Bill Summary – FastDemocracy

LEGISLATIVE GENERAL COUNSEL                                             S.B. 31
Approved for Filing: A. Weenig 6                             nd
                                                                   2 Sub. (Salmon)
         6 01-25-24 11:04 AM 6
                          Senator Curtis S. Bramble proposes the following substitute bill:
                                   INSURANCE AMENDMENTS
                                        2024 GENERAL SESSION
                                             STATE OF UTAH
                                 Chief Sponsor: Curtis S. Bramble
                                 House Sponsor: James A. Dunnigan
 6
 LONG TITLE
 General Description:
        This bill updates the Insurance Code.
 Highlighted Provisions:
        This bill:
        < defines terms;
        < exempts a health care sharing ministry from regulation under the Insurance Code,
 provided the health care sharing ministry makes certain disclosures to participants
 º [and the commissioner] » ;
        < requires that the commissioner evaluate annually the state's health insurance market
 and provide that evaluation to the Health and Human Services Interim Committee;
        < removes provisions relating to the commissioner declaring a rule in effect during a
 transition period;
        < clarifies the scope of the consumer assistance that the commissioner provides;             2nd Sub. S.B. 31
        < updates the duties of the Office of Consumer Health Assistance;
        < modifies the commissioner's enforcement authority to allow the commissioner to
 accept or compromise a forfeiture after the filing of a complaint;
        < amends provisions relating to mutual insurance holding companies;
        < amends the enforcement provisions under this chapter;
     *SB0031S02*
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         01-25-24 10:25 AM                                                   2nd Sub. (Salmon) S.B. 31
          (g) a prepaid contract of limited duration that provides for scheduled maintenance only.
          (2) (a) This title restricts otherwise legitimate business activity.
          (b) What this title does not prohibit is permitted unless contrary to other provisions of
  Utah law.
          (3) Except as otherwise expressly provided, this title does not apply to:
          (a) those activities of an insurer where state jurisdiction is preempted by Section 514 of
  the federal Employee Retirement Income Security Act of 1974, as amended;
          (b) ocean marine insurance;
          (c) death, accident, health, or disability benefits provided by an organization [if the
  organization:] that:
          (i) has as the organization's principal purpose to achieve charitable, educational, social,
  or religious objectives rather than to provide death, accident, health, or disability benefits;
          (ii) does not incur a legal obligation to pay a specified amount; [and]
          (iii) does not create reasonable expectations of receiving a specified amount on the part
  of an insured person; and
          (iv) is not a health care sharing ministry º that provides that a participant make a
134a contribution to pay another participant's qualified expenses with no assumption of risk or
134b promise to pay » .
          (d) other business specified in rules adopted by the commissioner on a finding that:
          (i) the transaction of the business in this state does not require regulation for the
  protection of the interests of the residents of this state; or
          (ii) it would be impracticable to require compliance with this title;
          (e) except as provided in Subsection (4), a transaction independently procured through
  negotiations under Section 31A-15-104;
          (f) self-insurance;
          (g) reinsurance;
          (h) subject to Subsection (5), an employee or labor union group insurance policy
  covering risks in this state or an employee or labor union blanket insurance policy covering
  risks in this state, if:
          (i) the policyholder exists primarily for purposes other than to procure insurance;
          (ii) the policyholder:
          (A) is not a resident of this state;
          (B) is not a domestic corporation; or
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         2nd Sub. (Salmon) S.B. 31                                                    01-25-24 11:04 AM
          (C) does not have the policyholder's principal office in this state;
          (iii) no more than 25% of the certificate holders or insureds are residents of this state;
          (iv) on request of the commissioner, the insurer files with the department a copy of the
  policy and a copy of each form or certificate; and
          (v) (A) the insurer agrees to pay premium taxes on the Utah portion of the insurer's
  business, as if the insurer were authorized to do business in this state; and
