manner [which][ which] that, under the particular circumstances, appears most likely to result in the payment of the full market value - 46 - HB0058 compared with HB0058S02 for the stock by persons who have the collective competence, experience, financial resources, and integrity to obtain approval under Subsection 31A-16-103(8).

(3)(3)(a) (a) The proceeds from sales [made] a person makes under this section shall be distributed first to the person required by this section to sell the stock, but only up to the amount the person originally [paid by the person] paid for the securities.

(5)(5)[(a)] [(a)] A director or officer of an insurance holding company system violates this chapter if the director or officer knowingly:

or [(ii)] (b) permits any of the officers or agents of the insurer to engage in a transaction or investment- described43 in- SubsectionH.B. [(5)(a)(i)] (5)(a).

58 Enrolled Copy investment described in Subsection [(5)(a)(i)] (5)(a).

and] [(iii) any other matters that justice requires.] (6)(6)(a) - 47 - HB0058 compared with HB0058S02 (a) When [it appears to ]the commissioner suspects that any insurer or any director, officer, employee, or agent of the insurer, has committed a willful violation of this chapter, the commissioner may refer the violation to the appropriate prosecutor.

(b)(b)(i) (i) An insurer that willfully violates this chapter may be fined not more than $20,000.

31A-17-201.31A-17-201 .

(a) any of the following acquired or held in accordance with Sections 31A-18-105,[31A-18-105[ and] , 31A-18-106, and 31A-18-110:

or (iv)- a44 loan;- Enrolled Copy H.B.

58 (iv) a loan;

(3)(3)(a) - 48 - HB0058 compared with HB0058S02 (a) Subject to Subsection (5) and even if the assets could not otherwise be counted under this chapter, assets acquired in the bona fide enforcement of creditors' rights may be counted for the purposes of Subsection (1) and Sections 31A-18-105,[31A-18-105[ and] , 31A-18-106, and 31A-18-110:

(b)(b)(i) (i) The commissioner may allow reasonable extensions of the periods described in Subsection (3)(a), if disposal of the assets within the periods given is not possible without substantial loss.

31A-17-202.31A-17-202 .

Status of assets that are not "qualified assets." (1)(1)(a) (a) Except as provided in Subsection (1)(b), if an insurer owns assets that are not qualified assets under Section 31A-17-201, the assets shall be disregarded in determining and reporting the financial condition of the insurer.

(b) An insurer may invest [its] the insurer's funds in investments that are permitted under Section [31A-18-105] 31A-18-110 but in excess of the limits under [Sections 31A-18-103 and 31A-18-106] Section 31A-18-111 or other assets [approved by] that the commissioner approves and these assets may be recognized and reported in the financial- condition45 of- theH.B. insurer to the extent the insurer has excess surplus, as that term is defined under Section 31A-1-301.

58 Enrolled Copy financial condition of the insurer to the extent the insurer has excess surplus, as that term is defined under Section 31A-1-301.

31A-18-117.31A-18-117 .

- 49 - HB0058 compared with HB0058S02 (1) [Except as provided in Subsection (2), the ] The provisions of this chapter apply if there is a conflict between this chapter and another provision of state statute,statute[.] except:[.], [(2)]except: (a) Chapter 16, Insurance Holding Companies, purporting to authorize an insurer to make a particular investment, supersedes this chapter[.] if there is a conflict between this chapter and Chapter 16, Insurance Holding Companies;

[(2)] (a) Chapter 16, Insurance Holding Companies, purporting to authorize an insurer to make a particular investment, supersedes this chapter[.] if there is a conflict between this chapter and Chapter 16, Insurance Holding Companies;

31A-20-108.31A-20-108 .

[(2)] (3)(3)(a) (a) Except as provided under [Subsections (3) and (4) and under Section 31A-20-109] Subsection (4), an insurer authorized to do [an ]insurance business in Utah may not expose itself to loss on a single risk in an amount exceeding 10% of [its] the insurer's capital and surplus.

[(3)]- (4)46 (a)- TheEnrolled commissionerCopy mayH.B. adopt rules, after hearings held with notice as required by law, to specify the maximum exposure to which an assessable mutual may subject itself.

-58 50[(3)] -(4)(a) HB0058The comparedcommissioner withmay HB0058S02adopt (b)rules, Theafter ruleshearings describedheld inwith Subsectionnotice [(3)(a)]as (4)(a)required mayby providelaw, forto classificationsspecify ofthe insurancemaximum andexposure insurers to preservewhich thean solidityassessable ofmutual insurers.may subject itself.

(b) The rules described in Subsection [(3)(a)] (4)(a) may provide for classifications of insurance and insurers to preserve the solidity of insurers.

31A-21-310.31A-21-310 .

(2)(2)(a) (a) [Any ] An insurer may distribute a portion of surplus attributable to policies other than life insurance or annuities, in amounts and with classifications the board of directors determines to be fair and reasonable.

(d) [ ]The commissioner shall keep the schedule confidential[shall[shall be kept confidential by the commissioner ]unless] confidential unless the commissioner finds that the interests of insureds and the public require that [it be made] the commissioner make the schedule public.

(3)(3)(a) (a) [Any ] An insurer may distribute surplus to any class of policyholder, even if [their] the insurer's policies do not provide for [it] the distribution.

