reglab/statecodes huggingface dataset:
2023 Utah Code › Title 31A - Insurance Code › Chapter 23a - Insurance Marketing - Licensing Producers, Consultants, and Reinsurance Intermediaries › Part 8 - Reinsurance Intermediaries › Section 809 - Penalties and liabilities.

31A-23a-809.
Penalties and liabilities.
(1) A reinsurance intermediary, insurer, or reinsurer found by the commissioner, after a hearing conducted in accordance with Title 63G, Chapter 4, Administrative Procedures Act, to be in violation of any provisions of this title, shall:
(a) for each separate violation, pay a civil penalty in an amount not exceeding $5,000;
(b) be subject to revocation or suspension of its license; and
(c) if a violation was committed by the reinsurance intermediary, the reinsurance intermediary shall make restitution to the insurer, reinsurer, rehabilitator, or liquidator of the insurer or reinsurer for the net losses incurred by the insurer or reinsurer attributable to the violation.
(2) Nothing contained in this section affects the right of the commissioner to impose any other penalties provided in this title.
(3) Nothing contained in this part is intended to, or in any manner limits or restricts the rights of policyholders, claimants, creditors, or other third parties; nor does it confer any rights to such persons.
Amended by Chapter 382, 2008 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 23a - Insurance Marketing - Licensing Producers, Consultants, and Reinsurance Intermediaries › Part 9 - Travel Insurance Act › Section 901 - Title.

Effective 5/13/2014
31A-23a-901.
Title.
This part is known as the "Travel Insurance Act."
Enacted by Chapter 277, 2014 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 23a - Insurance Marketing - Licensing Producers, Consultants, and Reinsurance Intermediaries › Part 9 - Travel Insurance Act › Section 902.1 - Scope.

Effective 5/4/2022
31A-23a-902.1.
Scope.
(1) The requirements under this part:
(a) apply to travel insurance:
(i) that covers a resident of this state;
(ii) that is sold, solicited, negotiated, or offered in this state; and
(iii) for which policies and certificates are delivered or issued for delivery in this state; and
(b) do not apply, except as expressly provided, to:
(i) a cancellation fee waiver; or
(ii) a travel assistance service.
(2) If there is a conflict between a provision of this part and another provision under this title, this part governs.
Enacted by Chapter 364, 2022 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 23a - Insurance Marketing - Licensing Producers, Consultants, and Reinsurance Intermediaries › Part 9 - Travel Insurance Act › Section 903 - Issuance of limited lines travel insurance producer license.

Effective 5/13/2014
31A-23a-903.
Issuance of limited lines travel insurance producer license.
Notwithstanding any other provision of this chapter:
(1) The commissioner may issue to an individual or business entity that has filed with the commissioner an application in a form and manner prescribed by the commissioner a limited lines travel insurance producer license that authorizes the limited lines travel insurance producer to sell, solicit, or negotiate travel insurance through a licensed insurer.
(2) A limited lines travel insurance producer, and those registered under the license of the limited lines travel producer, are exempt from:
(a) the examination requirements under Section 31A-23a-108; and
(b) the continuing education requirements under Section 31A-23a-202.
Enacted by Chapter 277, 2014 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 23a - Insurance Marketing - Licensing Producers, Consultants, and Reinsurance Intermediaries › Part 9 - Travel Insurance Act › Section 905 - Offering or disseminating travel insurance.

Effective 5/4/2022
31A-23a-905.
Offering or disseminating travel insurance.
(1) A travel retailer offering or disseminating travel insurance shall make available to a prospective purchaser a brochure or other written material that:
(a) provides the identity and contact information of the insurer and the limited lines travel insurance producer;
(b) explains that the purchase of travel insurance is not required to purchase any other product or service from the travel retailer; and
(c) explains that an unlicensed travel retailer is permitted to provide general information about the insurance offered by the travel retailer, including a description of the coverage and price, but is not qualified or authorized to:
(i) answer a technical question about the terms and conditions of the insurance the travel retailer offers; or
(ii) evaluate the adequacy of the prospective purchaser's existing insurance coverage.
(2) A travel retailer's employee or authorized representative who is not licensed as an insurance producer may not:
(a) evaluate or interpret the technical terms, benefits, and conditions of the offered travel insurance coverage;
(b) evaluate or provide advice concerning a prospective purchaser's existing insurance coverage; or
(c) hold the person out as a licensed insurer, licensed producer, or insurance expert.
(3) Notwithstanding any other provision of this chapter, a travel retailer whose insurance-related activities, and the activities of the travel retailer's employees and authorized representatives, are limited to offering and disseminating travel insurance on behalf of and under the direction of a limited lines travel insurance producer meeting the conditions stated in this part, is authorized to do so and receive related compensation for services, upon registration of the limited lines travel insurance producer as described in Subsection 31A-23a-904(2).
(4) As the insurer designee, the limited lines travel insurance producer:
(a) is responsible for the acts of the travel retailer; and
(b) shall use responsible means to ensure compliance by the travel retailer under this part.
(5) A person licensed in a general line of authority as an insurance producer is authorized to sell, solicit, and negotiate travel insurance.
Amended by Chapter 364, 2022 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 23a - Insurance Marketing - Licensing Producers, Consultants, and Reinsurance Intermediaries › Part 9 - Travel Insurance Act › Section 906 - Travel insurance.