          (B) the insurer provides the commissioner with the security the commissioner
  considers necessary for the payment of premium taxes under Title 59, Chapter 9, Taxation of
  Admitted Insurers;
          (i) to the extent provided in Subsection (6):
          (i) a manufacturer's or seller's warranty; and
          (ii) a manufacturer's or seller's service contract;
          (j) except to the extent provided in Subsection (7), a public agency insurance mutual;
  [or]
          (k) except as provided in Chapter 6b, Guaranteed Asset Protection Waiver Act, a
  guaranteed asset protection waiver[.]; or
          (l) a health care sharing ministry, if the health care sharing ministry:
          (i) provides to each participant upon enrollment and annually thereafter a written
  statement of nationwide º [and Utah-specific] » data from the preceding calendar year that
168a lists the
  total dollar amount of º [:] contributions provided to participants toward qualified
169a expenses; and »
          º [(A) expenses submitted for sharing;
         (B) expenses qualified for sharing;
         (C) qualified expenses published or assigned to participants for sharing;
         (D) contributions provided to participants toward qualified expenses; and
         (E) denied expenses; and] »
          (ii) includes a written disclaimer, titled "Notice", on or with each application and all
  guideline materials that states:
          (A) the health care sharing ministry is not an insurance company;
          (B) nothing the health care sharing ministry offers or provides is an insurance policy,
  including the health care sharing ministry's guidelines or plan of operations;
          (C) participation in the health care sharing ministry is entirely voluntary and no
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        01-25-24 10:25 AM                                                     2nd Sub. (Salmon) S.B. 31
 participant is compelled by law to contribute to another participant's expenses;
         (D) participation in the health care sharing ministry or subscription to any of the health
 care sharing ministry's services is not insurance; and
         (E) each participant is always personally responsible for the participant's expenses
 regardless of whether the participant receives payment for the expenses through the health care
 sharing ministry or whether this health care sharing ministry continues to operate º [; and] . »
         º [(iii) submits to the commissioner no later than April 1 of each year:
         (A) the information in Subsection (l)(i);
         (B) nationwide and Utah-specific enrollment data from the prior calendar year; and
         (C) the health care sharing ministry's contact information for consumers, providers, and
 the commissioner.] »
         (4) A transaction described in Subsection (3)(e) is subject to taxation under Section
 31A-3-301.
         (5) (a) After a hearing, the commissioner may order an insurer of certain group
 insurance policies or blanket insurance policies to transfer the Utah portion of the business
 otherwise exempted under Subsection (3)(h) to an authorized insurer if the contracts have been
 written by an unauthorized insurer.
         (b) If the commissioner finds that the conditions required for the exemption of a group
 or blanket insurer are not satisfied or that adequate protection to residents of this state is not
 provided, the commissioner may require:
         (i) the insurer to be authorized to do business in this state; or
         (ii) that any of the insurer's transactions be subject to this title.
         (c) Subsection (3)(h) does not apply to a blanket insurance policy offering accident and
 health insurance.
         (6) (a) As used in Subsection (3)(i) and this Subsection (6):
         (i) "manufacturer's or seller's service contract" means a service contract:
         (A) made available by:
         (I) a manufacturer of a product;
         (II) a seller of a product; or
         (III) an affiliate of a manufacturer or seller of a product;
         (B) made available:
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        01-25-24 10:25 AM                                                    2nd Sub. (Salmon) S.B. 31
  insurance providing a benefit for:
         (i) replacement of income;
         (ii) short-term accident;
         (iii) fixed indemnity;
         (iv) credit accident and health;
         (v) supplements to liability;
         (vi) workers' compensation;
         (vii) automobile medical payment;
         (viii) no-fault automobile;
         (ix) equivalent self-insurance; or
         (x) a type of accident and health insurance coverage that is a part of or attached to
  another type of policy.
         [(83)] (85) "Health care provider" means the same as that term is defined in Section
  78B-3-403.