- 51 - HB0058 compared with HB0058S02 (4) [It is permissible to ] An insurer may provide an indivisible dividend to classes of policyholders- having47 more- thanH.B. one type of policy, including a combination of life or annuities with other types of insurance.

(5)58 (a)Enrolled TheCopy provisionspolicyholders ofhaving thismore sectionthan doone nottype applyof topolicy, aincluding member dividend that a mutualcombination insurerof life or mutualannuities insurancewith holdingother companytypes pays.of insurance.

(5)(a) The provisions of this section do not apply to a member dividend that a mutual insurer or mutual insurance holding company pays.

31A-22-309.31A-22-309 .

(1)(1)(a) (a) A person who has or is required to have direct benefit coverage under a policy [which][ which] that includes personal injury protection may not maintain a cause of action for general damages arising out of personal injuries alleged to have been caused by an automobile accident, except where the person [has sustained] sustains one or more of the following:

(2)(2)(a) (a) [Any ] An insurer issuing personal injury protection coverage under this part may only exclude from this coverage benefits:

- 52 - HB0058 compared with HB0058S02 (iii) to [any] an injured person, if the person's conduct contributed to the person's injury:

(iv) for [any] an injury [sustained by any person] a person sustains arising out of the use- of48 [any]- aEnrolled motorCopy vehicleH.B. while located for use as a residence or premises;

(v)58 foruse [any]of an injury due to war, whether [or not ]declared, civil war, insurrection, rebellion, or revolution, or to [any] an act or a conditionmotor incidentvehicle towhile [anylocated offor theuse foregoing]as a war,residence civil war, insurrection, rebellion, or revolution;{[premises; or]} (vi) for [any] an injury resulting from the radioactive, toxic, explosive, or other hazardous properties of nuclear materials{[.{]} ;

or}(v) {(vii) for [any] an injury adue personto sustainswar, arisingwhether from[or thenot use]declared, ofcivil anwar, insuredinsurrection, motorrebellion, vehicleor whilerevolution, theor person uses the insured motor vehicle to provide[any] transportationan networkact services,or asa thatcondition termincident isto defined[any inof Section 13-51-102.} (b) This Subsection (2) does not limit the exclusionsforegoing] thata maywar, becivil containedwar, ininsurrection, otherrebellion, typesor ofrevolution; coverage.

or (vi) for [any] an injury resulting from the radioactive, toxic, explosive, or other hazardous properties of nuclear materials.

(b) This Subsection (2) does not limit the exclusions that may be contained in other types of coverage.

(5)(5)(a) (a) Payment of the benefits provided for in Section 31A-22-307 shall be made on a monthly basis as expenses are incurred.

(b) Benefits for any period are overdue if [they are not paid] the insurer does not pay the benefits within 30 days after the day on which the insurer receives reasonable proof of the fact and amount of expenses incurred during the period.

- 53 - HB0058 compared with HB0058S02 (c) [ ]If reasonable proof is not supplied as to the entire claim, the amount supported by reasonable proof is overdue if not paid within 30 days after the insurer receives that proof[ is received by the insurer].

[(d)] (f)(f)(i) (i) The person entitled to the benefits may bring an action in contract to recover the expenses plus the applicable interest.

(ii)- [49 ]If- theH.B. insurer is required by the action to pay any overdue benefits and interest, the insurer is also required to pay a reasonable attorney's fee to the claimant.

(6)58 (a)Enrolled ExceptCopy as(ii) provided[ in]If Subsectionthe (6)(b),insurer [every]is arequired policyby [providing]the thataction providesto personalpay injuryany protectionoverdue coveragebenefits and interest, the insurer is subjectalso required to pay a reasonable attorney's fee to the following:claimant.

(6)(a) Except as provided in Subsection (6)(b), [every] a policy [providing] that provides personal injury protection coverage is subject to the following:

(c)(c)(i) (i) If the insurer of the person who would be held legally liable for the personal injuries sustained reimburses a no-fault insurer [prior to] before settling a third party liability claim with an injured person and subsequently determines that some or all of the reimbursed amount is needed to settle a third party claim, the insurer of the person who would be held legally liable for the personal injuries - 54 - HB0058 compared with HB0058S02 sustained shall provide written notice to the no-fault insurer that some or all of the reimbursed amount is needed to settle a third party liability claim.

31A-22-505.- 50 - Enrolled Copy H.B.

58 31A-22-505 .

and - 55 - HB0058 compared with HB0058S02 (B) members of the association to have voting privileges and representation on any governing board or committee;

(3)(3)(a) (a) The following shall pay the premium under a group insurance policy offering life insurance that an insurer issues to an association group:

(ii)- employer51 members,- fromH.B. funds contributed by the covered persons;

58 Enrolled Copy (ii) employer members, from funds contributed by the covered persons;

(4)(4)(a) (a) An association group that meets the requirements described under Subsection (1) shall disclose the following to each insured member:

- 56 - HB0058 compared with HB0058S02 (A) through agreement;

31A-22-605.31A-22-605 .

(2)- This52 section- appliesEnrolled toCopy allH.B. individual and franchise accident and health policies.

58 (2) This section applies to all individual and franchise accident and health policies.