Effective 5/13/2014
31A-23a-906.
Travel insurance.
Travel insurance may be provided under an individual policy or under a group or master policy.
Enacted by Chapter 277, 2014 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 23a - Insurance Marketing - Licensing Producers, Consultants, and Reinsurance Intermediaries › Part 9 - Travel Insurance Act › Section 907 - Market conduct and penalties.

Effective 5/13/2014
31A-23a-907.
Market conduct and penalties.
A limited lines travel insurance producer and any travel retailer offering and disseminating travel insurance under the limited lines travel insurance producer license are subject to Sections 31A-2-308, 31A-23a-402, and 31A-23a-402.5.
Enacted by Chapter 277, 2014 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 23a - Insurance Marketing - Licensing Producers, Consultants, and Reinsurance Intermediaries › Part 9 - Travel Insurance Act › Section 908 - Travel protection plans.

Effective 5/4/2022
31A-23a-908.
Travel protection plans.
A person may offer a travel protection plan for one price for the combined features that the travel protection plan offers, if:
(1) the person ensures the travel protection plan:
(a) clearly discloses to the consumer, at or before the time of purchase, that the plan includes:
(i) travel insurance;
(ii) a travel assistance service; or
(iii) a cancellation fee waiver; and
(b) provides information and an opportunity, at or before the time of purchase, for the consumer to obtain additional information regarding the features and pricing of the travel insurance, travel assistance service, and cancellation fee waiver, as applicable; and
(2) the fulfillment material for the travel protection plan:
(a) describes and delineates the travel insurance, travel assistance services, and cancellation fee waiver in the travel protection plan;
(b) includes each travel insurance disclosure required under state law; and
(c) includes the contact information for each person providing a:
(i) travel assistance service; or
(ii) cancellation fee waiver.
Enacted by Chapter 364, 2022 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 23a - Insurance Marketing - Licensing Producers, Consultants, and Reinsurance Intermediaries › Part 9 - Travel Insurance Act › Section 910 - Travel administrators.

Effective 5/4/2022
31A-23a-910.
Travel administrators.
(1) A person may not act as or represent that the person is a travel administrator for travel insurance unless the person:
(a) is an insurance producer acting within the scope of the producer's license;
(b) is licensed as a managing general agent in accordance with Part 6, Managing General Agents; or
(c) is licensed as a third party administrator in accordance with Chapter 25, Third Party Administrators.
(2) An insurer is responsible for:
(a) an act of a travel administrator administering travel insurance the insurer underwrites; and
(b) ensuring that the travel administrator maintains all books and records relevant to the insurer.
(3) A travel administrator shall make the books and records described in Subsection (2)(b) available to the commissioner upon the commissioner's request.
Enacted by Chapter 364, 2022 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 23a - Insurance Marketing - Licensing Producers, Consultants, and Reinsurance Intermediaries › Part 9 - Travel Insurance Act › Section 911 - Classification of travel insurance -- Standards -- Status.

Effective 5/4/2022
31A-23a-911.
Classification of travel insurance -- Standards -- Status.
(1) An insurer shall classify and file travel insurance under an inland marine line of insurance.
(2) An insurer may:
(a) issue travel insurance as an individual, group, or blanket policy; or
(b) develop eligibility and underwriting standards for travel insurance based on travel protection plans designed for individual or identified marketing or distribution channels, if the standards also meet underwriting standards for inland marine insurance.
(3) Under this part, the following are not insurance:
(a) a cancellation fee waiver; and
(b) a travel assistance service.
Enacted by Chapter 364, 2022 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 23a - Insurance Marketing - Licensing Producers, Consultants, and Reinsurance Intermediaries › Part 9 - Travel Insurance Act › Section 912 - Rulemaking.

Effective 5/4/2022
31A-23a-912.
Rulemaking.
The commissioner may make rules in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, necessary to implement the provisions of this part.
Enacted by Chapter 364, 2022 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 23a - Insurance Marketing - Licensing Producers, Consultants, and Reinsurance Intermediaries › Part 10 - Affiliated Business in Title Insurance › Section 1002 - Regulation of affiliated business -- Applicable law.

