reglab/statecodes huggingface dataset:
2023 Utah Code › Title 31A - Insurance Code › Chapter 43 - Small Employer Stop-Loss Insurance Act › Part 3 - Stop-Loss Insurance › Section 304 - Administrative rules.

Effective 5/13/2014
31A-43-304.
Administrative rules.
The commissioner may adopt administrative rules in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, to:
(1) implement this chapter;
(2) define lasering practices that are prohibited by this chapter;
(3) establish the form and manner of the actuarial certification and the annual report on stop-loss experience required by Section 31A-43-302;
(4) establish the form and manner of the disclosure required by Section 31A-43-303;
(5) assure the rates associated with the specific attachment points and aggregate attachment points are actuarially sound and are not against the public interest; and
(6) assure that stop-loss contracts include provisions to cover incurred and unpaid claims if a small employer plan terminates.
Amended by Chapter 290, 2014 General Session
Amended by Chapter 300, 2014 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 1 - General Provisions › Section 102 - Definitions.

Effective 5/3/2023
31A-44-102.
Definitions.
As used in this chapter:
(1) "Continuing care" means furnishing or providing access to an individual, other than by an individual related to the individual by blood, marriage, or adoption, of lodging together with nursing services, medical services, or other related services pursuant to a contract requiring an entrance fee.
(2) "Continuing care contract" means a contract under which a provider provides continuing care to a resident.
(3)
(a) "Entrance fee" means an initial or deferred transfer to a provider of a sum of money or property made or promised to be made as full or partial consideration for acceptance of a specified individual as a resident in a facility.
(b) "Entrance fee" includes a monthly fee, assessed at a rate that is greater than the value of the provider's monthly services, that a resident agrees to pay in exchange for acceptance into a facility or a promise of future monthly fees assessed at a rate that is less than the value of the services rendered.
(c) "Entrance fee" does not include an amount less than the sum of the regular period charges for three months of residency in a facility.
(d) "Entrance fee" does not include a deposit of less than $1,000 made under a reservation agreement.
(4) "Facility" means a place in which a person provides continuing care pursuant to a continuing care contract.
(5) "Ground lease" means a lease to a provider of the land and infrastructure improvements to the land on which a facility is located.
(6) "Ground lessor" means, for a facility subject to a ground lease, the owner and lessor of the land and infrastructure improvements to the land on which the facility is located.
(7) "Insolvent" means:
(a) having generally ceased to pay debts in the ordinary course of business other than as a result of a bona fide dispute;
(b) being unable to pay debts as they become due; or
(c) being insolvent within the meaning of federal bankruptcy law.
(8) "Living unit" means a room, apartment, cottage, or other area within a facility set aside for the exclusive use or control of one or more identified individuals.
(9)
(a) "Provider" means:
(i) the owner of a facility;
(ii) a person, other than a resident, that claims a possessory interest in a facility; or
(iii) a person who enters into a continuing care contract with a resident or potential resident.
(b) "Provider" does not include a person who is solely a ground lessor.
(10) "Provider disclosure statement" means, for a given provider, the disclosure statement described in Section 31A-44-301.
(11) "Reservation agreement" means an agreement that requires the payment of a deposit to reserve a living unit for a prospective resident.
(12) "Resident" means an individual entitled to receive continuing care in a facility pursuant to a continuing care contract.
Amended by Chapter 271, 2023 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 1 - General Provisions › Section 103 - Advisory committee.

Effective 5/10/2016
31A-44-103.
Advisory committee.
(1) The commissioner may convene a continuing care advisory committee to advise the department on issues related to the continuing care industry, continuing care facility residents, and the department's duties under this chapter.
(2) The committee described in Subsection (1) shall consist of five members appointed by the department as follows:
(a) a representative from an organization that advocates for the elderly;
(b) a representative of nursing homes;
(c) a representative from the continuing care industry;
(d) a representative from the insurance community; and
(e) a member of the general public who is a resident of a continuing care facility.
(3)
(a) Except as required by Subsection (3)(b), the term of a member of the committee shall be four years and expire on July 1.
(b) The commissioner shall, at the time of appointment or reappointment, adjust the length of terms to ensure that the terms of members are staggered so that approximately half of the committee is appointed every two years.
(4) A member of the committee shall serve until the member's successor is appointed and qualified.
(5) When a vacancy occurs in the committee's membership, the department shall appoint a replacement.
(6) The department may dismiss and replace members of the committee at the department's discretion.
(7) The department may designate a chair of the committee.
(8) The committee shall meet when called by the department.
(9) A member may not receive compensation or benefits for the member's service, but may receive per diem and travel expenses in accordance with:
(a) Section 63A-3-106;
(b) Section 63A-3-107; and
(c) rules made by the Division of Finance pursuant to Sections 63A-3-106 and 63A-3-107.
(10) The department shall staff the committee.
Enacted by Chapter 270, 2016 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 1 - General Provisions › Section 104 - Scope of regulation -- When compliance is required.