- 57 - HB0058 compared with HB0058S02 (x) reductions;

(c) the content and format of the outline of coverage, in addition to that required under Subsection- (5);53 - H.B.

58 Enrolled Copy Subsection (5);

(b)(b)(i) - 58 - HB0058 compared with HB0058S02 (i) prescribing caption or notice requirements designed to inform prospective insureds that particular insurance coverages are not Medicare supplement insurance;

(6)(6)(a) (a) A policy covered by this section may be issued only if [it] the policy meets the minimum standards established by the commissioner under Subsection (3), an outline of coverage accompanies the policy or is delivered to the applicant at the time of the application, and, except with respect to direct response insurance policies, an acknowledged receipt is provided to the insurer.[ ] (b) The outline of coverage shall include:

[(d)]- (iv)54 a- statementEnrolled ofCopy theH.B. renewal provisions, including any reservation by the insurer of a right to change premiums;

58 [(d)] (iv) a statement of the renewal provisions, including any reservation by the insurer of a right to change premiums;

(8)(8)(a) (a) Notwithstanding Subsection 31A-22-606(1), limited accident and health policies or certificates issued to [persons] an individual eligible for Medicare shall contain a notice prominently printed on or attached to the cover or front page which states that the policyholder or certificate holder has the right to return the policy for any reason within 30 days after its delivery and to have the premium refunded.

- 59 - HB0058 compared with HB0058S02 (b) This Subsection (8) does not apply to a policy issued to an employer group.

31A-22-646.31A-22-646 .

(c) ["Dentist" ] "Dental provider" means an individual licensed under Title 58, Chapter 69,- Dentist55 and- DentalH.B. Hygienist Practice Act.

(2)58 (a)Enrolled ThisCopy section69, appliesDentist to:and Dental Hygienist Practice Act.

(2)(a) This section applies to:

or (ii)(ii)(A) - 60 - HB0058 compared with HB0058S02 (A) the dental services are not reimbursed by the dental plan;

Section 3831A-22-646.2 is enacted to read:

31A-22-646.2.31A-22-646.2 .

(1)(1)(a) (a) Notwithstanding Section 31A-1-103, an insurer that provides coverage for dental services that are completed in Utah to a patient that is a Utah resident shall comply with all Utah laws related to covered services, non-covered services, and reimbursement for services if 10% or more of the certificate holders or insureds are residents of this state.

(2)(2)(a) (a) A signed provider agreement shall govern the contractual rights and obligations of the parties for dental services provided in Utah.

(c)- An56 insurer- mayEnrolled notCopy requireH.B. a dental provider to comply with a provider handbook or policy that is not provided to the dental provider.

58 (c) An insurer may not require a dental provider to comply with a provider handbook or policy that is not provided to the dental provider.

31A-22-650.31A-22-650 .

- 61 - HB0058 compared with HB0058S02 (b) "Authorization" means a determination by an insurer that for health care with a preauthorization requirement:

(2)(2)(a) (a) An insurer may not modify an existing requirement for authorization unless, at least 30 days before the day on which the modification takes effect, the insurer:

(i)- complying57 with- SubsectionH.B. (2)(a) would create a danger to the enrollee's health or safety;

58 Enrolled Copy (i) complying with Subsection (2)(a) would create a danger to the enrollee's health or safety;

- 62 - HB0058 compared with HB0058S02 (iv) on the day on which the network provider renders the drug, device, or covered service to the enrollee:

(3)(3)(a) (a) An insurer that receives a request for authorization shall treat the request as a pre-service claim as that term is defined in 29 C.F.R.

(d)- The58 appeal- ofEnrolled anCopy adverseH.B. determination requested by a physician regarding clinical or medical necessity of a drug, may only be reviewed by an individual who is currently licensed in a state, district, or territory of the United States as:

58 (d) The appeal of an adverse determination requested by a physician regarding clinical or medical necessity of a drug, may only be reviewed by an individual who is currently licensed in a state, district, or territory of the United States as:

or - 63 - HB0058 compared with HB0058S02 (ii) consults with a specialist who has knowledge of the medical condition or disease of the enrollee for whom the authorization is requested regarding the request before making the determination.

(4)(4)(a) (a) An insurer that removes a drug from the insurer's formulary shall:

(5)(5)(a) (a) Each April 1, an insurer with a preauthorization requirement shall report to the department, for the previous calendar year, the percentage of authorizations, not including a claim involving urgent care as defined in 29 C.F.R.

(A)- were59 approved;- H.B.

58 Enrolled Copy (A) were approved;

and - 64 - HB0058 compared with HB0058S02 (iii) for urgent pre-service preauthorization requests, the percentage of individual service requests that:

31A-22-701.31A-22-701 .

(i) to which a group life insurance policy may be issued under Section 31A-22-502, 31A-22-503,- 31A-22-504,60 31A-22-505,- 31A-22-506,Enrolled 31A-22-507,Copy orH.B. 31A-22-508[, or 31A-22-509];

58 31A-22-503, 31A-22-504, 31A-22-505, 31A-22-506, 31A-22-507, or 31A-22-508[, or 31A-22-509];

- 65 - HB0058 compared with HB0058S02 (ii) the group is actuarially sound;

and (d)- may61 be- issuedH.B. only to:

58 Enrolled Copy (d) may be issued only to:

- 66 - HB0058 compared with HB0058S02 (iii) an institution of learning, including a school district, a school jurisdictional unit, or the head, principal, or governing board of a school jurisdictional unit, as policyholder, covering students, teachers, or employees;

or (c)- both62 risks- describedEnrolled inCopy SubsectionsH.B. (3)(a) and (b).