Effective 5/14/2019
31A-23a-1002.
Regulation of affiliated business -- Applicable law.
(1) Except as provided in this part, for purposes of state law, Section 8 of RESPA governs an affiliated business arrangement involving a title entity.
(2) The division shall enforce the provisions of this part, including Section 8 of RESPA.
(3) In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, the division may make rules necessary to implement the provisions of this part.
Enacted by Chapter 475, 2019 General Session
Technically renumbered for proper placement in chapter.
2023 Utah Code › Title 31A - Insurance Code › Chapter 23a - Insurance Marketing - Licensing Producers, Consultants, and Reinsurance Intermediaries › Part 10 - Affiliated Business in Title Insurance › Section 1003 - Affiliated business arrangements.

Effective 5/12/2020
31A-23a-1003.
Affiliated business arrangements.
(1) An affiliated business arrangement between a person and a title entity violates Section 8 of RESPA for purposes of state law if:
(a) the title entity does not have sufficient capital and net worth in a reserve account in the title entity's name; or
(b) more than 70% of the title entity's annual title insurance business is affiliated business on or after the later of:
(i) two years after the title entity begins an affiliated business arrangement; or
(ii) June 1, 2021.
(2) In addition to Subsection (1), the division may find that an affiliated business arrangement between a person and a title entity violates Section 8 of RESPA after evaluating and weighing the following factors in light of the specific facts before the division:
(a) whether the title entity:
(i) is staffed with the title entity's own employees to conduct title insurance business;
(ii) manages the title entity's own business affairs;
(iii) has a physical office for business that is separate from any producer's or associate's office and pays market rent;
(iv) provides the essential functions of title insurance business for a fee, including incurring the risks and receiving the rewards of any comparable title entity; and
(v) performs the essential functions of title insurance business itself;
(b) if the title entity contracts with another person to perform a portion of the title entity's title insurance business, whether the contract:
(i) is with an independent third party; and
(ii) provides payment for the services that bears a reasonable relationship to the value of the services or goods received; and
(c) whether the person from whom the title entity receives referrals under the affiliated business arrangement also sends title insurance business to other title entities.
Amended by Chapter 448, 2020 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 23a - Insurance Marketing - Licensing Producers, Consultants, and Reinsurance Intermediaries › Part 10 - Affiliated Business in Title Insurance › Section 1004 - Annual affiliated business report.

Effective 5/12/2020
31A-23a-1004.
Annual affiliated business report.
Before March 1 each year, each new or newly affiliated title entity shall submit a report to the division that:
(1) contains the following for the preceding calendar year:
(a) the name and address of any producer or associate that owns a financial interest in the new or newly affiliated title entity;
(b) for each producer and associate identified under Subsection (1)(a), the percentage of the new or newly affiliated title entity's affiliated business that is the result of an affiliated business arrangement with the producer or associate;
(c) a description of any affiliated business arrangement the new or newly affiliated title entity has with a person other than a producer or associate identified under Subsection (1)(a);
(d) the percentage of the new or newly affiliated title entity's annual title insurance business that is affiliated business;
(e) proof of sufficient capital and net worth; and
(f) any other information required by the division by rule; and
(2) is certified by an officer of the new or newly affiliated title entity that the information contained in the report is true to the best of the officer's knowledge, information, and belief.
Amended by Chapter 448, 2020 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 23a - Insurance Marketing - Licensing Producers, Consultants, and Reinsurance Intermediaries › Part 10 - Affiliated Business in Title Insurance › Section 1005 - Investigations.

Effective 5/14/2019
31A-23a-1005.
Investigations.
(1) To enforce the provisions of this part, including Section 8 of RESPA, the division may conduct a public or private investigation within or outside of the state as the division considers necessary to determine whether a person has violated a provision of this part, including Section 8 of RESPA.
(2) For the purpose of an investigation described in Subsection (1), the division may:
(a) administer an oath or affirmation;
(b) issue a subpoena that requires:
(i) the attendance and testimony of a witness; or
(ii) the production of evidence;
(c) take evidence;
(d) require the production of a book, paper, contract, record, other document, or information relevant to the investigation; and
(e) serve a subpoena by certified mail.
(3)
(a) A court of competent jurisdiction shall enforce, according to the practice and procedure of the court, a subpoena issued by the division.
(b) The division shall pay any witness fee, travel expense, mileage, or any other fee required by the service statutes of the state where the witness or evidence is located.
Enacted by Chapter 475, 2019 General Session
Technically renumbered for proper placement in chapter.
2023 Utah Code › Title 31A - Insurance Code › Chapter 23a - Insurance Marketing - Licensing Producers, Consultants, and Reinsurance Intermediaries › Part 10 - Affiliated Business in Title Insurance › Section 1006 - Disciplinary action.

