reglab/statecodes huggingface dataset:
2023 Utah Code › Title 31A - Insurance Code › Chapter 8 - Health Maintenance Organizations and Limited Health Plans › Part 2 - Domestic Organizations › Section 217 - Material transactions by insurers which are part of holding company system.

31A-8-217.
Material transactions by insurers which are part of holding company system.
(1) This section applies to an insurer licensed under this chapter that is part of a holding company system, for purposes of:
(a) the reporting requirements of Section 31A-16-105; and
(b) the material transaction standards of Section 31A-16-106.
(2) Unless otherwise provided by rule, a transaction is not material under Subsection 31A-16-105(4) if the transaction involves an amount:
(a) of not more than:
(i) 10% for each transaction; or
(ii) 20% for cumulative transactions during any one calendar year; and
(b) calculated:
(i) on the basis of the organization's surplus requirement, determined in accordance with Section 31A-5-211; and
(ii) as of December 31 of the year immediately preceding the transaction.
Amended by Chapter 252, 2003 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 8 - Health Maintenance Organizations and Limited Health Plans › Part 3 - Foreign Organizations › Section 301 - Requirements for doing business in state.

31A-8-301.
Requirements for doing business in state.
(1) Only a corporation incorporated and licensed under Part 2, Domestic Organizations, may do business in this state as an organization.
(2) 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 under Part 2, Domestic Organizations, for its Utah business. Except as to Chapter 16, Insurance Holding Companies, the laws applicable to a domestic organization apply only to the domestic organization and not to its foreign parent corporation.
Amended by Chapter 319, 2013 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 8 - Health Maintenance Organizations and Limited Health Plans › Part 4 - Operations › Section 401 - Enrollee participation.

31A-8-401.
Enrollee participation.
Every organization shall provide a reasonable procedure, consistent with Section 31A-4-116, for allowing enrollees to participate in matters of policy of the organization and for resolving complaints and adverse benefit determinations initiated by enrollees or providers.
Amended by Chapter 308, 2002 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 8 - Health Maintenance Organizations and Limited Health Plans › Part 4 - Operations › Section 403 - Examination of organization and providers.

31A-8-403.
Examination of organization and providers.
Examinations of a health maintenance organization and its providers shall be conducted according to the provisions of Chapter 2, Administration of the Insurance Laws. Except during an audit of the internal quality control system, medical records of individual patients kept by the organization or its providers are not subject to examination.
Enacted by Chapter 204, 1986 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 8 - Health Maintenance Organizations and Limited Health Plans › Part 4 - Operations › Section 404 - Annual audit of internal quality control.

31A-8-404.
Annual audit of internal quality control.
Each organization shall prepare an annual report of the effectiveness of the organization's internal quality control. The report shall be in a form prescribed by the commissioner after consultation with the director of the Department of Health, and shall be certified and signed by two officers of the organization. The commissioner may at any time require an audit of an organization's quality control system. The audit shall be performed by qualified persons designated by the commissioner. Auditors shall have full access to all records of the organization and its providers, including medical records of individual patients. The information contained in the medical records of individual patients shall remain confidential, and information derived from those records may not be used in a manner that could directly or indirectly identify an individual. 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 legal proceeding except hearings before the commissioner or the director of the Department of Health concerning alleged violations of the provisions of this chapter.
Amended by Chapter 314, 1994 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 8 - Health Maintenance Organizations and Limited Health Plans › Part 4 - Operations › Section 405 - Confidentiality of medical records and audits.

31A-8-405.
Confidentiality of medical records and audits.
Unless a court orders otherwise, the department shall treat the following records and information as confidential and prevent their disclosure to the public:
(1) the medical records of enrollees of an organization; and
(2) the annual audits performed under Section 31A-8-404.
Enacted by Chapter 204, 1986 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 8 - Health Maintenance Organizations and Limited Health Plans › Part 4 - Operations › Section 406 - Distribution by nonprofit organizations.

31A-8-406.
Distribution by nonprofit organizations.
A nonprofit organization may pay compensation in a reasonable amount to its members, trustees, or officers for services rendered, may make reasonable incentive payments to its providers, may confer benefits upon its members in conformity with its purposes, may pay interest on certificates of indebtedness issued by it evidencing capital contributions, and upon dissolution or final liquidation may make distributions to its members as permitted by Title 16, Chapter 6a, Utah Revised Nonprofit Corporation Act, and no such payment, benefit, or distribution shall be considered to be a dividend or distribution of income. Notwithstanding Section 31A-8-105, and in addition to the powers granted in that section, a nonprofit organization has all powers conferred upon it by Section 16-6a-302.
Amended by Chapter 300, 2000 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 8 - Health Maintenance Organizations and Limited Health Plans › Part 4 - Operations › Section 408 - Organizations offering point of service or point of sales products.