58 (c) both risks described in Subsections (3)(a) and (b).

31A-22-2002.31A-22-2002 .

[(1) "Applicant" means:] - 67 - HB0058 compared with HB0058S02 [(a) when referring to an individual limited long-term care insurance policy, the person who seeks to contract for benefits;

and] [(b) to an eligible group, as described under Subsection 31A-22-701(1).] [(4)] (1)(1)[(a)] [(a)] "Limited long-term care"[ insurance"] means [an insurance policy, endorsement, or rider that is advertised, marketed, offered, or designed to provide ]coverage:] coverage:

[(b) "Limited long-term care insurance" includes a policy or rider described in Subsection (4)(a) that provides for payment of benefits based on cognitive impairment or the loss of functional capacity.] (2)(2)(a) (a) "Limited long-term care insurance" means an insurance policy, endorsement, or rider that is advertised, marketed, offered, or designed to provide coverage for limited long-term care.

(i)- basic63 Medicare- supplementH.B. insurance coverage;

58 Enrolled Copy (i) basic Medicare supplement insurance coverage;

- 68 - HB0058 compared with HB0058S02 (viii) specified disease or specified accident coverage;

31A-22-2006.31A-22-2006 .

and] [(g) establishing the rules regarding contingent benefits upon lapse, including:] [(i)- a64 determination- ofEnrolled theCopy specifiedH.B. period of time during which a contingent benefit upon lapse will be available;

58 [(i) a determination of the specified period of time during which a contingent benefit upon lapse will be available;

- 69 - HB0058 compared with HB0058S02 Section 43.

31A-23a-111.31A-23a-111 .

(a)- a65 licensee- noH.B. longer meets the qualifications pertaining to a line of authority[ are no longer met by the licensee];

58 Enrolled Copy (a) a licensee no longer meets the qualifications pertaining to a line of authority[ are no longer met by the licensee];

or - 70 - HB0058 compared with HB0058S02 (iv) is voluntarily surrendered;

(5)(5)(a) (a) If the commissioner makes a finding under Subsection (5)(b), as part of an adjudicative proceeding under Title 63G, Chapter 4, Administrative Procedures Act, the commissioner may:

(B)- a66 rule- thatEnrolled isCopy validH.B. under Subsection 31A-2-201(3);

58 (B) a rule that is valid under Subsection 31A-2-201(3);

- 71 - HB0058 compared with HB0058S02 (v) fails to meet the same good faith obligations in claims settlement that is required of admitted insurers;

or (B)- a67 misdemeanor- involvingH.B. fraud, misrepresentation, theft, or dishonesty;

58 Enrolled Copy (B) a misdemeanor involving fraud, misrepresentation, theft, or dishonesty;

- 72 - HB0058 compared with HB0058S02 (xvii) has had an insurance license or other professional or occupational license, or an equivalent to an insurance license or registration, or other professional or occupational license or registration:

(c) For purposes of this section, if a license is held by an agency, both the agency [itself ]and] any- individual68 designated- underEnrolled theCopy licenseH.B. are considered to be the holders of the license.

58 and any individual designated under the license are considered to be the holders of the license.

or - 73 - HB0058 compared with HB0058S02 (B) knowingly participates in the act or failure to act that is the ground for suspending, revoking, or limiting the license;

or (iii)(iii)(A) (A) the individual;

(iv)- a69 violation- ofH.B. an insurance law or rule;

58 Enrolled Copy (iv) a violation of an insurance law or rule;

(8)(8)(a) (a) An order revoking a license under Subsection (5) or an agreement to surrender a license in lieu of administrative action may specify a time, not to exceed five years, within which the former licensee may not apply for a new license.

- 74 - HB0058 compared with HB0058S02 (b) If no time is specified in an order or agreement described in Subsection (8)(a), the former licensee may not apply for a new license for five years from the day on which the order or agreement is made without the express approval by the commissioner.

31A-23a-202.31A-23a-202 .

(2)(2)(a) (a) The commissioner may not state a continuing education requirement in terms of formal education.

(b) The commissioner may state a continuing education requirement in terms of hours of insurance-insurance-related related instruction received.

(3)(3)(a) (a) The commissioner shall impose continuing education requirements in accordance with a two-year licensing period in which the licensee meets the requirements of this Subsection (3).

(b)(b)(i) (i) Except as provided in this section, the continuing education requirements shall require:

(ii)- An70 hour- ofEnrolled continuingCopy educationH.B. in accordance with Subsection (3)(b)(i) may be obtained through:

58 (ii) An hour of continuing education in accordance with Subsection (3)(b)(i) may be obtained through:

- 75 - HB0058 compared with HB0058S02 (D) experience credit;

(iii)(iii)(A) (A) Notwithstanding Subsections (3)(b)(i)(A) and (B), an individual title insurance producer is required to complete 12 credit hours of continuing education for every two-year licensing period, with 3 of the credit hours being ethics courses unless the individual title insurance producer is licensed in this state as an individual title insurance producer for 20 or more consecutive years.