Effective 5/12/2020
31A-23a-1006.
Disciplinary action.
(1) Subject to the requirements of Section 31A-23a-1007, the division may impose a sanction described in Subsection (2) against a person if the person is:
(a) a title entity or a person previously licensed as a title entity for an act the person committed while licensed; and
(b) violates a provision of this part, including Section 8 of RESPA.
(2) The division may, against a person described in Subsection (1):
(a) impose an educational requirement;
(b) impose a civil penalty in an amount not to exceed $5,000 for each violation;
(c) do any of the following to a title entity:
(i) suspend;
(ii) revoke; or
(iii) place on probation;
(d) issue a cease and desist order; or
(e) impose any combination of sanctions described in this Subsection (2).
(3)
(a) If the presiding officer in a disciplinary action under this part issues an order that orders a fine as part of a disciplinary action against a person, including a stipulation and order, the presiding officer shall state in the order the deadline, that is no more than one year after the day on which the presiding officer issues the order, by which the person shall comply with the fine.
(b) If a person fails to comply with a stated deadline:
(i) the person's license is automatically suspended:
(A) beginning the day specified in the order as the deadline for compliance; and
(B) ending the day on which the person complies in full with the order; and
(ii) if the person fails to pay a fine required by an order, the division may begin a collection process:
(A) established by the division by rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act; and
(B) subject to Title 63A, Chapter 3, Part 5, Office of State Debt Collection.
(4) The division may delegate to an administrative law judge the authority to conduct a hearing under this part.
Amended by Chapter 448, 2020 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 23a - Insurance Marketing - Licensing Producers, Consultants, and Reinsurance Intermediaries › Part 10 - Affiliated Business in Title Insurance › Section 1007 - Adjudicative proceedings -- Review -- Coordination with department.

Effective 5/12/2020
31A-23a-1007.
Adjudicative proceedings -- Review -- Coordination with department.
(1)
(a) Before an action described in Section 31A-23a-1006 may be taken, the division shall:
(i) give notice to the person against whom the action is brought; and
(ii) commence an adjudicative proceeding.
(b) If after the adjudicative proceeding is commenced under Subsection (1)(a) the presiding officer determines that a title entity has violated a provision of this part, including Section 8 of RESPA, the division may take an action described in Section 31A-23a-1006 by written order.
(2) In accordance with Title 63G, Chapter 4, Administrative Procedures Act, a person against whom action is taken under this part may seek review of the action by the executive director of the Department of Commerce.
(3) If a person prevails in a judicial appeal and the court finds that the state action was undertaken without substantial justification, the court may award reasonable litigation expenses to that individual or entity as provided under Title 78B, Chapter 8, Part 5, Small Business Equal Access to Justice Act.
(4)
(a) An order issued under this section takes effect 30 days after the service of the order unless otherwise provided in the order.
(b) If a person appeals an order issued under this section, the division may stay enforcement of the order in accordance with Section 63G-4-405.
(5)
(a) Except as provided in Subsection (5)(b), the division shall commence a disciplinary action under this chapter no later than the earlier of the following:
(i) four years after the day on which the violation is reported to the division; or
(ii) 10 years after the day on which the violation occurred.
(b) The division may commence a disciplinary action under this part after the time period described in Subsection (5)(a) expires if:
(i)
(A) the disciplinary action is in response to a civil or criminal judgment or settlement; and
(B) the division initiates the disciplinary action no later than one year after the day on which the judgment is issued or the settlement is final; or
(ii) the division and the person subject to a disciplinary action enter into a written stipulation to extend the time period described in Subsection (5)(a).
(6)
(a) Within two business days after the day on which a presiding officer issues an order under this part that suspends or revokes a title entity's license, the division shall deliver written notice to the department that states the action the presiding officer ordered against the title entity's license.
(b) Upon receipt of the notice described in Subsection (6)(a), the department shall implement the action ordered against the title entity's license.
Amended by Chapter 448, 2020 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 23b - Navigator License Act › Part 1 - General Provisions › Section 102 - Definitions.

Effective 5/3/2023
31A-23b-102.
Definitions.
As used in this chapter:
(1) "Enroll" and "enrollment" mean to:
(a)
(i) obtain personally identifiable information about an individual; and
(ii) inform an individual about accident and health insurance plans or public programs offered on an exchange;
(b) solicit insurance; or
(c) submit to the exchange:
(i) personally identifiable information about an individual; and
(ii) an individual's selection of a particular accident and health insurance plan or public program offered on the exchange.
(2) "Navigator":
(a) means a person who facilitates enrollment in an exchange by offering to assist, or who advertises any services to assist, with:
(i) the selection of and enrollment in a qualified health plan or a public program offered on an exchange; or
(ii) applying for premium subsidies through an exchange; and
(b) includes a person who is an in-person assister or a certified application counselor as described in federal regulations or guidance issued under PPACA.
(3) "Personally identifiable information" is as defined in 45 C.F.R. Sec. 155.260.
(4) "Public programs" means the state Medicaid program in Title 26B, Chapter 3, Health Care - Administration and Assistance, and Title 26B, Chapter 3, Part 9, Utah Children's Health Insurance Program.
(5) "Resident" is as defined by rule made by the commissioner in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
(6) "Solicit" means the same as that term is defined in Section 31A-23a-102.
Amended by Chapter 328, 2023 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 23b - Navigator License Act › Part 2 - Licensing › Section 201 - Requirement of license.