31A-8-408.
Organizations offering point of service or point of sales products.
Effective July 1, 1991, a health maintenance organization offering products that permit members the option of obtaining covered services from a noncontracted provider, which is a point of service or point of sale product, shall comply with the requirements of Subsections (1) through (7).
(1) The cost of an encounter with a noncontracted provider is considered an uncovered expenditure as defined in Section 31A-8-101.
(2)
(a) An organization shall report to the commissioner on a monthly basis the number of encounters with contracted and noncontracted providers if the organization offers to sell a:
(i) point of service product; or
(ii) point of sale product.
(b) The commissioner shall:
(i) define the form, content, and due date of the report required by this Subsection (2); and
(ii) require audited reports of the information on a yearly basis.
(3) An organization may not offer a point of service product or a point of sale product unless the organization has secured contracts with participating providers located within the organization's service area for each covered service other than those unusual or infrequently used health services that are not available from the organization's health care providers.
(4) An organization may not enroll a member who does not work or reside in the service area as defined by rule, except this Subsection (4) does not apply to a dependent of an enrollee.
(5) Any organization that exceeds the 10% limit of unusual or infrequently used health services as defined in Section 31A-8-101 is subject to a forfeiture of up to $50 per encounter.
(6) An organization shall disclose to employees and members the existence of the 10% limit:
(a) at enrollment; or
(b) prior to enrollment.
(7) The commissioner shall hold hearings and adopt rules providing any additional limitations or requirements necessary to secure the public interest in conformity with this section.
Amended by Chapter 308, 2002 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 8a - Health Discount Program Consumer Protection Act › Part 1 - General Provisions › Section 102 - Definitions.

Effective 5/8/2018
31A-8a-102.
Definitions.
As used in this chapter:
(1) "Fee" means any periodic charge for use of a discount program.
(2) "Health care provider" means a health care provider as defined in Section 78B-3-403, with the exception of "licensed athletic trainer," who:
(a) is practicing within the scope of the provider's license; and
(b) has agreed either directly or indirectly, by contract or any other arrangement with a health discount program operator, to provide a discount to enrollees of a health discount program.
(3)
(a) "Health discount program" means a business arrangement or contract in which a person pays fees, dues, charges, or other consideration in exchange for a program that provides access to health care providers who agree to provide a discount for health care services.
(b) "Health discount program" does not include a program that does not charge a membership fee or require other consideration from the member to use the program's discounts for health services.
(4) "Health discount program marketer" means a person, including a private label entity, that markets, promotes, sells, or distributes a health discount program but does not operate a health discount program.
(5) "Health discount program operator" means a person that provides a health discount program by entering into a contract or agreement, directly or indirectly, with a person or persons in this state who agree to provide discounts for health care services to enrollees of the health discount program and determines the charge to members.
(6) "Marketing" means making or causing to be made any communication that contains information that relates to a product or contract regulated under this chapter.
(7) "Value-added benefit" means a discount offering with no additional charge made by a health insurer or health maintenance organization that is licensed under this title, in connection with existing contracts with the health insurer or health maintenance organization.
Amended by Chapter 319, 2018 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 8a - Health Discount Program Consumer Protection Act › Part 1 - General Provisions › Section 103 - Scope and purposes.

Effective 5/12/2015
31A-8a-103.
Scope and purposes.
(1) A person shall comply with the provisions of this chapter if the person operates a health discount program in this state.
(2) Notwithstanding any provision in this title, a person who only operates or markets a health discount program is exempt from:
(a) Section 31A-4-113;
(b) Section 31A-4-113.5;
(c)Chapter 6a, Service Contracts;
(d)Chapter 7, Nonprofit Health Service Insurance Corporations;
(e) Section 31A-8-209;
(f) Section 31A-8-211;
(g) Section 31A-8-214;
(h)Chapter 9, Insurance Fraternals, Chapter 10, Annuities, Chapter 11, Motor Clubs, and Chapter 12, State Risk Management Fund;
(i)Chapter 17, Determination of Financial Condition, and Chapter 18, Investments;
(j)Chapter 19a, Utah Rate Regulation Act;
(k) Sections 31A-23a-103 and 31A-23a-104;
(l)Chapter 25, Third Party Administrators, and Chapter 26, Insurance Adjusters;
(m)Chapter 28, Guaranty Associations; and
(n)Chapter 35, Bail Bond Act, Chapter 36, Life Settlements Act, Chapter 37, Captive Insurance Companies Act, and Chapter 38, Federal Health Care Tax Credit Program Act.
(3) A person licensed under this title as an accident and health insurer or health maintenance organization:
(a) is not required to obtain a license as required by Section 31A-8a-201 to operate a health discount program; and
(b) is required to comply with all other provisions of this chapter.
(4) The purposes of this chapter include:
(a) full disclosure in the sale of health discount programs;
(b) reasonable regulation of the marketing and disclosure practices of health discount program operators; and
(c) licensing standards for health discount programs.
(5) Nothing in this chapter prohibits a health discount program operator from marketing a health discount program operator's own services without a health discount program marketer license.
Amended by Chapter 258, 2015 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 8a - Health Discount Program Consumer Protection Act › Part 2 - Licensure › Section 201 - License required.