(C) Notwithstanding Subsection (3)(b)(iii)(A) or (B), an individual title insurance producer is considered to have met the continuing education requirements imposed under Subsection (3)(b)(iii)(3)(b)(iii)(A) (A) or (B) if at the time of license renewal the individual title insurance producer:

(d)(d)(i) (i) A licensee is exempt from continuing education requirements under this section if:

(B) the license does not have a continuous lapse for a period of more than one year,- except71 for- aH.B. license for which the licensee has had an exemption approved before May 11, 2011;

58 Enrolled Copy year, except for a license for which the licensee has had an exemption approved before May 11, 2011;

- 76 - HB0058 compared with HB0058S02 (i) publish a list of insurance professional designations whose continuing education requirements can be used to meet the requirements for continuing education under Subsection (3)(b);

(6)- The72 requirements- ofEnrolled thisCopy sectionH.B. apply only to a producer or consultant who is an individual.

58 (6) The requirements of this section apply only to a producer or consultant who is an individual.

-31A-23a-203 77. - HB0058 compared with HB0058S02 31A-23a-203.

[(3)[(3)(a) (a) A resident producer with an accident and health line of authority may only sell long-term care insurance if the producer:] [(i) initially completes a minimum of three hours of long-term care training before selling long-term care coverage;

and] [(ii) after completing the training required by Subsection (3)(a)(i), completes a minimum of three hours of long-term care training during each subsequent two-year licensing period.] [(b) A course taken to satisfy a long-term care training requirement may be used toward satisfying a producer continuing education requirement.] [(c) Long-term care training is not a continuing education requirement to renew a producer license.] [(d) An insurer that issues long-term care insurance shall demonstrate to the commissioner, upon request, that a producer who is appointed by the insurer and who sells long-term care insurance coverage is in compliance with this Subsection (3).] [(4)]- (3)73 (a)- AH.B. resident producer with a property line of authority may only sell flood insurance coverage under the National Flood Insurance Program if the producer completes a minimum of three hours of flood insurance training related to the National Flood Insurance Program before selling flood insurance coverage.

58 Enrolled Copy [(4)] (3)(a) A resident producer with a property line of authority may only sell flood insurance coverage under the National Flood Insurance Program if the producer completes a minimum of three hours of flood insurance training related to the National Flood Insurance Program before selling flood insurance coverage.

- 78 - HB0058 compared with HB0058S02 (d) An insurer that issues flood insurance shall demonstrate to the commissioner, upon request, that a producer who is appointed by the insurer and who sells flood insurance coverage is in compliance with this Subsection [(4)] (3).

31A-23a-203.5.31A-23a-203.5 .

and (b)- if74 the- coverageEnrolled requiredCopy byH.B. Subsection (1) is terminated during a resident individual producer's license term, requirements to:

58 (b) if the coverage required by Subsection (1) is terminated during a resident individual producer's license term, requirements to:

- 79 - HB0058 compared with HB0058S02 (a) the individual title insurance producer who is not designated by an agency title producer maintains the individual title insurance producer's own bond, policy, or other financial protection in accordance with Subsection [31A-23a-204(2)] 31A-23a-204(3);

31A-23a-204.31A-23a-204 .

[(1)] (2)(2)(a) (a) A person that receives a new license under this title as an agency title insurance producer shall at the time of licensure be owned or managed by at least one individual who is licensed for at least three of the five years immediately [preceding the date on] before the day on which the agency title insurance producer applies for a license with both:

and (ii)- an75 escrow- lineH.B. of authority.

58 Enrolled Copy (ii) an escrow line of authority.

and - 80 - HB0058 compared with HB0058S02 (ii) one or more individuals who are licensed with the escrow line of authority for the time period provided in Subsection [(1)(a)] (2)(a).

(e)(e)(i) (i) An individual who satisfies the requirements of this Subsection [(1)] (2) is known as a "qualifying licensee." (ii) [ ]At any given time, an individual may be a qualifying licensee for not more than two agency title insurance producers.

[(2)] (3)(3)(a) (a) An individual title insurance producer or agency title insurance producer [appointed[ appointed by an insurer] that an insurer appoints shall maintain:

(i)(i)(A) (A) a fidelity bond that covers loss of third party funds that the producer holds and covers theft of funds by an owner of the producer;

or (B) a [fidelity bond] crime insurance policythatpolicy that covers loss of third party funds that the producer holds and covers theft of funds by an owner of the producer;

(i) shall be supplied under a contract [approved by ]the commissioner approves to provide protection against the improper performance of [any] a service, including escrow- service,76 in- conjunctionEnrolled withCopy theH.B. issuance of a contract or policy of title insurance;

58 escrow service, in conjunction with the issuance of a contract or policy of title insurance;

- 81 - HB0058 compared with HB0058S02 (c) The Title and Escrow Commission may by rule, subject to Section 31A-2-404, exempt individual title insurance producer or agency title insurance producers from the requirements of this Subsection [(2)] (3) upon a finding that, and only [so long as] if, the required [policy or bond] insurance is generally unavailable at reasonable rates.

