(b) the insurer to be in hazardous financial condition set forth in Section 31A-27a-101. (64) (a) "Escrow" means: (i) a transaction that effects the sale, transfer, encumbering, or leasing of real property, when a person not a party to the transaction, and neither having nor acquiring an interest in the title, performs, in accordance with the written instructions or terms of the written agreement between the parties to the transaction, any of the following actions: (A) the explanation, holding, or creation of a document; or (B) the receipt, deposit, and disbursement of money; or (ii) a settlement or closing involving: (A) a mobile home; (B) a grazing right; (C) a water right; or (D) other personal property authorized by the commissioner. (b) "Escrow" does not include: (i) the following notarial acts performed by a notary within the state: (A) an acknowledgment; (B) a copy certification; (C) jurat; and (D) an oath or affirmation; (ii) the receipt or delivery of a document; or (iii) the receipt of money for delivery to the escrow agent. (65) "Escrow agent" means an agency title insurance producer meeting the requirements of Sections 31A-4-107, 31A-14-211, and 31A-23a-204, who is acting through an individual title insurance producer licensed with an escrow subline of authority. (66) (a) "Excludes" is not exhaustive and does not mean that another thing is not also excluded. (b) The items listed in a list using the term "excludes" are representative examples for use in interpretation of this title. (67) "Exclusion" means for the purposes of accident and health insurance that an insurer does not provide insurance coverage, for whatever reason, for one of the following: (a) a specific physical condition; (b) a specific medical procedure; (c) a specific disease or disorder; or (d) a specific prescription drug or class of prescription drugs. (68) "Fidelity insurance" means insurance guaranteeing the fidelity of a person holding a position of public or private trust. (69) (a) "Filed" means that a filing is: (i) submitted to the department as required by and in accordance with applicable statute, rule, or filing order; (ii) received by the department within the time period provided in applicable statute, rule, or filing order; and (iii) accompanied by the appropriate fee in accordance with: (A) Section 31A-3-103; or (B) rule. (b) "Filed" does not include a filing that is rejected by the department because it is not submitted in accordance with Subsection (69)(a). (70) "Filing," when used as a noun, means an item required to be filed with the department including: (a) a policy; (b) a rate; (c) a form; (d) a document; (e) a plan; (f) a manual; (g) an application; (h) a report; (i) a certificate; (j) an endorsement; (k) an actuarial certification; (l) a licensee annual statement; (m) a licensee renewal application; (n) an advertisement; (o) a binder; or (p) an outline of coverage. (71) "First party insurance" means an insurance policy or contract in which the insurer agrees to pay a claim submitted to it by the insured for the insured's losses. (72) (a) "Fixed indemnity insurance" means accident and health insurance written to provide a fixed amount for a specified event relating to or resulting from an illness or injury. (b) "Fixed indemnity insurance" includes hospital confinement indemnity insurance. (73) "Foreign insurer" means an insurer domiciled outside of this state, including an alien insurer. (74) (a) "Form" means one of the following prepared for general use: (i) a policy; (ii) a certificate; (iii) an application; (iv) an outline of coverage; or (v) an endorsement. (b) "Form" does not include a document specially prepared for use in an individual case. (75) "Franchise insurance" means an individual insurance policy provided through a mass marketing arrangement involving a defined class of persons related in some way other than through the purchase of insurance. (76) "General lines of authority" include: (a) the general lines of insurance in Subsection (77); (b) title insurance under one of the following sublines of authority: (i) title examination, including authority to act as a title marketing representative; (ii) escrow, including authority to act as a title marketing representative; and (iii) title marketing representative only; (c) surplus lines; (d) workers' compensation; and (e) another line of insurance that the commissioner considers necessary to recognize in the public interest. (77) "General lines of insurance" include: (a) accident and health; (b) casualty; (c) life; (d) personal lines; (e) property; and (f) variable contracts, including variable life and annuity. (78) "Group health plan" means an employee welfare benefit plan to the extent that the plan provides medical care: (a) (i) to an employee; or (ii) to a dependent of an employee; and (b) (i) directly; (ii) through insurance reimbursement; or (iii) through another method. (79) (a) "Group insurance policy" means a policy covering a group of persons that is issued: (i) to a policyholder on behalf of the group; and (ii) for the benefit of a member of the group who is selected under a procedure defined in: (A) the policy; or (B) an agreement that is collateral to the policy. (b) A group insurance policy may include a member of the policyholder's family or a dependent. (80) "Group-wide supervisor" means the commissioner or other regulatory official designated as the group-wide supervisor for an internationally active insurance group under Section 31A-16-108.6. (81) "Guaranteed automobile protection insurance" means insurance offered in connection with an extension of credit that pays the difference in amount between the insurance settlement and the balance of the loan if the insured automobile is a total loss. (82) (a) "Health benefit plan" means a policy, contract, certificate, or agreement offered or issued by an insurer to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care, including major medical expense coverage. (b) "Health benefit plan" does not include: (i) coverage only for accident or disability income insurance, or any combination thereof; (ii) coverage issued as a supplement to liability insurance; (iii) liability insurance, including general liability insurance and automobile liability insurance; (iv) workers' compensation or similar insurance; (v) automobile medical payment insurance; (vi) credit-only insurance; (vii) coverage for on-site medical clinics; (viii) other similar insurance coverage, specified in federal regulations issued pursuant to Pub. L. No. 104-191, under which benefits for health care services are secondary or incidental to other insurance benefits; (ix) the following benefits if they are provided under a separate policy, certificate, or contract of insurance or are otherwise not an integral part of the plan: (A) limited scope dental or vision benefits; (B) benefits for long-term care, nursing home care, home health care, community-based care, or any combination thereof; or (C) other similar limited benefits, specified in federal regulations issued pursuant to Pub. L. No. 104-191; (x) the following benefits if the benefits are provided under a separate policy, certificate, or contract of insurance, there is no coordination between the provision of benefits and any exclusion of benefits under any health plan, and the benefits are paid with respect to an event without regard to whether benefits are provided under any health plan: (A) coverage only for specified disease or illness; or (B) fixed indemnity insurance; (xi) the following if offered as a separate policy, certificate, or contract of insurance: (A) Medicare supplement insurance; (B) coverage supplemental to the coverage provided under United States Code, Title 10, Chapter 55, Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); or (C) similar supplemental coverage provided to coverage under a group health insurance plan; (xii) short-term limited duration health insurance; and (xiii) student health insurance, except as required under 45 C.F.R. Sec. 147.145. (83) "Health care" means any of the following intended for use in the diagnosis, treatment, mitigation, or prevention of a human ailment or impairment: (a) a professional service; (b) a personal service; (c) a facility; (d) equipment; (e) a device; (f) supplies; or (g) medicine. (84) (a) "Health care insurance" or "health insurance" means insurance providing: (i) a health care benefit; or (ii) payment of an incurred health care expense. (b) "Health care insurance" or "health insurance" does not include accident and health 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. (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; (d) requires an individual to make one or more minimum payments or contributions 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 (e) in carrying out the functions described in this Subsection (86), makes no assumption of risk or promise to pay any qualified expenses. (87) "Health insurance exchange" means an exchange as defined in 45 C.F.R. Sec. 155.20. (88) "Health Insurance Portability and Accountability Act" means the Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191, 110 Stat. 1936, as amended. (89) "Income replacement insurance" or "disability income insurance" means insurance written to provide payments to replace income lost from accident or sickness. (90) "Indemnity" means the payment of an amount to offset all or part of an insured loss. (91) "Independent adjuster" means an insurance adjuster required to be licensed under Section
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