31A-23b-201.
Requirement of license.
(1)
(a) Except as provided in Section 31A-23b-211, a person may not perform, offer to perform, or advertise any service as a navigator in the state, without:
(i) a valid navigator license issued under this chapter; or
(ii) a valid producer license under Subsection 31A-23a-106(2)(a) with a line of authority that permits the person to sell, negotiate, or solicit accident and health insurance.
(b) A person may not utilize the services of another as a navigator if that person knows or should know that the other person does not have a license as required by law.
(2) An insurance contract is not invalid as a result of a violation of this section.
Enacted by Chapter 341, 2013 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 23b - Navigator License Act › Part 2 - Licensing › Section 202.5 - License types.

Effective 5/8/2018
31A-23b-202.5.
License types.
(1) A license issued under this chapter shall be issued under the license types described in Subsection (2).
(2) A license type under this chapter shall be a navigator line of authority or a certified application counselor line of authority. A license type is intended to describe the matters to be considered under any education, examination, and training required of an applicant under this chapter.
(3)
(a) A navigator line of authority includes the enrollment process as described in Subsection 31A-23b-102(2)(a).
(b)
(i) A certified application counselor line of authority is limited to providing information and assistance to individuals and employees about public programs and premium subsidies available through the exchange.
(ii) A certified application counselor line of authority does not allow the certified application counselor to assist a person with the selection of or enrollment in a qualified health plan offered on an exchange.
Amended by Chapter 319, 2018 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 23b - Navigator License Act › Part 2 - Licensing › Section 203 - Application for individual license -- Application for agency license.

31A-23b-203.
Application for individual license -- Application for agency license.
(1) This section applies to an initial or renewal license as a navigator.
(2)
(a) Subject to Subsection (2)(b), to obtain or renew an individual license, an individual shall:
(i) file an application for an initial or renewal individual license with the commissioner on forms and in a manner the commissioner prescribes; and
(ii) pay a license fee that is not refunded if the application:
(A) is denied; or
(B) is incomplete when filed and is never completed by the applicant.
(b) An application described in this Subsection (2) shall provide:
(i) information about the applicant's identity;
(ii) the applicant's Social Security number;
(iii) the applicant's personal history, experience, education, and business record;
(iv) whether the applicant is 18 years of age or older;
(v) whether the applicant has committed an act that is a ground for denial, suspension, or revocation as set forth in Section 31A-23b-401 or 31A-23b-402;
(vi) that the applicant complies with the surety bond requirements of Section 31A-23b-207;
(vii) that the applicant completed the training requirements in Section 31A-23b-205; and
(viii) any other information the commissioner reasonably requires.
(3) The commissioner may require a document reasonably necessary to verify the information contained in an application filed under this section.
(4) An applicant's Social Security number contained in an application filed under this section is a private record under Section 63G-2-302.
(5)
(a) Subject to Subsection (5)(b), to obtain or renew a navigator agency license, a person shall:
(i) file an application for an initial or renewal navigator agency license with the commissioner on forms and in a manner the commissioner prescribes; and
(ii) pay a license fee that is not refunded if the application:
(A) is denied; or
(B) is incomplete when filed and is never completed by the applicant.
(b) An application described in Subsection (5)(a) shall provide:
(i) information about the applicant's identity;
(ii) the applicant's federal employer identification number;
(iii) the designated responsible licensed individual;
(iv) the identity of the owners, partners, officers, and directors;
(v) whether the applicant, or individual identified in Subsections (5)(b)(iii) and (iv), has committed an act that is a ground for denial, suspension, or revocation as set forth in Section 31A-23b-401; and
(vi) any other information the commissioner reasonably requires.
Enacted by Chapter 341, 2013 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 23b - Navigator License Act › Part 2 - Licensing › Section 204 - Character requirements.

Effective 5/8/2018
31A-23b-204.
Character requirements.
An applicant for a license under this chapter shall demonstrate to the commissioner that:
(1) the applicant has the intent, in good faith, to engage in the practice of a navigator as the license would permit;
(2)
(a) if a natural person, the applicant is:
(i) competent; and
(ii) trustworthy; or
(b) if the applicant is an agency:
(i) the partners, directors, or principal officers or persons having comparable powers are trustworthy; and
(ii) that it will transact business in a way that the acts that may only be performed by a licensed navigator are performed only by a natural person who is licensed under this chapter, or Chapter 23a, Insurance Marketing - Licensing Producers, Consultants, and Reinsurance Intermediaries;
(3) the applicant intends to comply with the surety bond requirements of Section 31A-23b-207;
(4) if a natural person, the applicant is at least 18 years of age; and
(5) the applicant does not have a conflict of interest as defined by regulations issued under PPACA.
Amended by Chapter 319, 2018 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 23b - Navigator License Act › Part 2 - Licensing › Section 205 - Examination and training requirements.