Effective 7/17/2016
31A-44-104.
Scope of regulation -- When compliance is required.
(1) The regulation of providers under this chapter does not limit or replace regulation by any other governmental entity of continuing care facilities or providers.
(2) The department may not regulate, or in any manner inquire into, the quality of care provided in a facility.
(3) A record that the department receives from a provider that is not required to be part of a disclosure statement under this chapter is a protected record under Title 63G, Chapter 2, Government Records Access and Management Act.
(4) The department shall determine the amount of any fee required under this chapter, in accordance with Section 63J-1-504, and in an amount that covers the department's cost to administer this chapter.
(5) A provider that begins marketing a continuing care facility project on or before May 10, 2016, is not required to comply with this chapter until May 10, 2017.
Amended by Chapter 8, 2016 Special Session 3
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 2 - Registration › Section 201 - Registration required.

Effective 5/10/2016
31A-44-201.
Registration required.
(1) A person may not provide or offer to provide continuing care unless the person is registered with the department.
(2) A registration expires on December 31 of a given year, unless a provider renews the provider's registration under Section 31A-44-203.
Enacted by Chapter 270, 2016 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 2 - Registration › Section 202 - Registration.

Effective 5/10/2016
31A-44-202.
Registration.
(1) To register under this part, a person shall:
(a) pay an original registration fee established by the department in accordance with Section 63J-1-504; and
(b) submit a registration statement, in a form approved by the department, that contains the information described in Subsection (2).
(2) A provider's registration statement shall include:
(a) the provider disclosure described in Section 31A-44-301;
(b) a copy of the continuing care contract that the provider will propose to a prospective facility resident;
(c) evidence that the provider's facility is located or will be located in a zone that a municipality or county has zoned for continuing care facilities; and
(d) information required by the department by rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
(3) The department shall accept or deny a registration no later than 180 days after the day on which the provider applies for registration.
Enacted by Chapter 270, 2016 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 2 - Registration › Section 203 - Renewal process.

Effective 5/10/2016
31A-44-203.
Renewal process.
In order to renew a registration under this section, a provider shall:
(1) pay an annual fee established by the department in accordance with Section 63J-1-504;
(2) submit an updated provider disclosure statement that complies with Section 31A-44-301;
(3) submit a copy of the most recent version of the continuing care contract the provider will propose to a prospective facility resident; and
(4) comply with rules made by the department under Subsection 31A-44-202(2).
Enacted by Chapter 270, 2016 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 2 - Registration › Section 204 - Actuarial review.

Effective 5/10/2016
31A-44-204.
Actuarial review.
(1)
(a) This section applies only to a provider that directly or indirectly offers a future guarantee of continuing care that the department determines develops current actuarial liabilities.
(b) This section does not apply to a provider that offers continuing care under a fee-for-service model with a required entrance fee.
(2) A provider subject to this section shall file, with the department, an actuarial review:
(a) upon being notified of the department's determination; and
(b) on a day designated by the department in the year five years after the day on which the department last received an actuarial review from the provider.
(3) The department may require an actuarial review in addition to the actuarial reviews required by Subsection (2) if the department determines that the provider shows an indication of financial instability.
Enacted by Chapter 270, 2016 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 2 - Registration › Section 205 - Suspension or revocation of registration.

Effective 5/10/2016
31A-44-205.
Suspension or revocation of registration.
The department may suspend or revoke a provider's registration if the provider intentionally violates this chapter.
Enacted by Chapter 270, 2016 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 3 - Provider Disclosure › Section 301 - Precontractual recording requirements.