[(8)] (9)(9)(a) (a) A person licensed to practice law in Utah is exempt from the requirements of Subsections [(2)] (3) and [(3)] (4) if that person issues 12 or less policies in any 12-month period.

[(10)] (11) - 8277 - HB0058H.B. compared with HB0058S02 (a) The [department] commissioner may, in accordance with Title 63G, Chapter 4, Administrative Procedures Act, take [any of the following actions] an action described in Subsection (11)(b) against a title insurance producer if the title insurance producer:

(i)58 (A)Enrolled conductsCopy title[(10)] insurance(11)(a) businessThe without[department] commissioner may, in accordance with Title 63G, Chapter 4, Administrative Procedures Act, take [any of the following actions] an appointmentaction fromdescribed in Subsection (11)(b) against a title insurer;insurance producer if the title insurance producer:

(i)(A) conducts title insurance business without an appointment from a title insurer;

or [(e)] (v) post, at the title producer's business location, a notice of an action listed in Subsections [(10)[(10)(a)] (a)] (11)(b)(i) through [(10)(d)] (iv).

(12)(12)(a) (a) If an agency title insurance producer becomes aware of facts that support a reasonable belief that an electronic wire funds transfer related to a real estate or title insurance transaction did not reach the intended recipient of the electronic wire funds transferwithintransfer within two business days after the day on which the transfer occurs, the agency title insurance producer shall report the facts to:

(b){(d)}(d) The requirement described in Subsection (12)(a) applies if:

- 8378 - HB0058Enrolled comparedCopy withH.B. HB0058S02 {(c) {An agency title insurance producer shall make a report described in Subsection (12)(a) no later than seven business days after the day on which the agency title insurance producer became aware of the facts that initiated the report.} } (d){(e)} (i) Except as provided in Subsection {(12)(d)(ii)} (12)(e)(ii), an agency title insurance producer is immune from civil action, civil penalty, or damages, if the producer makes a good faith report under this Subsection (12).

(ii)58 (e)(i) Except as provided in Subsection {(12)(d)(i)(12)(e)(ii), }an (12)(e)(i)agency doestitle notinsurance applyproducer inis animmune actionfrom thatcivil theaction, departmentcivil commencespenalty, againstor adamages, if the producer formakes thea violationgood offaith report under this title.Subsection (12).

(e){(f)}(ii) TheSubsection identity(12)(e)(i) ofdoes annot agencyapply titlein insurancean produceraction that makesthe adepartment reportcommences underagainst Subsection (12)(a) (i) is a protectedproducer recordfor underthe Titleviolation 63G,of Chapterthis 2,title. Government Records Access and Management Act.

(13)(f) (a)The Aidentity titleof insureran shallagency reporttitle toinsurance theproducer commissionerthat themakes terminationa ofreport anunder appointmentSubsection of(12)(a)(i) is a titleprotected insurancerecord producerunder withinTitle seven63G, daysChapter after2, theGovernment dayRecords onAccess whichand terminationManagement occurs.Act.

(13)(a) A title insurer shall report to the commissioner the termination of an appointment of a title insurance producer within seven days after the day on which termination occurs.

31A-23a-401.31A-23a-401 .

(1)(1)(a) (a) Except as provided under Subsection (1)(b):

or - 84 - HB0058 compared with HB0058S02 (B) to which the producer for the insured or consultant has the type of relation that a material benefit would accrue to the producer for the insured or consultant or spouse as a result of the purchase.

(A) the producer for the insured's or consultant's interest as a producer for the insurer,- or79 the- relationshipH.B. to an insurer or other producer;

58 Enrolled Copy insurer, or the relationship to an insurer or other producer;

31A-23a-406.31A-23a-406 .

- 85 - HB0058 compared with HB0058S02 (a) the individual title insurance producer or agency title insurance producer is licensed with:

(b)- a80 title- insurerEnrolled authorizedCopy toH.B. do business in this state appoints the individual title insurance producer or agency title insurance producer[ is appointed by a title insurer authorized to do business in the state];

58 (b) a title insurer authorized to do business in this state appoints the individual title insurance producer or agency title insurance producer[ is appointed by a title insurer authorized to do business in the state];

- 86 - HB0058 compared with HB0058S02 (i) construction money;

and (ii)- upon81 {receiving- anH.B. order } initial delivery of a commitment for a {policy of } title insurancepolicy, notifies the parties proposed to be insured under the {real estate transaction } commitment of{:} the availability of a closing protection letter described in Section 31A-4-117.

(3)58 {theEnrolled availabilityCopy (ii) upon initial delivery of a policycommitment offor a title insurance;}insurance {(B)}policy, {thenotifies costthe parties proposed to be insured under the commitment of athe policyavailability of titlea insurance;closing protection letter described in Section 31A-4-117.

and}(3) {(C)} {protections available from a closing protection letter described in Section 31A-4-117.} {(3)} Notwithstanding Subsection (2), an individual title insurance producer or agency title insurance producer may engage in the escrow business if:

(4)(4)(a) (a) Subsection (2)(c) does not apply if the transaction is for the transfer of real property from the School and Institutional Trust Lands Administration.

and - 87 - HB0058 compared with HB0058S02 (c) may not be used until the conditions of the escrow are met.