31A-8a-201.
License required.
(1) Except as provided in Subsection 31A-8a-103(3), prior to operating or marketing a health discount program, a person shall:
(a) be authorized to transact business in this state; and
(b) be licensed by the commissioner.
(2)
(a) An application for licensure under this chapter shall be filed with the commissioner on a form prescribed by the commissioner.
(b) The application shall be sworn to by an officer or authorized representative of the health discount program and shall include:
(i) articles of incorporation with bylaws or other enabling documents that establish the organizational structure;
(ii) information required by the commissioner by administrative rule which the commissioner determines is necessary to:
(A) identify and locate principals, operators, and marketers involved with the health discount program; and
(B) protect the interests of enrollees of health discount programs, health care providers, and consumers;
(iii) biographical information, and when requested by the commissioner, a criminal background check, under the provisions of Subsection 31A-23a-105(3);
(iv) the disclosures required in Section 31A-8a-203; and
(v) the fee established in accordance with Section 31A-3-103.
Amended by Chapter 135, 2013 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 8a - Health Discount Program Consumer Protection Act › Part 2 - Licensure › Section 202 - Commissioner to issue license -- Renewals.

31A-8a-202.
Commissioner to issue license -- Renewals.
(1) The commissioner may issue a license to a person:
(a) who files an application and pays the fee in accordance with Section 31A-8a-201; and
(b) who the commissioner determines is in compliance with this chapter.
(2)
(a) A license issued under this chapter is valid until the immediately following December 31 and may be renewed in accordance with Subsection (2)(b).
(b) A license may be renewed if:
(i) the commissioner finds that the person operating the health discount program is in compliance with this chapter;
(ii) the health discount program operator or health discount program marketer submits the appropriate renewal application and pays any applicable fees for renewal; and
(iii) the health discount program certifies that the information in the application for renewal is accurate.
Amended by Chapter 135, 2013 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 8a - Health Discount Program Consumer Protection Act › Part 2 - Licensure › Section 202.5 - Reporting of administrative actions and criminal prosecution.

31A-8a-202.5.
Reporting of administrative actions and criminal prosecution.
(1) A health discount program operator or health discount program marketer shall report to the commissioner any administrative action or criminal prosecution brought against the health discount program operator, health discount program marketer, or an owner, officer, or principal of the health discount program operator or health discount program marketer, other than an administrative action brought by the department.
(2) The health discount program operator or health discount program marketer shall file the report described in Subsection (1):
(a) at the time the health discount program operator or health discount program marketer files an application for licensure or renewal; and
(b)
(i) for an administrative action that occurs on or after the day on which the health discount program operator or health discount program marketer files an application for licensure or renewal, within 30 days after the day on which the final disposition of the administrative action is issued; or
(ii) for a criminal prosecution, within 30 days after the health discount program operator's or health discount program marketer's initial appearance before a court.
(3) The report described in Subsection (1) shall include:
(a) a copy of the complaint or other relevant legal documents related to the administrative action or criminal prosecution; and
(b) an explanation or other information that the health discount program operator or health discount program marketer desires to submit in relation to the action or charge.
Enacted by Chapter 135, 2013 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 8a - Health Discount Program Consumer Protection Act › Part 2 - Licensure › Section 203 - Information filed with the department.

31A-8a-203.
Information filed with the department.
(1) Prior to operating a health discount program, a person shall submit the following to the commissioner:
(a) a copy of contract forms used by the health discount program for:
(i) health care providers or health care provider networks participating in the health discount program, including the discounts for medical services provided to enrollees;
(ii) marketing;
(iii) administration of the health discount program;
(iv) enrollment;
(v) investment management for the health discount programs; and
(vi) subcontracts for any services;
(b) the program's proposed marketing plan; and
(c) dispute resolution procedures for program holders.
(2) The company shall file prior to use:
(a) the form of contracts used by the health discount program operator;
(b) the marketing plan; and
(c) dispute resolution procedures.
(3) The commissioner may adopt rules in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, to implement this section.
Amended by Chapter 297, 2011 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 8a - Health Discount Program Consumer Protection Act › Part 2 - Licensure › Section 204 - Advertising restrictions and requirements.