Effective 5/10/2016
31A-44-301.
Precontractual recording requirements.
(1) A provider shall file with the department a current disclosure statement that meets the requirements of this part.
(2) A provider shall comply with Subsection (1) before the provider:
(a) contracts to provide continuing care to a resident in this state;
(b) extends the term of an existing continuing care contract with a resident in this state that requires a person to pay an entrance fee, regardless of whether the extended continuing care contract requires an entrance fee; or
(c) solicits or offers, or directs another person to solicit or offer, a continuing care contract to a resident of the state.
(3) A provider solicits or offers a contract under Subsection (2)(c), if, after 12 months before the day on which a party to a continuing care contract signs or accepts a continuing care contract, the provider or a person acting on behalf of the provider gives information concerning the facility or the availability of a continuing care contract for the facility:
(a) in a direct communication to an individual in the state; or
(b) in a paid advertisement published in or broadcast from the state, except for a paid advertisement in a publication with more than two-thirds of the publication's circulation outside of the state.
Enacted by Chapter 270, 2016 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 3 - Provider Disclosure › Section 302 - Delivery of disclosure statement.

Effective 5/10/2016
31A-44-302.
Delivery of disclosure statement.
(1) A provider shall deliver a disclosure statement to an individual before the earlier of the date:
(a) the provider executes a continuing care contract with the individual; or
(b) the individual transfers an entrance fee or a nonrefundable deposit to the provider.
(2) The most recently filed disclosure statement:
(a) is current for the purpose of this chapter; and
(b) is the only disclosure statement that satisfies the requirements described in Subsection (1).
Enacted by Chapter 270, 2016 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 3 - Provider Disclosure › Section 303 - Cover page of disclosure statement.

Effective 5/10/2016
31A-44-303.
Cover page of disclosure statement.
The cover page of a disclosure statement shall state:
(1) the disclosure statement's date in a prominent location and in type that is boldfaced, capitalized, underlined, or otherwise set out from the surrounding written material so as to be conspicuous;
(2) that the provider is required to deliver a disclosure statement to an individual before the provider executes a continuing care contract with the individual or accepts payment of an entrance fee or a nonrefundable deposit from the individual; and
(3) that the disclosure statement has not been approved by a government agency to ensure the disclosure statement's accuracy.
Enacted by Chapter 270, 2016 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 3 - Provider Disclosure › Section 304 - Disclosure statement -- Contents -- Provider characteristics.

Effective 5/10/2016
31A-44-304.
Disclosure statement -- Contents -- Provider characteristics.
A provider disclosure statement shall contain:
(1) the name and business address of each provider officer, director, trustee, and managing or general partner of the provider;
(2) the name and business address of each person who has at least a 10% interest in the provider and a description of the person's interest in or occupation with the provider;
(3) a statement of whether the continuing care provider is a for-profit or not-for-profit entity, and a statement of the provider's tax-exempt status, if any;
(4)
(a) the location and a description of the proposed or existing physical property of the facility; and
(b) if the physical property is proposed:
(i) the property's estimated completion date;
(ii) whether construction has begun; and
(iii) conditions known to the provider under which the property's construction could be deferred;
(5) if the provider intends to contract with a person other than an employee of the provider to manage the operations of the facility:
(a) a description of the person's experience in the operation or management of a continuing care or similar facility;
(b) a description of any entity that controls or is controlled by the person that proposes to provide goods, leases, or services to residents of the facility, of an aggregate value of $500 or greater in a year;
(c) a description of any goods, leases, or services described in Subsection (5)(b), and a statement of the probable or anticipated cost to the facility, provider, or residents for the goods, leases, or services, or a statement that the provider is unable to estimate the cost; and
(d) a description of any matter in which the person:
(i) has been convicted of a felony;
(ii) is subject to a restrictive court order; or
(iii) has had a state or federal license revoked as a result of a matter related to a continuing care facility or a related health care field; and
(6)
(a) any religious, charitable, or nonprofit organization affiliated with the provider;
(b) the extent of the affiliation and the extent to which the organization is responsible for contractual or financial obligations of the provider; and
(c) the organization's tax-exempt status, if any.
Enacted by Chapter 270, 2016 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 3 - Provider Disclosure › Section 305 - Disclosure statement -- Contents -- Contract.

