31A-8-103 - Applicability to other provisions of law.
31A-8-103. Applicability to other provisions of law.
(1) (a) Except for exemptions specifically granted under this title, an organization issubject to regulation under all of the provisions of this title.
(b) Notwithstanding any provision of this title, an organization licensed under thischapter:
(i) is wholly exempt from:
(A) Chapter 7, Nonprofit Health Service Insurance Corporations;
(B) Chapter 9, Insurance Fraternals;
(C) Chapter 10, Annuities;
(D) Chapter 11, Motor Clubs;
(E) Chapter 12, State Risk Management Fund;
(F) Chapter 13, Employee Welfare Funds and Plans;
(G) Chapter 19a, Utah Rate Regulation Act; and
(H) Chapter 28, Guaranty Associations; and
(ii) is not subject to:
(A) Chapter 3, Department Funding, Fees, and Taxes, except for Part 1, Funding theInsurance Department;
(B) Section 31A-4-107;
(C) Chapter 5, Domestic Stock and Mutual Insurance Corporations, except for provisionsspecifically made applicable by this chapter;
(D) Chapter 14, Foreign Insurers, except for provisions specifically made applicable bythis chapter;
(E) Chapter 17, Determination of Financial Condition, except:
(I) Part 2, Qualified Assets, and Part 6, Risk-Based Capital; or
(II) as made applicable by the commissioner by rule consistent with this chapter;
(F) Chapter 18, Investments, except as made applicable by the commissioner by ruleconsistent with this chapter; and
(G) Chapter 22, Contracts in Specific Lines, except for Part 6, Accident and HealthInsurance, Part 7, Group Accident and Health Insurance, and Part 12, Reinsurance.
(2) The commissioner may by rule waive other specific provisions of this title that thecommissioner considers inapplicable to health maintenance organizations or limited health plans,upon a finding that the waiver will not endanger the interests of:
(a) enrollees;
(b) investors; or
(c) the public.
(3) Title 16, Chapter 6a, Utah Revised Nonprofit Corporation Act, and Title 16, Chapter10a, Utah Revised Business Corporation Act, do not apply to an organization except asspecifically made applicable by:
(a) this chapter;
(b) a provision referenced under this chapter; or
(c) a rule adopted by the commissioner to deal with corporate law issues of healthmaintenance organizations that are not settled under this chapter.
(4) (a) Whenever in this chapter, Chapter 5, Domestic Stock and Mutual InsuranceCorporations, or Chapter 14, Foreign Insurers, is made applicable to an organization, theapplication is:
(i) of those provisions that apply to a mutual corporation if the organization is nonprofit;and
(ii) of those that apply to a stock corporation if the organization is for profit.
(b) When Chapter 5, Domestic Stock and Mutual Insurance Corporations, or Chapter 14,Foreign Insurers, is made applicable to an organization under this chapter, "mutual" meansnonprofit organization.
(5) Solicitation of enrollees by an organization is not a violation of any provision of lawrelating to solicitation or advertising by health professionals if that solicitation is made inaccordance with:
(a) this chapter; and
(b) Chapter 23a, Insurance Marketing - Licensing Producers, Consultants, andReinsurance Intermediaries.
(6) This title does not prohibit any health maintenance organization from meeting therequirements of any federal law that enables the health maintenance organization to:
(a) receive federal funds; or
(b) obtain or maintain federal qualification status.
(7) Except as provided in Section 31A-8-501, an organization is exempt from statutes inthis title or department rules that restrict or limit the organization's freedom of choice incontracting with or selecting health care providers, including Section 31A-22-618.
(8) An organization is exempt from the assessment or payment of premium taxesimposed by Sections 59-9-101 through 59-9-104.
Amended by Chapter 324, 2010 General Session