31A-8a-204.
Advertising restrictions and requirements.
(1) An operator of a health discount program may not:
(a) use any form of words or terms that may confuse health discount programs with other types of health insurance in advertising or marketing such as "health plan," "health benefit plan," "coverage," "copay," "copayments," "preexisting conditions," "guaranteed issue," "premium," and "preferred provider";
(b) use other terms as designated by the commissioner by administrative rule in advertisement or marketing that could reasonably mislead a consumer to believe that a discount health program is any other form of health insurance; or
(c) refer to sales representatives as "agents," "producers," or "consultants."
(2) A health discount program operator:
(a) shall have a written agreement with any marketer of the health discount program prior to marketing, selling, promoting, or distributing the health discount programs;
(b) shall file with the commissioner all advertisement, marketing materials, brochures, and discount programs prior to their use or distribution; and
(c) shall make the following disclosures:
(i) in writing in at least 10-point type and bolded; and
(ii) with any marketing or advertising to the public and with any enrollment forms given to an enrollee:
(A) the program is not a health insurance policy;
(B) the program provides discounts only at certain health care providers for health care services;
(C) the program holder is obligated to pay for all health care services but will receive a discount from those health care providers who have contracted with the health discount program; and
(D) the corporate name and the location of the health discount program operator.
(3) A health discount program operator or marketer who sells the health discount program with another product shall provide the consumer a written itemization of the fees of the health discount program separate from any fees or charges for the other product, which can be purchased separately.
Amended by Chapter 297, 2011 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 8a - Health Discount Program Consumer Protection Act › Part 2 - Licensure › Section 205 - Disclosure of health discount program terms.

31A-8a-205.
Disclosure of health discount program terms.
(1)
(a) Health discount program operators shall provide to each purchaser or potential purchaser a copy of the terms of the discount program at the time of purchase.
(b) For purposes of this section "purchaser" means the employer in an employer sponsored plan, or an individual purchasing outside of an employer relationship.
(2) The disclosure required by Subsection (1) should be clear and thorough and should include any administrative or monthly fees, trial periods, procedures for securing discounts, cancellation procedures and corresponding refund requests, and procedures for filing disputes.
(3)
(a) A contract shall be signed by the purchaser acknowledging the terms before any fees are collected and shall include notice of the purchaser's 30-day free look rights.
(b) For purposes of this Subsection (3) and Section 46-4-201, when a contract is entered into via telephone, facsimile transmission or the Internet, the following is considered a signing of the contract:
(i) if via the Internet, the online application form is completed and sent by the purchaser to the health discount program operator;
(ii) if via facsimile transmission, the application is completed, signed and faxed to the health discount program operator; or
(iii) if via telephone, the script used by the health discount program operator to solicit the purchaser shall include any limitations or exclusions to the program, and the contract shall be provided to the purchaser via facsimile, mail, or email within 10 working days of the purchaser consenting to enrolling over the telephone.
Amended by Chapter 135, 2013 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 8a - Health Discount Program Consumer Protection Act › Part 2 - Licensure › Section 205.5 - Free look right.

31A-8a-205.5.
Free look right.
(1) Except as provided in Subsection (2), a person that purchases a health discount program may, with or without cause, within 30 days after the day on which the purchase contract is signed, cancel the contract without payment, damages, penalty, or liability of any kind by giving written notice of cancellation to the other party to the contract.
(2) A person may not exercise the right of cancellation described in Subsection (1) if the person has used the services of the health discount program under the contract.
(3) If a person cancels a contract under Subsection (1), the other party to the contract shall refund all money and other consideration paid in relation to the health discount program, less a maximum of $25 of any enrollment charge, regardless of whether the enrollment charge was designated as nonrefundable.
Enacted by Chapter 135, 2013 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 8a - Health Discount Program Consumer Protection Act › Part 2 - Licensure › Section 206 - Provider agreements -- Record keeping.

31A-8a-206.
Provider agreements -- Record keeping.
(1) A health discount program operator may not place any restrictions on an enrollee's access to health care providers such as waiting periods or notification periods.
(2) A health discount program operator may not reimburse health care providers for services rendered to an enrollee, unless the health discount program operator is a licensed third party administrator.
(3)
(a) A health discount program operator shall have a written agreement with a health care provider who agrees to provide discounts to health discount program enrollees.
(b) If the written agreement is with a provider network, the health discount plan shall require the provider network to have written agreements with each of its health care providers.
(4) The health discount program operator shall maintain a copy of each active health care provider agreement.
Amended by Chapter 297, 2011 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 8a - Health Discount Program Consumer Protection Act › Part 2 - Licensure › Section 207 - Notice of change.

31A-8a-207.
Notice of change.
(1) A health discount program operator shall provide the commissioner notice of:
(a) any change in the health discount program's organizational name, change of business or mailing address, or change in ownership or principals; and
(b) any change in the information submitted in accordance with Section 31A-8a-203.
(2)
(a) The notice required by Subsection (1) shall be submitted 30 days prior to any change.
(b) Approval by the commissioner is required for any changes in forms that required approval under Section 31A-8a-203.
(3) A health insurer or health maintenance organization licensed under this title shall annually file with the Accident and Health Data Survey, a list of all value-added benefits offered at no cost to its enrollees.
Amended by Chapter 297, 2011 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 8a - Health Discount Program Consumer Protection Act › Part 2 - Licensure › Section 208 - Representing or aiding an unauthorized insurer.