Effective 5/10/2016
31A-44-305.
Disclosure statement -- Contents -- Contract.
A provider disclosure statement shall include a description of the following provisions contained in the provider's continuing care contract:
(1) a description of the services provided under the provider's proposed continuing care contract, including a description of:
(a) the extent to which the provider will offer or provide medical care to a resident; and
(b) the services the provider includes under the contract, and the services the provider offers at an extra charge;
(2) the fees the provider requires a resident to pay, including any entrance fees or periodic charges;
(3) a description of the conditions, in the provider's continuing care contract, under which:
(a) a provider or a resident may cancel the continuing care contract;
(b) a provider will refund all or part of an entrance fee; or
(c) a provider may adjust a fee the provider charges a resident and any limitations on those adjustments;
(4) any health or financial criteria that a resident is required to meet under the continuing care contract for acceptance to the facility or for the resident to continue living in the facility, including the effect of any change in the health or financial condition of an individual between the date of the continuing care contract and the date on which the individual initially occupies a living unit;
(5) the provider's policy for the spouse of a resident, regarding:
(a) the conditions under which the spouse is allowed to live in the resident's unit; and
(b) the financial or other consequences to the resident if the spouse does not meet the requirements for admission;
(6) the provider's policy regarding changes in the number of people residing in a living unit because of marriage or other relationships;
(7) the conditions under which a living unit occupied by a resident may be made available by the provider to a different resident other than on the death of the previous resident; and
(8) the number of continuing care contracts terminated, other than by the resident's death, at the provider's facility in the state during the three most recent calendar years.
Enacted by Chapter 270, 2016 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 3 - Provider Disclosure › Section 306 - Disclosure statement -- Contents -- Health care information.

Effective 5/10/2016
31A-44-306.
Disclosure statement -- Contents -- Health care information.
The provider disclosure statement shall include:
(1) a description of the facility as an independent living, assisted living, or nursing care facility, or a combination of facility types;
(2) a general description of medical services provided at the facility in addition to assisted living services and nursing care services;
(3) a statement as to whether the facility accepts Medicare and Medicaid reimbursements; and
(4) notice of the online federal nursing care facility database and the online federal nursing care facility database's Internet address.
Enacted by Chapter 270, 2016 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 3 - Provider Disclosure › Section 307 - Disclosure statement -- Contents -- Financial information.

Effective 5/10/2016
31A-44-307.
Disclosure statement -- Contents -- Financial information.
The provider disclosure statement shall:
(1) describe any provisions the provider made or will make to provide reserve funding or security to enable the provider to fully perform the provider's obligations under a continuing care contract, including:
(a) the establishment of an escrow account, trust, or reserve fund, and the manner in which the provider will invest the account, trust, or reserve funds; and
(b) the name and experience of an individual in the provider's direct employment who will make the investment decisions;
(2) contain a provider financial statement, prepared in accordance with generally accepted accounting principles, and audited by an independent certified public account, that includes:
(a) a balance sheet as of the end of the most recent fiscal year;
(b) an income statement for each of the three most recent fiscal years; and
(c) a cash flow statement for each of the three most recent fiscal years.
Enacted by Chapter 270, 2016 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 3 - Provider Disclosure › Section 308 - Anticipated source and application of funds.

Effective 5/10/2016
31A-44-308.
Anticipated source and application of funds.
If a provider's facility is not in operation, the provider disclosure statement shall include a statement of the provider's anticipated source and application of funds to be used in the purchase or construction of the facility, including:
(1) an estimate of the cost of purchasing or constructing and of equipping the facility, including financing expenses, legal expenses, land costs, occupancy development costs, and any other costs that the provider expects to incur or to become obligated to pay before the facility begins operating;
(2) a description of any mortgage loan or other long-term financing arrangement for the facility, including the anticipated terms and costs of the financing;
(3) an estimate of the total entrance fees to be received from, or on behalf of, residents before the facility begins operation; and
(4) an estimate of any funds the provider anticipates are necessary to cover the facility's initial losses.
Enacted by Chapter 270, 2016 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 3 - Provider Disclosure › Section 309 - Standard contract form.

Effective 5/10/2016
31A-44-309.
Standard contract form.
(1) A provider shall attach a copy of the provider's standard contract form to a disclosure statement.
(2) The standard contract form shall specify the refund provisions of Sections 31A-44-312 and 31A-44-313.
Enacted by Chapter 270, 2016 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 3 - Provider Disclosure › Section 310 - Annual disclosure statement revision.

Effective 5/10/2016
31A-44-310.
Annual disclosure statement revision.
(1) A provider shall file a revised disclosure statement with the department before 120 days after the day on which the provider's fiscal year ends.
(2) The revised disclosure statement shall revise, as of the end of the provider's fiscal year, the information required by this part.
(3) The revised disclosure statement shall describe any material differences between:
(a) the estimated income statements filed under Section 31A-44-307 as a part of the disclosure statement the provider filed after the start of the provider's most recently completed fiscal year; and
(b) the actual result of operations during that fiscal year with the revised estimated income statements filed as a part of the revised disclosure statement.
(4) A provider may revise the provider's disclosure statement and may file a revised disclosure statement at any time if, in the provider's opinion, a revision is necessary to prevent a disclosure statement from containing a material misstatement of fact or omitting a material fact required by this part.
(5) The department:
(a) shall review the disclosure statement for completeness; and
(b) is not required to review the disclosure statement for accuracy.
Enacted by Chapter 270, 2016 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 3 - Provider Disclosure › Section 311 - Advertisement in conflict with disclosures.