         (86) "Health care sharing ministry" means an entity that:
         (a) is a tax-exempt nonprofit entity under the Internal Revenue Code;
         (b) limits participants to those who are of a similar faith;
         (c) facilitates the sharing of a participant's qualified expenses, as defined by the entity,
  among other participants by:
         (i) matching a participant who has qualified expenses with one or more participants
  who are able to contribute to paying for the qualified expenses; and
         (ii) arranging, directly or indirectly, for each contributing participant's contribution to
  be used to pay for the qualified expenses;
         º [(d) provides that a participant make a contribution to pay another participant's qualified
 expenses with no assumption of risk or promise to pay;
        (e)] (d) » requires an individual to make one or more minimum payments or contributions
826a as
  a condition of one or more of the following:
         (i) becoming a participant;
         (ii) remaining a participant; or
         (iii) receiving a contribution to pay qualified expenses; and
         º [(f)] (e) » in carrying out the functions described in this Subsection (86), makes no
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Statutes affected: 
Introduced: 31A-1-103, 31A-1-301, 31A-2-201.2, 31A-2-211, 31A-2-215, 31A-2-216, 31A-2-308, 31A-4-113.5, 31A-16-102.6, 31A-20-108, 31A-21-316, 31A-21-402, 31A-22-401, 31A-22-605, 31A-22-614, 31A-22-620, 31A-22-802, 31A-22-2002, 31A-26-301.6, 31A-28-113, 31A-31-108, 31A-35-202, 31A-35-406, 31A-37-202, 31A-37-204, 31A-37-502
Amended: 31A-1-103, 31A-1-301, 31A-2-201.2, 31A-2-211, 31A-2-215, 31A-2-216, 31A-2-308, 31A-4-113.5, 31A-16-102.6, 31A-20-108, 31A-21-316, 31A-21-402, 31A-22-401, 31A-22-605, 31A-22-614, 31A-22-620, 31A-22-802, 31A-22-2002, 31A-26-301.6, 31A-28-113, 31A-31-108, 31A-35-202, 31A-35-406, 31A-37-202, 31A-37-204, 31A-37-502
Enrolled: 31A-1-103, 31A-1-301, 31A-2-201.2, 31A-2-211, 31A-2-215, 31A-2-216, 31A-2-308, 31A-4-113.5, 31A-16-102.6, 31A-20-108, 31A-21-316, 31A-21-402, 31A-22-401, 31A-22-605, 31A-22-614, 31A-22-620, 31A-22-802, 31A-22-2002, 31A-26-301.6, 31A-28-113, 31A-31-108, 31A-35-202, 31A-35-406, 31A-37-202, 31A-37-204, 31A-37-502
S.B. 31 1st Substitute (Not Adopted) Text: 31A-1-103, 31A-1-301, 31A-2-201.2, 31A-2-211, 31A-2-215, 31A-2-216, 31A-2-308, 31A-4-113.5, 31A-20-108, 31A-21-402, 31A-22-605, 31A-22-620, 31A-22-802, 31A-22-2002, 31A-26-301.6, 31A-28-113, 31A-31-108, 31A-35-202, 31A-35-406, 31A-37-202, 31A-37-204, 31A-37-502
S.B. 31 2nd Substitute : 31A-1-103, 31A-1-301, 31A-2-201.2, 31A-2-211, 31A-2-215, 31A-2-216, 31A-2-308, 31A-4-113.5, 31A-16-102.6, 31A-20-108, 31A-21-402, 31A-22-605, 31A-22-620, 31A-22-802, 31A-22-2002, 31A-26-301.6, 31A-28-113, 31A-31-108, 31A-35-202, 31A-35-406, 31A-37-202, 31A-37-204, 31A-37-502
S.B. 31 3rd Substitute (Not Adopted) Text: 31A-1-103, 31A-1-301, 31A-2-201.2, 31A-2-211, 31A-2-215, 31A-2-216, 31A-2-308, 31A-4-113.5, 31A-16-102.6, 31A-20-108, 31A-21-316, 31A-21-402, 31A-22-401, 31A-22-605, 31A-22-614, 31A-22-620, 31A-22-802, 31A-22-2002, 31A-26-301.6, 31A-28-113, 31A-31-108, 31A-35-202, 31A-35-406, 31A-37-202, 31A-37-204, 31A-37-502