(7)(7)(a) (a) A check from the trust account described in Subsection (2)(d) may not be drawn, executed, or dated, or money otherwise disbursed unless the segregated trust account from which money is to be disbursed contains a sufficient credit balance consisting of collected and cleared money at the time the check is drawn, executed, or dated, or money is otherwise disbursed.

(b) As used in this Subsection (7), money is considered to be "collected and cleared," and- may82 be- disbursedEnrolled asCopy follows:H.B.

58 and may be disbursed as follows:

or (D) a check drawn on the trust account of another individual title insurance producer or agency title insurance producer, if the individual title insurance producer or agency title insurance producer in the escrow transaction has reasonable and prudent grounds to believe that sufficient money - 88 - HB0058 compared with HB0058S02 will be available for withdrawal from the account upon which the check is drawn at the time of disbursement of money from the trust account of the individual title insurance producer or agency title insurance producer in the escrow transaction;

and (D) either the ACH network payment type or the title insurance producer's systems prevent the transaction from being unilaterally canceled or reversed by the- consumer83 once- theH.B. transferred funds are deposited to the individual title insurance producer or agency title producer;

58 Enrolled Copy the consumer once the transferred funds are deposited to the individual title insurance producer or agency title producer;

- 89 - HB0058 compared with HB0058S02 Section 50.

31A-23a-409.31A-23a-409 .

(1)(1)(a) (a) Subject to Subsection (7), a licensee is a trustee for money that is paid to, received by, or collected by a licensee for forwarding to insurers or to insureds.

(b)(b)(i) (i) Except as provided in Subsection (1)(b)(ii), a licensee may not commingle trust funds with:

(A)- amounts84 necessary- toEnrolled payCopy bankH.B. charges;

58 (A) amounts necessary to pay bank charges;

(d)(d)(i) (i) Unless money is sent to the appropriate payee by the close of the next business day after their receipt, the licensee shall deposit them in an account authorized under Subsection (2).

(2)(2)(a) (a) [Money] A licensee shall deposit money required to be deposited under Subsection (1)[ shall be deposited]:

- 90 - HB0058 compared with HB0058S02 [(i)] (A) the commissioner approves by rule or order;

(4)(4)(a) (a) A trust account into which a licensee deposits money [is deposited ]may be interest bearing.

(5) A depository institution or other organization holding trust funds under this section may not- offset85 or- impoundH.B. trust account funds against debts and obligations [incurred by ]the licensee incurs.

58 Enrolled Copy not offset or impound trust account funds against debts and obligations [incurred by ]the licensee incurs.

31A-23a-501.31A-23a-501 .

(b)(b)(i) - 91 - HB0058 compared with HB0058S02 (i) "Compensation from an insurer or third party administrator" means commissions, fees, awards, overrides, bonuses, contingent commissions, loans, stock options, gifts, prizes, or any other form of valuable consideration:

(c)- (i)86 "Customer"- means:Enrolled Copy H.B.

58 (c)(i) "Customer" means:

or (B) a group or blanket insurance policy or group annuity contract {the[sold, producer or affiliate sells, solicits, or negotiates}[sold, solicited, or negotiated by the producer or affiliate] the producer or affiliate sells, solicits, or negotiates.

(d)(d)(i) (i) "Noncommission compensation" includes all funds paid to or credited for the benefit of a licensee other than commission compensation.

(2)(2)(a) - 92 - HB0058 compared with HB0058S02 (a) Except as provided in Subsection (3), a licensee may receive from an insured or from a person purchasing an insurance policy, noncommission compensation.

and (iv)- a87 compensation- arrangementH.B. that the commissioner approves after finding that the arrangement:

58 Enrolled Copy (iv) a compensation arrangement that the commissioner approves after finding that the arrangement:

(3)(3)(a) (a) A surplus lines producer may receive noncommission compensation when acting as a producer for the insured in a surplus lines transaction, if:

- 93 - HB0058 compared with HB0058S02 (A) the amount of any known noncommission compensation;

[(4)[(4)(a) (a) For purposes of this Subsection (4):] [(i) "Large customer" means an employer who, with respect to a calendar year and to a plan year:] [(A) employed an average of at least 100 eligible employees on each business day during the preceding calendar year;

or] [(C) a consultant.] [(b) A producer may not accept or receive any compensation from an insurer or third party administrator for the initial placement of a health benefit plan, other than a hospital- confinement88 indemnity- policy,Enrolled unlessCopy priorH.B. to a large customer's initial purchase of the health benefit plan the producer discloses in writing to the large customer that the producer will receive compensation from the insurer or third party administrator for the placement of insurance, including the amount or type of compensation known to the producer at the time of the disclosure.] [(c) A producer shall:] [(i) obtain the large customer's signed acknowledgment that the disclosure under Subsection (4)(b) was made to the large customer;

or]58 [(ii)hospital (A)confinement signindemnity policy, unless prior to a statementlarge customer's initial purchase of the health benefit plan the producer discloses in writing to the large customer that the disclosureproducer requiredwill byreceive compensation from the insurer or third party administrator for the placement of insurance, including the amount or type of compensation known to the producer at the time of the disclosure.] [(c) A producer shall:] [(i) obtain the large customer's signed acknowledgment that the disclosure under Subsection (4)(b) was made to the large customer;