Effective 5/10/2016
31A-44-311.
Advertisement in conflict with disclosures.
A provider may not engage in any type of advertisement for a continuing care contract or facility if the advertisement contains a statement or representation in conflict with the disclosures required under this part.
Enacted by Chapter 270, 2016 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 3 - Provider Disclosure › Section 312 - Rescission of contract -- Required language.

Effective 5/10/2016
31A-44-312.
Rescission of contract -- Required language.
(1) An individual who executes a continuing care contract with a provider may rescind the contract at any time before the later of:
(a) midnight on the day seven days after the day on which the individual executes the continuing care contract; or
(b) a time specified in the continuing care contract that is:
(i) after the day on which the continuing care contract is executed; or
(ii) after the day on which the individual receives a disclosure statement that meets the requirements of this part.
(2) A provider may not require an individual who executes a continuing care contract with the provider to move into a facility before the end of the rescission period described in Subsection (1).
(3) If an individual rescinds a continuing care contract under this section, the provider shall refund any money or property that the individual transferred to the provider, other than periodic charges specified in the contract and applicable only to the period the individual occupied a living unit, before 30 days after the day on which the individual rescinds the contract.
(4) A continuing care contract shall include the following statement, or a substantially equivalent statement, in type that is boldfaced, capitalized, underlined, or otherwise set out from the surrounding written material so as to be conspicuous:
"You may cancel this contract at any time before midnight on the day seven days after the day on which you sign the contract, or before a later day if specified in the contract that is after the later of the day on which you sign the contract or you receive the facility's disclosure statement. If you elect to cancel the contract, you are required to cancel the contract in writing, and you are entitled to receive a refund of all assets transferred other than periodic charges applicable to the time you occupied your living unit."
(5) In addition to Subsection (4), a continuing care contract shall include the following statement in type that is boldfaced, capitalized, underlined, or otherwise set out from the surrounding written material so as to be conspicuous:
"This document, if executed, constitutes a legal and binding contract between you and __________ (Legal name of the continuing care provider). You may wish to consult a legal or financial advisor before signing, although it is not required that you do so to make this contract binding."
Enacted by Chapter 270, 2016 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 3 - Provider Disclosure › Section 313 - Cancellation of contract -- Death or incapacity before occupancy.

Effective 5/10/2016
31A-44-313.
Cancellation of contract -- Death or incapacity before occupancy.
(1) A continuing care contract to provide continuing care in a living unit in a facility is cancelled if the resident:
(a) dies before occupying a living unit in the facility; or
(b) is precluded under the terms of the contract from occupying a living unit in the facility because of illness, injury, or incapacity.
(2) If a continuing care contract is cancelled under this section, the resident or the resident's legal representative is entitled to a refund of all money or property transferred to the provider, minus:
(a) any nonstandard costs specifically incurred by the provider or facility at the request of the resident that are described in the contract or in an addendum to the contract signed by the resident; and
(b) a reasonable service charge, if set out in the contract, that may not exceed the greater of:
(i) $1,000; or
(ii) 2% of the entrance fee.
Enacted by Chapter 270, 2016 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 3 - Provider Disclosure › Section 314 - Disclosure statement fees.

Effective 5/10/2016
31A-44-314.
Disclosure statement fees.
A provider that files a disclosure statement under this chapter shall pay to the department a fee established by the department in accordance with Section 63J-1-504.
Enacted by Chapter 270, 2016 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 3 - Provider Disclosure › Section 315 - Financial assessment.

Effective 5/3/2023
31A-44-315.
Financial assessment.
(1) The department shall assess the financial condition of a provider no less than once per year.
(2) The department may consider any relevant documents and information in performing an assessment.
(3) A provider shall prepare and timely provide to the department documents and information requested by the department in connection with an assessment.
(4) Department work papers created or relied upon in connection with an assessment are protected under Title 63G, Chapter 2, Government Records Access and Management Act.
(5) The department may conduct any portion of an assessment at the provider's facility during regular business hours if the department notifies the provider of the anticipated visit and assessment at least seven calendar days in advance.
(6) The department shall prepare a written report of the assessment and provide a copy of the report to the provider within 28 days after the day on which the department completes the gathering of information necessary to complete the assessment.
Enacted by Chapter 271, 2023 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 4 - Operations › Section 401 - Continuing care contract requirements -- No waiver.