31A-8a-208.
Representing or aiding an unauthorized insurer.
(1) The provisions of this chapter and Chapter 15, Unauthorized Insurers, Surplus Lines, and Risk Retention Groups, apply to the activities of an unlicensed health discount program operator as if the health discount program was an unauthorized insurance contract and the unlicensed health discount program operator was an unauthorized insurer.
(2) A person who knowingly and intentionally represents or aids an unauthorized insurer in violation of the provisions of this chapter or Chapter 15, Unauthorized Insurers, Surplus Lines, and Risk Retention Groups, is guilty of a third degree felony.
Enacted by Chapter 58, 2005 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 8a - Health Discount Program Consumer Protection Act › Part 2 - Licensure › Section 209 - Health discount program fraud.

31A-8a-209.
Health discount program fraud.
For purposes of Chapter 31, Insurance Fraud Act, a health discount program operator is an insurer as defined in Section 31A-31-102 and is subject to the provisions of Chapter 31, Insurance Fraud Act.
Enacted by Chapter 58, 2005 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 8a - Health Discount Program Consumer Protection Act › Part 2 - Licensure › Section 210 - Rulemaking authority.

31A-8a-210.
Rulemaking authority.
The commissioner has authority to adopt administrative rules in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act:
(1) to enforce this chapter; and
(2) as necessary to protect the public interest.
Amended by Chapter 382, 2008 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 9 - Insurance Fraternals › Part 1 - General Provisions › Section 101 - Definitions.

31A-9-101.
Definitions.
(1) As used in this chapter:
(a) "Fraternal" or "fraternal benefit society" means a corporation organized or operating under this chapter that:
(i) has no capital stock;
(ii) exists solely for:
(A) the benefit of its members and their beneficiaries; and
(B) any lawful social, intellectual, educational, charitable, benevolent, moral, fraternal, patriotic, or religious purpose for the benefit of its members or the public, carried on through voluntary activity of its members in their local lodges or through institutional programs of the fraternal or its local lodges;
(iii) has a lodge system;
(iv) has a representative form of government; and
(v) provides insurance benefits authorized under this chapter.
(b) "Laws of a fraternal" include its articles of incorporation and bylaws, however designated.
(c) "Lodge system" means one in which:
(i) there is a supreme governing body;
(ii) subordinate to the supreme governing body are local lodges, however designated, into which natural persons are admitted as members in accordance with the laws of the fraternal;
(iii) the local lodges are required by the laws of the fraternal to hold regular meetings at least monthly; and
(iv) the local lodges regularly engage in programs involving member participation to implement the purposes of Subsection (1)(a)(ii).
(d) "Representative form of government" means the fraternal complies with Section 31A-9-403.
(2) In any provisions of law made applicable to fraternals by this chapter, the technical terms used in those provisions are applicable to fraternals despite the use of other parallel terms by fraternals.
(3) The definitions in Section 31A-1-301 and the definitions to the following terms in Section 16-6a-102 apply to fraternals:
(a) "articles of incorporation";
(b) "bylaws"; and
(c) "member."
Amended by Chapter 386, 2009 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 9 - Insurance Fraternals › Part 1 - General Provisions › Section 102 - Scope and purposes.

31A-9-102.
Scope and purposes.
(1)
(a) This chapter applies to all fraternals organized under the laws of this state.
(b) Except as expressly provided in this chapter and in Section 31A-14-210, this chapter does not apply to nondomestic fraternals.
(2) The purposes of this chapter include:
(a) providing a complete, self-contained procedure for the formation of fraternals;
(b) assuring the solidity of fraternals by providing an organizational framework to facilitate sound management, operation, and regulation;
(c) strengthening internal fraternal democracy through member participation; and
(d) encouraging the fulfillment of the special purposes of fraternals.
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 9 - Insurance Fraternals › Part 1 - General Provisions › Section 103 - Orders imposing and relaxing restrictions.

31A-9-103.
Orders imposing and relaxing restrictions.
(1) The commissioner may subject any fraternal to some or all of the restrictions of Subsections 31A-5-305(2)(a)(i) and (ii), and Subsection 31A-5-410(1)(b), as such provisions are incorporated by Sections 31A-9-303 and 31A-9-407.
(2) The commissioner may free a fraternal from any of the restrictions applicable to fraternals under the provisions enumerated in Subsection (1), if he is satisfied that the fraternal's financial condition, management, and other circumstances give assurance that the interests of insureds and the public will not be endangered by the waiver.
Amended by Chapter 204, 1986 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 9 - Insurance Fraternals › Part 1 - General Provisions › Section 104 - Applicability of other insurance laws to fraternals.

