§ 31A-34-108. Powers of and restrictions on alliances.  


Latest version.
  • (1) An alliance may only exercise the powers necessary to:
    (a) make health insurance available to its members and enrollees from multiple unaffiliated insurers through the use of coordinated actuarial models, coordinated underwriting, or coordinated marketing methodologies; and
    (b) subject to Subsection (3)(d), make available to its members other related insurance products and services, including dental, vision, and life insurance.
    (2) In addition to the powers granted to a nonprofit corporation in Title 16, Chapter 6a, Utah Revised Nonprofit Corporation Act, or to the powers of a trust under common law, the powers of an alliance include:
    (a) setting reasonable fees and conditions for membership, which may vary by group size, to reflect reasonable and necessary costs incurred in administering the alliance;
    (b) providing or contracting for premium collection services consistent with the requirements of Title 31A, Chapter 25, Third Party Administrators; or
    (c) contracting with qualified independent third parties for any service necessary to carry out the powers and duties authorized or required by this chapter.
    (3) Notwithstanding Subsection (1), an alliance may not:
    (a) purchase health care services;
    (b) assume risk for the cost or provision of health services;
    (c) contract with health care providers for the provision of health care services to enrollees; or
    (d) condition alliance membership on the purchase or subscription of a product or service other than health insurance.
Amended by Chapter 300, 2000 General Session