Effective 7/17/2016
31A-44-401.
Continuing care contract requirements -- No waiver.
(1) A continuing care contract shall:
(a) provide that the provider shall refund the portion of a departing resident's entrance fee that the provider has agreed to refund, if any, no later than the earlier of:
(i) if the departing resident ceased occupancy of the departing resident's unit before any other departing resident who has not received an entrance fee refund, 30 days after the day on which the provider accumulates an amount of money, from sales of living units previously occupied by departing residents, that is equal to the departing resident's entrance fee refund; or
(ii) one year after the day on which the departing resident ceases to occupy the departing resident's living unit, unless the provider proves that the provider has made and is making a good faith effort to find an occupant for a living unit that was previously occupied by a departing resident;
(b) provide that the resident may terminate the continuing care contract upon giving notice of termination:
(i) with or without cause; and
(ii) clearly stating what portion of the entrance fee the provider will refund and the date by which the provider will make the refund; and
(c) provide that a continuing care contract is terminated by the resident's death and clearly state:
(i) what portion of the entrance fee the provider will refund in the event of the resident's death;
(ii) the date before which the provider will make the refund; and
(iii) to whom the provider will make the refund.
(2) A continuing care contract may permit involuntary dismissal of a resident from a continuing care facility upon a reasonable determination by the provider that the resident's health and well-being require termination of the continuing care contract.
(3) If a resident is dismissed under Subsection (2) and is in a condition of financial hardship, as defined by the department by rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, the provider shall refund the resident's entrance fee:
(a) in an amount provided in the continuing care contract; and
(b) before the earlier of:
(i) a time provided in the continuing care contract; and
(ii) 60 days after the day on which the provider dismisses the resident from the facility.
(4) A resident may not waive a provision of this chapter by agreement.
Amended by Chapter 8, 2016 Special Session 3
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 4 - Operations › Section 402 - Actuarial reserve -- Department may require.

Effective 5/3/2023
31A-44-402.
Actuarial reserve -- Priority of entrance fee refunds.
(1) The department may require a provider that the department determines has actuarial liability under Section 31A-44-204 to create an additional reserve fund to offset the actuarial liability.
(2) The department may require the additional reserve fund described in Subsection (1) by rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
(3) If a refund or remittance of funds is owed in relation to a living unit due to the death or relocation of a resident, the provider shall prioritize the sale of the resident's living unit over the sale of other units for which a refund or remittance of funds is not owed.
Amended by Chapter 271, 2023 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 4 - Operations › Section 403 - Resident advisory committee.

Effective 5/10/2016
31A-44-403.
Resident advisory committee.
(1) A provider shall maintain, beginning no later than two years after the day on which a facility is operational, a resident advisory committee for the facility that meets the requirements of this section.
(2) A resident advisory committee shall:
(a) consist of no fewer than the lesser of five residents or all residents;
(b) meet no less than once per month; and
(c) discuss resident concerns and communications relevant to the provider or the facility.
(3) A provider shall:
(a) meet with the resident advisory committee no fewer than three times per year; and
(b) distribute a provider disclosure statement to the resident advisory committee each time the provider is required to renew the provider disclosure statement under Section 31A-44-301.
Enacted by Chapter 270, 2016 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 4 - Operations › Section 404 - Nondisturbance of residents.

Effective 5/3/2023
31A-44-404.
Nondisturbance of residents.
(1) A person may not directly or indirectly disturb the rights of a resident or third party beneficiary under a continuing care contract and this chapter if the resident has substantially performed the resident's obligations under the continuing care contract.
(2) If the person to whom a resident owes performance under the continuing care contract is contested, and a court has not issued a temporary or permanent order resolving the contest:
(a) the department may appoint a temporary receiver to receive the performance of the resident; and
(b) a court may appoint a receiver upon the department's petition, or the department's motion under an existing action.
(3)
(a) Except as provided in Subsection (3)(b), a person other than a resident that holds a present right to possess a facility, including a ground lessor but only after the ground lessor acquires a provider's possessory interest by termination of a ground lease or otherwise, is bound by every continuing care contract related to the facility, including a continuing care contract that provides for the return of part or all of a resident's entrance fee.
(b) If a ground lessor acquires a provider's possessory interest by termination of a ground lease or otherwise, the ground lessor's obligation under the continuing care contracts is limited to the monetary obligations of the provider to which the ground lessor succeeds.
(4)
(a) The commissioner holds a covenant that:
(i) runs with the land on which a facility is located; and
(ii) except as provided in Subsection (4)(b), binds a person with a present right to possess the land on which the facility is located, including a ground lessor but only after the ground lessor acquires a provider's possessory interest by termination of a ground lease or otherwise, to every continuing care contract related to the facility, including a continuing care contract that provides for the return of all or part of a resident's entrance fee.
(b) If a ground lessor acquires a provider's possessory interest by termination of a ground lease or otherwise, the ground lessor's obligation under the continuing care contracts under the covenant described in Subsection (4)(a) is limited to the monetary obligations of the provider to which the ground lessor succeeds.
(c) A person may not sell the land on which the facility is located free and clear of the interest described in Subsection (4)(a).
(5) A person may not sell or transfer the land on which a facility subject to a ground lease is located free and clear of the provider's possessory interest in the ground lease.
Amended by Chapter 271, 2023 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 4 - Operations › Section 405 - Continuing care facilities not exempt from property tax.