Effective 5/8/2018
31A-23b-205.
Examination and training requirements.
(1) The commissioner may require an applicant for a license to pass an examination and complete a training program as a requirement for a license.
(2) The examination described in Subsection (1) shall reasonably relate to:
(a) the duties and functions of a navigator;
(b) requirements for navigators as established by federal regulation under PPACA; and
(c) other requirements that may be established by the commissioner by administrative rule.
(3) The examination may be administered by the commissioner or as otherwise specified by administrative rule.
(4) The training required by Subsection (1) shall be approved by the commissioner and shall include:
(a) accident and health insurance plans;
(b) qualifications for and enrollment in public programs;
(c) qualifications for and enrollment in premium subsidies;
(d) cultural and linguistic competence;
(e) conflict of interest standards;
(f) exchange functions; and
(g) other requirements that may be adopted by the commissioner by administrative rule.
(5)
(a) For the navigator line of authority, the training required by Subsection (1) shall consist of at least 21 credit hours of training before obtaining the license, which shall include the navigator training and certification program developed by the Centers for Medicare and Medicaid Services.
(b) For the certified application counselor line of authority, the training required by Subsection (1) shall consist of at least six hours of training before obtaining a license, which shall include the certified application counselor training and certification program developed by the Centers for Medicare and Medicaid Services.
(6) This section applies only to an applicant who is a natural person.
Amended by Chapter 319, 2018 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 23b - Navigator License Act › Part 2 - Licensing › Section 207 - Requirement to obtain surety bond.

31A-23b-207.
Requirement to obtain surety bond.
(1)
(a) Except as provided in Subsections (1)(b)(ii) and (2), a navigator shall obtain a surety bond in an amount designated by the commissioner by administrative rule to cover the legal liability of the navigator as the result of an erroneous act or failure to act in the navigator's capacity as a navigator.
(b) The navigator shall:
(i) maintain a surety bond at all times during the term of the navigator's license; or
(ii) demonstrate to the commissioner that the navigator is capable of covering a legal liability for erroneous acts or failure to act in a manner approved by the commissioner.
(2) A navigator is not required to obtain and maintain a surety bond during a period in which the navigator's scope of practice is limited to assisting individuals with:
(a) enrollment in public programs; and
(b) qualification for premium and cost sharing subsidies.
Enacted by Chapter 341, 2013 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 23b - Navigator License Act › Part 2 - Licensing › Section 208 - Form and contents of license.

31A-23b-208.
Form and contents of license.
(1) A license issued under this chapter shall be in the form the commissioner prescribes and shall set forth:
(a) the name and address of the licensee;
(b) the date of license issuance; and
(c) any other information the commissioner considers necessary.
(2) A licensee under this chapter doing business under a name other than the licensee's legal name shall notify the commissioner before using the assumed name in this state.
Enacted by Chapter 341, 2013 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 23b - Navigator License Act › Part 2 - Licensing › Section 210 - Place of business and residence address -- Records.

Effective 5/9/2017
31A-23b-210.
Place of business and residence address -- Records.
(1)
(a) A licensee under this chapter shall register and maintain with the commissioner:
(i) the address and the one or more telephone numbers of the licensee's principal place of business; and
(ii) a valid business email address at which the commissioner may contact the licensee.
(b) If a licensee is an individual, in addition to complying with Subsection (1)(a), the individual shall register and maintain with the commissioner the individual's residence address and telephone number.
(c) A licensee shall notify the commissioner within 30 days of a change of any of the following required to be registered with the commissioner under this section:
(i) an address;
(ii) a telephone number; or
(iii) a business email address.
(2) Except as provided under Subsection (3), a licensee under this chapter shall keep at the principal place of business address registered under Subsection (1), separate and distinct books and records of the transactions consummated under the Utah license.
(3) Subsection (2) is satisfied if the books and records specified in Subsection (2) can be obtained immediately from a central storage place or elsewhere by online computer terminals located at the registered address.
(4)
(a) The books and records maintained under Subsection (2) shall be available for the inspection by the commissioner during the business hours for a period of time after the date of the transaction as specified by the commissioner by rule, but in no case for less than the current calendar year plus three years.
(b) Discarding books and records after the applicable record retention period has expired does not place the licensee in violation of a later-adopted longer record retention period.
Amended by Chapter 168, 2017 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 23b - Navigator License Act › Part 4 - License Denial and Discipline › Section 402 - Probation -- Grounds for revocation.