31A-9-104.
Applicability of other insurance laws to fraternals.
(1) No section of Chapter 5, Domestic Stock and Mutual Insurance Corporations, applies to fraternals unless it is specifically made applicable by this chapter.
(2) Each section of the Insurance Code, other than in Chapter 5, Domestic Stock and Mutual Insurance Corporations, that applies to mutuals subject to Chapter 5, Domestic Stock and Mutual Insurance Corporations, also applies to domestic and nondomestic fraternals unless:
(a) this chapter or the particular section provides otherwise; or
(b) the particular section is inconsistent with a provision applying explicitly to fraternals, in this chapter or elsewhere.
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 9 - Insurance Fraternals › Part 1 - General Provisions › Section 105 - General corporate powers and procedures.

31A-9-105.
General corporate powers and procedures.
(1) Section 16-10a-302 applies to the general powers of fraternals.
(2) Section 16-6a-304 applies to ultra vires issues in fraternals.
(3) Subsection 31A-5-104(3) applies to the omission of a seal in a fraternal.
(4) Sections 16-6a-705 and 16-6a-707 apply to waiver of notice and consent to action without a meeting in a fraternal.
(5) Subsection 31A-5-104(5) applies to the power to hold assets as a trustee in a fraternal.
Amended by Chapter 300, 2000 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 9 - Insurance Fraternals › Part 2 - Organization of Fraternals › Section 202 - Members and applicants in fraternals.

31A-9-202.
Members and applicants in fraternals.
(1) A fraternal may admit any natural person to membership under the conditions and for the type of insurance and other benefits its laws prescribe, subject to this chapter and other applicable laws. A member without insurance ceases to be a member for insurance purposes if the fraternal is converted to a mutual.
(2) Subject to Section 31A-21-104, fraternals may provide insurance for the benefit of members, their dependents, and persons who are eligible for membership except for age.
(3) A fraternal may organize lodges for children who are not old enough for membership, but who are to be covered by insurance. Membership in local lodges is not required for those children, and they have no voting rights.
(4) A fraternal may extend temporary or conditional insurance coverage to a nonmember who has applied for membership in the fraternal.
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 9 - Insurance Fraternals › Part 2 - Organization of Fraternals › Section 204 - Articles of incorporation and bylaws.

31A-9-204.
Articles of incorporation and bylaws.
(1) The articles of incorporation shall set forth:
(a) the name of the corporation, which shall include the word "fraternal" or words of equivalent meaning;
(b) the location of the principal office of the fraternal, which shall be in this state;
(c) the purposes of the corporation, which shall include one or more of the purposes specified in Subsection 31A-9-101(1)(a)(ii)(B), but shall otherwise be restricted to those permitted under Section 31A-4-107;
(d) the classes of members, and the qualifications and rights of the members of each class;
(e) a description of the fraternal's representative form of government, conforming to Section 31A-9-403;
(f) the manner in which local lodges or branches may be formed and the powers they shall have, or a statement that the formation and powers of local lodges or branches is provided for in the bylaws;
(g) a provision for fraternal bonds, if any are to be authorized, which shall conform to Section 31A-9-303; and
(h) a provision for amendment of the articles, which shall conform to Section 31A-9-213.
(2) The articles of incorporation are not required to recite the corporate powers enumerated in this chapter, as these powers are authorized by law.
(3) Section 16-6a-818 applies to the officers of fraternals. The articles or bylaws shall specifically designate three or more offices, which shall be held by the principal officers of the fraternal. The principal offices shall be held by at least three separate natural persons.
(4) The bylaws shall comply with the provisions of this chapter. A copy of the bylaws and any amendments to them shall be filed with the commissioner promptly after their adoption. Notice of amendments to the bylaws shall be given promptly to members. Subject to this chapter, Section 16-6a-206 applies to the bylaws and resolutions of fraternals.
Amended by Chapter 300, 2000 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 9 - Insurance Fraternals › Part 2 - Organization of Fraternals › Section 205 - Organization permit and certificate of incorporation.

31A-9-205.
Organization permit and certificate of incorporation.
(1) Section 31A-5-204 applies to fraternals except that the word "mutual" shall be read "fraternal" and "Section 31A-5-211" in Subsection 31A-5-204(5) shall be read "Section 31A-9-209."
(2) The application for an organization permit shall include, in addition to those things required under Subsection 31A-5-204(2), a statement of the plan for fraternal activities and for the formation of a representative government under Section 31A-9-403.
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 9 - Insurance Fraternals › Part 2 - Organization of Fraternals › Section 206 - Powers under organization permit and deposit of proceeds of subscriptions.