Effective 5/10/2016
31A-44-405.
Continuing care facilities not exempt from property tax.
Notwithstanding any tax-exempt status of a provider or facility, a provider or facility is liable for property tax due under Title 59, Chapter 2, Property Tax Act.
Enacted by Chapter 270, 2016 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 5 - Rehabilitation and Liquidation › Section 501.1 - Receivership.

Effective 5/3/2023
31A-44-501.1.
Receivership.
(1) The department may, by petition or motion, request that a court appoint the commissioner as receiver for a provider.
(2) The court may appoint the commissioner as receiver if, as determined by the commissioner, the provider:
(a) is insolvent or at material risk of becoming insolvent within the next 12 months;
(b) is materially unable to meet the income or available cash projections described in the provider's disclosure statement; or
(c) is unable or at risk of being unable to perform a material obligation under a continuing care contract within the next 12 months.
(3) In evaluating whether a receiver is appropriate under this section, the court:
(a) shall evaluate and promote the best interests of the residents that have contracted with the provider; and
(b) may require the proceeds of a lien imposed under Section 31A-44-601 to be used to pay an entrance fee to another facility on behalf of a resident of the provider's facility.
(4) The commissioner may not file an independent proceeding or action described in this section if another judicial proceeding or action based on the provider's financial condition is pending, but may move to intervene in a pending proceeding or action that is based on the provider's financial condition.
Enacted by Chapter 271, 2023 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 5 - Rehabilitation and Liquidation › Section 502 - Order to rehabilitate.

Effective 5/3/2023
31A-44-502.
Relief available.
(1) In a judicial proceeding, including under Sections 31A-44-501 and 31A-44-501.1, a court may:
(a) direct a receiver to take possession of the provider's property in order to conduct the provider's business, including employing any manager or agent that the receiver considers necessary; and
(b) direct a receiver to eliminate the causes and conditions that made receivership necessary, which action may include:
(i) selling the facility;
(ii) requiring a purchaser of the facility to honor any continuing care contract for the facility; and
(iii) collecting and liquidating all or a portion of the provider's assets within the court's jurisdiction.
(2)
(a) For a facility subject to a ground lease, a court may, in addition to the actions described in Subsection (1), direct a receiver to purchase from the ground lessor, or assign to another person that agrees to operate the facility, for market value, the ground lessor's interest in the land and the infrastructure improvements to the land on which the facility is located.
(b) A court may direct a receiver to purchase from a ground lessor the land and infrastructure improvements to the land on which a facility is located, regardless of the terms of the ground lease agreement.
(c) If a court directs a receiver to purchase or assign the land and infrastructure improvements to the land under Subsection (2)(a), the ground lessor shall sell or assign the land and infrastructure improvements to the land in compliance with the court order.
(d) In determining market value under Subsection (2)(a), the commissioner shall:
(i) value the land and infrastructure improvements to the land on which the facility is located as though the land and infrastructure improvements to the land were not subject to the ground lease; and
(ii) disregard the monetized value of an existing ground lease.
(3) A provider that is subject to a liquidation order may not enter into a new continuing care contract.
(4) Solely for the purpose of enforcing this section, a court has personal jurisdiction in a proceeding under this section over:
(a) the owner of a facility; and
(b) the owner of the land and infrastructure improvements to the land on which a facility is located.
(5) If the commissioner is appointed as receiver, the commissioner may hire or retain a deputy receiver to perform any duties of receivership.
Amended by Chapter 271, 2023 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 5 - Rehabilitation and Liquidation › Section 504 - Bond.