Effective 5/13/2014
31A-23b-402.
Probation -- Grounds for revocation.
(1) The commissioner may place a licensee on probation for a period not to exceed 24 months as follows:
(a) after an adjudicative proceeding under Title 63G, Chapter 4, Administrative Procedures Act, for any circumstances that would justify a suspension under this section; or
(b) at the issuance of a new license:
(i) with an admitted violation under 18 U.S.C. Sec. 1033; or
(ii) with a response to background information questions on a new license application indicating that:
(A) the person has been convicted of a crime that is listed by rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, as a crime that is a ground for probation;
(B) the person is currently charged with a crime that is listed by rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, as a crime that is a ground for probation regardless of whether adjudication is withheld;
(C) the person has been involved in an administrative proceeding regarding any professional or occupational license; or
(D) any business in which the person is or was an owner, partner, officer, or director has been involved in an administrative proceeding regarding any professional or occupational license.
(2) The commissioner may place a licensee on probation for a specified period no longer than 24 months if the licensee has admitted to a violation under 18 U.S.C. Sec. 1033.
(3) The probation order shall state the conditions for revocation or retention of the license, which shall be reasonable.
(4) Any violation of the probation is a ground for revocation pursuant to any proceeding authorized under Title 63G, Chapter 4, Administrative Procedures Act.
Amended by Chapter 290, 2014 General Session
Amended by Chapter 300, 2014 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 23b - Navigator License Act › Part 4 - License Denial and Discipline › Section 403 - License lapse and voluntary surrender.

31A-23b-403.
License lapse and voluntary surrender.
(1)
(a) A license issued under this chapter shall lapse if the licensee fails to:
(i) pay when due a fee under Section 31A-3-103;
(ii) complete continuing education requirements under Section 31A-23b-206 before submitting the license renewal application;
(iii) submit a completed renewal application as required by Section 31A-23b-203;
(iv) submit additional documentation required to complete the licensing process; or
(v) maintain an active license in a resident state if the licensee is a nonresident licensee.
(b)
(i) A licensee whose license lapses due to the following may request an action described in Subsection (1)(b)(ii):
(A) military service;
(B) voluntary service for a period of time designated by the person for whom the licensee provides voluntary service; or
(C) other extenuating circumstances, including long-term medical disability.
(ii) A licensee described in Subsection (1)(b)(i) may request:
(A) reinstatement of the license no later than one year after the day on which the license lapses; and
(B) waiver of any of the following imposed for failure to comply with renewal procedures:
(I) an examination requirement;
(II) reinstatement fees set under Section 31A-3-103;
(III) continuing education requirements; or
(IV) other sanctions imposed for failure to comply with renewal procedures.
(2) If a license issued under this chapter is voluntarily surrendered, the license may be reinstated:
(a) during the license period in which the license is voluntarily surrendered; and
(b) no later than one year after the day on which the license is voluntarily surrendered.
(3) A voluntarily surrendered license that is reinstated during the license period set forth in Subsection (2) may not be reinstated until the person who voluntarily surrendered the license complies with any applicable continuing education requirements for the period during which the license was voluntarily surrendered.
Enacted by Chapter 341, 2013 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 23b - Navigator License Act › Part 4 - License Denial and Discipline › Section 404 - Penalties.

31A-23b-404.
Penalties.
(1)
(a) If, after notice and opportunity to be heard, the commissioner finds that the navigator or any other person has not materially complied with this part, or any rule made or order issued under this chapter, the commissioner may order the navigator or other person to cease doing business in the state.
(b) If the commissioner finds that because of the material noncompliance an insurer, any policyholder of an insurer, or a recipient of a public program who used the services of the navigator or other person has suffered any loss or damage due to the material noncompliance, the commissioner may:
(i) maintain a civil action or may intervene in an action brought by or on behalf of the insurer, policyholder, or the recipient of the public program, for recovery of compensatory damages for the benefit of the insurer, policyholder, or recipient of a public program; or
(ii) seek other appropriate relief.
(2) Nothing in this section affects the right of the commissioner to impose any other penalties provided for in this title.
(3) Nothing contained in this section is intended to or shall in any manner alter or affect the rights of policyholders, claimants, creditors, or other third parties.
Enacted by Chapter 341, 2013 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 25 - Third Party Administrators › Part 1 - General Provisions › Section 102 - Scope and purposes.

31A-25-102.
Scope and purposes.
(1) This chapter applies to all third party administrators.
(2) The purposes of this chapter include:
(a) encouraging disclosure of contracts between insurers and third party administrators, both to potential insureds and to the commissioner;
(b) promoting the financial responsibility of third party administrators;
(c) subjecting persons administering insurance in Utah to the jurisdiction of the Utah commissioner and courts;
(d) regulating third party administrators' practices in conformity with the general purposes of this title; and
(e) governing the qualifications and procedures for the licensing of third party administrators.
Amended by Chapter 116, 2001 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 25 - Third Party Administrators › Part 2 - Licensing of Third Party Administrators › Section 201 - License and authority from insurers required.