and]or] [(B)[(ii)(A) keepsign thea signed statement onthat file in the producer'sdisclosure officerequired whileby theSubsection health(4)(b) benefitwas planmade placedto with the large customercustomer; is in force.] [(d) A licensee who collects or receives any part of the compensation from an insurer or third party administrator in a manner that facilitates an audit shall, while the health benefit plan placed with the large customer is in force, maintain a copy of:] - 94 - HB0058 compared with HB0058S02 [(i) the signed acknowledgment described in Subsection (4)(c)(i);

and] [(B) keep the signed statement on file in the producer's office while the health benefit plan placed with the large customer is in force.] [(d) A licensee who collects or receives any part of the compensation from an insurer or third party administrator in a manner that facilitates an audit shall, while the health benefit plan placed with the large customer is in force, maintain a copy of:] [(i) the signed acknowledgment described in Subsection (4)(c)(i);

or] [(ii) the placement of insurance in a secondary or residual market.] [(f)[(f)(i) (i) A producer shall provide to a large customer listed in this Subsection (4)(f) an annual accounting, as defined by rule made by the department in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, of all amounts the producer receives in commission compensation from an insurer or third party administrator as a result of the sale or placement of a health benefit plan to a large customer that is:] [(A) the state;] [(B) a political subdivision or instrumentality of the state or a combination thereof primarily engaged in educational activities or the administration or servicing of educational activities, including the State Board of Education and its instrumentalities, an institution of higher education and its branches, a school district and its instrumentalities, a vocational and technical school, and an entity arising out of a consolidation agreement between entities described under- this89 Subsection (4)(f)(i)(B);] [(C) a county, city, town, special district under Title 17B, Limited Purpose Local Government Entities - SpecialH.B. Districts, special service district under Title 17D, Chapter 1, Special Service District Act, an entity created by an interlocal cooperation agreement under Title 11, Chapter 13, Interlocal Cooperation Act, or any other governmental entity designated in statute as a political subdivision of the state;

58 Enrolled Copy under this Subsection (4)(f)(i)(B);] [(C) a county, city, town, special district under Title 17B, Limited Purpose Local Government Entities - Special Districts, special service district under Title 17D, Chapter 1, Special Service District Act, an entity created by an interlocal cooperation agreement under Title 11, Chapter 13, Interlocal Cooperation Act, or any other governmental entity designated in statute as a political subdivision of the state;

or] [(ii) an Internal Revenue Service Form 5500 and its relevant attachments.] - 95 - HB0058 compared with HB0058S02 [(5)] (4) This section does not alter the right of any licensee to recover from an insured the amount of any premium due for insurance effected by or through that licensee or to charge a reasonable rate of interest upon past-due accounts.

31A-26-301.31A-26-301 .

(1)(1)(a) (a) Unless otherwise provided by law, an insurer shall timely pay every valid insurance claim made by an insured.

(2)(2)(a) (a) Notwithstanding Subsection (1) and subject to Subsection (2)(b), the payment of a claim- is90 not- overdueEnrolled duringCopy anyH.B. period in which:

58 claim is not overdue during any period in which:

- 96 - HB0058 compared with HB0058S02 (b) described as a covered person under the terms of a policy of health care insurance as defined in Section 31A-1-301;

(4)(4)(a) (a) A dental insurer that pays a claim with a tangible check shall send the tangible check to the address designated by the provider.

or (B)- contacted91 the- dentalH.B. insurer about the payment.

58 Enrolled Copy (B) contacted the dental insurer about the payment.

31A-26-301.6.31A-26-301.6 .

or - 97 - HB0058 compared with HB0058S02 (ii) Title 58, Occupations and Professions.

(3)(3)(a) (a) Except as provided in Subsection (4), within 30 days of the day on which the insurer receives a written claim, an insurer shall:

(b)(b)(i) (i) Subject to Subsection (3)(b)(ii), the time period described in Subsection (3)(a) may be extended by 15 days if the insurer:

and (II)- the92 date- byEnrolled whichCopy theH.B. insurer expects to pay the claim or deny the claim with a written explanation for the denial.

58 (II) the date by which the insurer expects to pay the claim or deny the claim with a written explanation for the denial.

- 98 - HB0058 compared with HB0058S02 (A) the notice of extension required by this Subsection (3)(b) shall specifically describe the required information;

(4)(4)(a) (a) In the case of a claim for income replacement benefits, within 45 days of the day on which the insurer receives a written claim, an insurer shall:

(i)- the93 standards- onH.B. which entitlement to a benefit is based;

58 Enrolled Copy (i) the standards on which entitlement to a benefit is based;

- 99 - HB0058 compared with HB0058S02 (e) If an extension allowed by Subsection (4)(b) or (c) is necessary due to a failure of the insured to submit the information necessary to decide the claim:

(7)(7)(a) (a) [Whenever ] If an insurer makes a payment to a provider on any part of a claim under this section, the insurer shall also send to the insured an explanation of benefits paid.

(8)(8)(a) (a) A late fee shall be imposed on:

(b) The late fee described in Subsection (8)(a) shall be determined by multiplying together:- 94 - Enrolled Copy H.B.