Effective 5/10/2016
31A-44-504.
Bond.
A court may refuse to make or vacate an order to rehabilitate a provider's facility under this part if the provider posts a bond that is:
(1) in an amount that the court determines is equal to the reserve funding the provider needs to fulfill the provider's obligations under all of the continuing care contracts for the facility;
(2) issued by a recognized surety authorized to do business in the state; and
(3) executed in favor of the state on behalf of any individual entitled to an entrance fee refund or other damages from the provider.
Enacted by Chapter 270, 2016 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 5 - Rehabilitation and Liquidation › Section 505 - Termination of rehabilitation.

Effective 5/3/2023
31A-44-505.
Termination of receivership.
(1) A court may terminate a receivership of a provider's facility and order the return of the facility and the facility's assets to the provider if the court determines:
(a) the objectives of the receivership orders have been accomplished; and
(b) termination of the receivership will not jeopardize the interests of the facility's residents, creditors, owners, or the public.
(2) A court may enter an order under this section after the court enters:
(a) a full report and accounting of the conduct of the facility's affairs during the rehabilitation; and
(b) a report on the facility's financial condition.
Amended by Chapter 271, 2023 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 5 - Rehabilitation and Liquidation › Section 506 - Payment of trustee.

Effective 5/3/2023
31A-44-506.
Payment of receiver.
A receiver's and any deputy receiver's reasonable costs, expenses, and fees are payable from a provider's or facility's assets.
Amended by Chapter 271, 2023 General Session
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 6 - Enforcement › Section 602 - Enforcement by department -- Rulemaking.

Effective 7/17/2016
31A-44-602.
Enforcement by department -- Rulemaking.
(1) Subject to the requirements of Title 63G, Chapter 4, Administrative Procedures Act, the department may:
(a) receive and act on a complaint from a resident about a provider or a facility;
(b) take action designed to obtain voluntary compliance by the provider with this chapter for the benefit of a resident;
(c) commence administrative or judicial proceedings on the commission's own in order to enforce compliance by a provider with this chapter for the benefit of a resident;
(d) after a complaint by a resident about a provider for a facility subject to a ground lease, require the provider to pay rent in accordance with the ground lease; or
(e) take action against a provider who fails to:
(i) respond to the department, in writing, before 30 business days after the day on which the provider receives notice from the department of a complaint filed with the department; or
(ii) submit information requested by the department.
(2) The department may:
(a) counsel an individual on the individual's rights or duties under this chapter;
(b) make rules in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, to:
(i) restrict or prohibit practices by the provider that are misleading, unfair, or abusive;
(ii) promote or assure fair and full disclosure of the terms and conditions of continuing care contracts, agreements, and communications between a resident and a provider;
(iii) promote or assure the ability of the public to compare continuing care contracts, providers, and facilities; and
(iv) clearly disclose any financial risks related to a provider's facility to the facility's residents;
(c) employ hearing examiners, clerks, and other employees and agents as necessary to perform the department's duties under this chapter;
(d) appoint a receiver for a provider; and
(e) upon request by a provider, subordinate a lien imposed under Section 31A-44-601 for the purpose of the provider obtaining secondary financing or refinancing of a facility if:
(i) the facility is financially sound; and
(ii) subordinating the lien does not adversely affect the residents of the facility.
Amended by Chapter 8, 2016 Special Session 3
2023 Utah Code › Title 31A - Insurance Code › Chapter 44 - Continuing Care Provider Act › Part 6 - Enforcement › Section 603 - Examinations.

Effective 5/9/2017
31A-44-603.
Examinations.
(1) The department may conduct periodic on-site examinations of a provider.
(2) In conducting an examination, the department or the department's staff:
(a) shall have full and free access to all the provider's records; and
(b) may summon and qualify as a witness, under oath, and examine, any director, officer, member, agent, or employee of the provider, and any other person, concerning the condition and affairs of the provider or a facility.
(3) Books and records shall be kept for not less than three calendar years in addition to the current calendar year.
(4) The provider shall pay the reasonable costs of an examination under this section.
(5) The department may conduct an on-site examination in conjunction with an examination performed by a representative of an agency of another state.
(6)
(a) The department, in lieu of an on-site examination, may accept the examination report of an agency of another state that has regulatory oversight of the provider, or a report prepared by an independent accounting firm.
(b) A report accepted under Subsection (6)(a) is considered for all purposes an official report of the department.
(7) Upon reasonable cause, the department may conduct an on-site examination of an unlicensed person to determine whether a violation of this chapter has occurred.
Amended by Chapter 168, 2017 General Session