31A-9-206.
Powers under organization permit and deposit of proceeds of subscriptions.
Subsection 31A-5-207(2) and Section 31A-5-208 apply to fraternals, except that:
(1) the word "mutual" shall be read "fraternal"; and
(2) there are no qualifying insurance policies as referred to in Subsection 31A-5-207(2)(a).
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 9 - Insurance Fraternals › Part 2 - Organization of Fraternals › Section 207 - Termination of organization permit and payment of organization expenses.

31A-9-207.
Termination of organization permit and payment of organization expenses.
Section 31A-5-209, other than Subsection (3)(c), applies to fraternals, except that:
(1) the word "mutual" shall be read "fraternal"; and
(2) the reference to "Section 31A-5-212" shall be read "Section 31A-9-210."
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 9 - Insurance Fraternals › Part 2 - Organization of Fraternals › Section 208 - Incorporators' liability and organization expenses.

31A-9-208.
Incorporators' liability and organization expenses.
Subsections 31A-5-210(1) and (2)(b) apply to fraternals, except that the word "mutual" shall be read "fraternal."
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 9 - Insurance Fraternals › Part 2 - Organization of Fraternals › Section 209 - Initial surplus requirements.

31A-9-209.
Initial surplus requirements.
(1)
(a) The requirements of Subsections 31A-5-211(1) through (4) apply to fraternals with respect to the amount of permanent surplus required of the fraternal.
(b) For purposes of Subsection (1)(a):
(i) wherever the word "mutual" appears in Subsections 31A-5-211(1) through (4), it means "fraternal;" and
(ii) the reference to "Section 31A-5-212" in Subsection 31A-5-211(1) means "Section 31A-9-210."
(2)
(a) Every fraternal shall include in its laws a provision that if the financial position of the fraternal becomes impaired, the board of directors or the supreme governing body may determine on an equitable basis the proportionate share of the deficiency of each member of the fraternal.
(b) The member may then:
(i) pay the member's share of the deficiency;
(ii) accept the imposition of a lien on the certificate of insurance, to bear interest at the rate charged on policy loans under the certificate, compounded annually until paid; or
(iii) accept a proportionate reduction in benefits under the certificate.
(c) The fraternal may specify the manner of the election and which alternative is to be presumed if no election is made.
(3) Except as provided in Subsection (2), no fraternal may operate on an assessment basis.
Amended by Chapter 9, 1996 Special Session 2
Amended by Chapter 9, 1996 Special Session 2
2023 Utah Code › Title 31A - Insurance Code › Chapter 9 - Insurance Fraternals › Part 2 - Organization of Fraternals › Section 210 - Certificate of authority.

31A-9-210.
Certificate of authority.
Section 31A-5-212 applies to certificates of authority for fraternals, except that references to other sections in Chapter 5, Domestic Stock and Mutual Insurance Corporations, shall be read to refer to the corresponding sections in Chapter 9, Insurance Fraternals.
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 9 - Insurance Fraternals › Part 2 - Organization of Fraternals › Section 211 - Accelerated organization procedure.

31A-9-211.
Accelerated organization procedure.
Section 31A-5-213 applies to the accelerated organization procedure for fraternals, except that the word "mutual" shall be read "fraternal."
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 9 - Insurance Fraternals › Part 2 - Organization of Fraternals › Section 212 - Separate accounts and subsidiaries.

31A-9-212.
Separate accounts and subsidiaries.
(1) Except as provided in Subsections (2) and (3), Sections 31A-5-217 and 31A-5-218 apply to separate accounts and subsidiaries of fraternals. If a fraternal issues contracts on a variable basis, Subsections 31A-22-902(2) and (6) and 31A-9-209(2) do not apply, except that Subsection 31A-9-209(2) applies to any benefits contained in the variable contracts which are fixed or guaranteed dollar amounts.
(2) If a fraternal engages in any insurance business other than life, accident and health, annuities, property, or liability insurance, it shall do so through a subsidiary under Section 31A-5-218.
(3)
(a) A local lodge may incorporate under Title 16, Chapter 6a, Utah Revised Nonprofit Corporation Act, or the corresponding law of the state where it is located, to carry out the noninsurance activities of the local lodge.
(b) Corporations may be formed under Title 16, Chapter 6a, Utah Revised Nonprofit Corporation Act, to implement Subsection 31A-9-602(2).
Amended by Chapter 116, 2001 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 9 - Insurance Fraternals › Part 2 - Organization of Fraternals › Section 213 - Amendment of articles of incorporation.