31A-25-201.
License and authority from insurers required.
(1) A person may not perform, offer to perform, or advertise any service as a third party administrator in Utah, without a valid license under Section 31A-25-203 and express authority from all insurers it represents. A person may not utilize the services of another as a third party administrator if he knows or should know that the other does not have a license or the insurer authority as required by law. The commissioner shall be notified of the commencement or termination of insurer authority in a form established by rules.
(2) The commissioner may by rule exempt certain persons or classes of persons from the license requirement of Subsection (1) if the functions they perform do not require the special competence, trustworthiness, or regulatory surveillance made possible by licensing.
(3) A contract is not invalid as a result of a violation of this section.
Amended by Chapter 261, 1989 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 25 - Third Party Administrators › Part 2 - Licensing of Third Party Administrators › Section 202 - Application for license.

31A-25-202.
Application for license.
(1)
(a) An application for a license as a third party administrator shall be:
(i) made to the commissioner on forms and in a manner the commissioner prescribes; and
(ii) accompanied by the applicable fee, which is not refundable if the application is denied.
(b) The application for a license as a third party administrator shall:
(i) state the applicant's:
(A) Social Security number; or
(B) federal employer identification number;
(ii) provide information about:
(A) the applicant's identity;
(B) the applicant's personal history, experience, education, and business record;
(C) if the applicant is a natural person, whether the applicant is 18 years of age or older; and
(D) whether the applicant has committed an act that is a ground for denial, suspension, or revocation as set forth in Section 31A-25-208; and
(iii) any other information as the commissioner reasonably requires.
(2) The commissioner may require documents reasonably necessary to verify the information contained in the application.
(3) An applicant's Social Security number contained in an application filed under this section is a private record under Section 63G-2-302.
Amended by Chapter 382, 2008 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 25 - Third Party Administrators › Part 2 - Licensing of Third Party Administrators › Section 204 - Character requirements.

Effective 5/8/2018
31A-25-204.
Character requirements.
Each applicant for a license under this chapter shall show to the commissioner all of the following:
(1) that the applicant has the good faith intent to engage in the type of business the license applied for would permit;
(2)
(a) if a natural person, that the applicant is:
(i) competent; and
(ii) trustworthy; or
(b) if a partnership or corporation, that all the partners, directors, principal officers, or persons having comparable powers are trustworthy; and
(3) if a natural person, that the applicant is at least 18 years of age.
Amended by Chapter 319, 2018 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 25 - Third Party Administrators › Part 2 - Licensing of Third Party Administrators › Section 205 - Financial responsibility.

31A-25-205.
Financial responsibility.
(1) Every person licensed under this chapter shall maintain an insurance policy or surety bond:
(a)
(i) while licensed; and
(ii) for one year after the person is licensed; and
(b) issued:
(i) by an authorized insurer;
(ii) in an amount specified under Subsection (2); and
(iii) on a policy or contract form that is acceptable under Subsection (3).
(2)
(a) Insurance policies or surety bonds satisfying the requirement of Subsection (1) shall be in a face amount equal to:
(i) at least the greater of:
(A) 10% of the total funds handled by the administrator; or
(B) $5,000; and
(ii) may not exceed $500,000.
(b) In fixing the policy or bond face amount under Subsection (2)(a), the total funds handled is:
(i) the greater of:
(A) the premiums received during the previous calendar year; or
(B) claims paid through the administrator during the previous calendar year; or
(ii) if no funds were handled during the preceding year, the total funds reasonably anticipated to be handled by the administrator during the current calendar year.
(c) This section does not prohibit any person dealing with the administrator from requiring, by contract, insurance coverage in amounts greater than the insurance coverage required under this section.
(3)
(a) Insurance policies or surety bonds issued to satisfy Subsection (1) shall:
(i) be on forms approved by the commissioner; and
(ii) require the insurer to pay, up to the policy or bond face amount, any judgment:
(A) obtained by participants in or beneficiaries of plans administered by the insured licensee; and
(B) that arises from the negligence or culpable acts of the licensee or any employee or agent of the licensee in connection with the activities of a third party administrator as defined in Section 31A-1-301.
(b) The commissioner may require that policies or bonds issued to satisfy the requirements of this section require the insurer to give the commissioner 20 day prior notice of policy cancellation.
(4) The commissioner shall establish annual reporting requirements and forms to monitor compliance with this section.
(5) This section may not be construed as limiting any cause of action an insured would otherwise have against the insurer.
Amended by Chapter 71, 2002 General Session
Amended by Chapter 308, 2002 General Session