31A-9-213.
Amendment of articles of incorporation.
(1) The articles of a fraternal may provide for amendment by the supreme governing body or by the board of directors, and may also provide for amendment by an affirmative vote of a majority of those members who vote in a referendum. Only votes cast within 60 days from the date of mailing the first ballot by the fraternal are counted. The timeliness of a vote is determined by the date of its mailing as evidenced by its postmark or other suitable evidence.
(2) For five years after the initial issuance of a certificate of authority, proposed amendments of the articles shall be filed with the commissioner at least 30 days before the amendment is submitted for approval to the members or to the supreme governing body. If the approval of the members or the supreme governing body is not required, proposed amendments to the articles shall be filed with the commissioner at least 30 days before their effective date.
(3) No amendment is effective until the articles of amendment are filed with the commissioner, together with a statement of the results of the voting on the amendment or a statement that no vote is required.
(4) Within four months after filing the articles of amendment with the commissioner, they shall be furnished to all members either by mail or under Subsection 31A-9-402(1).
Amended by Chapter 204, 1986 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 9 - Insurance Fraternals › Part 3 - Securities of Fraternals › Section 301 - Securities regulation.

31A-9-301.
Securities regulation.
Section 31A-5-301 applies to fraternal bonds but does not apply to contribution notes, as they are defined in Section 31A-5-305, as incorporated by Section 31A-9-303.
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 9 - Insurance Fraternals › Part 3 - Securities of Fraternals › Section 303 - Authorized securities.

31A-9-303.
Authorized securities.
Subsection 31A-5-305(2) applies to authorized securities of fraternals, except that the words "mutual" and "nonassessable mutual" shall be read "fraternal."
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 9 - Insurance Fraternals › Part 4 - Management of Fraternals › Section 401 - Principal office, registered agent, and corruption in members' meetings.

31A-9-401.
Principal office, registered agent, and corruption in members' meetings.
Section 31A-5-401 governs the location of the principal office and existence of a registered agent for fraternals. Section 31A-5-403 applies to members' meetings of domestic fraternals.
Amended by Chapter 204, 1986 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 9 - Insurance Fraternals › Part 4 - Management of Fraternals › Section 402 - Communications to members.

31A-9-402.
Communications to members.
(1) A fraternal may provide in its laws for an official publication in which any notice, report, or statement required by law to be given to members, including a notice of election, may be published. Any required notice shall be printed conspicuously in the publication.
(2) The commissioner may by rule prescribe that copies of specified classes of communications published generally to members, including the official publication, be sent to the commissioner when they are sent to the members.
(3) If the records of a fraternal show that two or more members have the same mailing address, an official publication mailed to one member is considered to be notice to all members at the same address, unless a member requests a separate copy.
Enacted by Chapter 242, 1985 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 9 - Insurance Fraternals › Part 4 - Management of Fraternals › Section 403 - Representative form of government.

31A-9-403.
Representative form of government.
(1) A fraternal shall have a supreme governing body consisting either of:
(a) A board of directors is the supreme governing body of a fraternal. It consists of some directors elected directly by the members or by their representatives in intermediate assemblies under Subsection (2), and other directors prescribed in the fraternal's laws. A majority of the board shall be elected directors, having a sufficient number of votes to amend the articles or bylaws of the fraternal which can be amended without the consent of the members. The board shall meet at least quarterly to conduct the business of the fraternal. The elected directors shall be elected on a plan that ensures approximately equal weight to each fraternal member's vote. Voting may be by mail.
(b) Delegates elected directly by the members or at intermediate assemblies or conventions of members or their representatives, together with other delegates prescribed in the fraternal's laws form an assembly that is a supreme governing body of a fraternal. A majority of the assembly shall be elected delegates, having at least two-thirds of the votes and with a sufficient number of votes to amend the articles or bylaws that can be amended without consent of the members. The assembly, whatever designated, shall meet at least once every four years and shall elect a board of directors to conduct the business of the fraternal between meetings of the assembly. The delegates making up the supreme governing body shall be elected on a plan that ensures approximately equal weight to each fraternal member's vote.
(2) The laws of a fraternal may provide that:
(a) delegates to intermediate assemblies may represent geographical districts or lodges; or
(b) delegates may represent the members in defined classes determined on a reasonable basis; and
(c) the vote of a representative to an intermediate assembly is treated as the vote of the members represented.
(3) No votes may be cast by proxy.
Amended by Chapter 20, 1995 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 9 - Insurance Fraternals › Part 4 - Management of Fraternals › Section 404 - Annual report to fraternal members.

31A-9-404.
Annual report to fraternal members.
(1) Every domestic fraternal shall send to each member having insurance or shall publish in the official publication under Subsection 31A-9-402(1), an abbreviated annual report.
(2) This report shall contain:
(a) basic financial and operating data;
(b) information about important business and corporate developments;
(c) other information the fraternal wishes to include; or
(d) other information the commissioner by rule requires it to include to adequately inform its members.
(3) The fraternal shall send a business mail reply form on which the member may request a more complete annual report. This complete annual report shall contain the information prescribed by rule under Subsection 31A-2-201(3).
Amended by Chapter 91, 1987 General Session