Utah Code § 31A-8-601 Definitions.
31A-8-601. Definitions.
Reserved.
Enacted by Chapter 45, 2026 General Session
Ambulance Membership Plans
Utah Code tit. 31A, ch. 31A-8, pt. 31A-8-P6
in effectUtah Code § 31A-8-602 Ambulance membership plan requirements.
31A-8-602. Ambulance membership plan requirements.
(1) An ambulance membership organization may assess a one-time application processing fee to the ambulance membership organization's members that may not exceed $25.
(2) If an ambulance membership organization cancels an ambulance membership plan for any reason other than nonpayment of charges by a member, the ambulance membership organization shall issue a pro rata refund of all periodic charges and membership fees to the member.
(3) An ambulance membership organization, or a person that sells an ambulance membership plan for an ambulance membership organization, shall disclose each charge and fee for each ambulance membership plan to each prospective member.
(4) An ambulance membership organization shall provide the terms and conditions of an ambulance membership plan to each prospective enrollee before the day on which the prospective enrollee enters into the ambulance membership plan.
(5) An ambulance membership organization shall file a copy of each ambulance membership plan with the commissioner before the ambulance membership plan goes into effect.
(6) An ambulance membership plan described in Subsection (5) shall:
(a) identify the ambulance membership organization, including the ambulance membership organization's:
(i) physical address;
(ii) website address; and
(iii) toll-free phone number;
(b) conspicuously state:
(i) the total purchase price of the ambulance membership plan, including any membership fees; and
(ii) that the ambulance membership plan is not an insurance contract;
(c) state:
(i) the terms under which the ambulance membership plan is to be paid;
(ii) any cost sharing requirements;
(iii) the services the ambulance membership organization shall provide under the ambulance membership plan, and any limitation, exception, or exclusion;
(iv) any term, restriction, or condition that governs the cancellation of the ambulance membership plan by either the enrollee or the ambulance membership organization;
(v) that if the enrollee cancels the ambulance membership plan within 30 days after the day on which the enrollee purchases the ambulance membership plan, the ambulance membership organization shall refund to the enrollee:
(A) any one-time charge the enrollee pays that exceeds $25; and
(B) each periodic charge and membership fee the enrollee pays; and
(vi) what constitutes acceptable insurance coverage if eligibility for the ambulance membership plan is conditioned on the member's current and continuing health insurance coverage; and
(d) define "medical necessity," if membership coverage of a transport is conditioned on a finding of medical necessity.
Enacted by Chapter 45, 2026 General Session
Utah Code § 31A-8-603 Certificate of authority renewal -- Reporting requirements.
31A-8-603. Certificate of authority renewal -- Reporting requirements.
(1) At least 90 days before the day on which an ambulance membership organization's certificate of authority expires, the ambulance membership organization seeking renewal of the ambulance membership organization's certificate of authority shall submit an annual report to the commission in a form the commissioner approves.
(2) The report described in Subsection (1) shall include:
(a) an updated list of the name and address of each ambulance provider of the ambulance membership organization, including:
(i) the extent and nature of any contract or arrangement with the ambulance provider; and
(ii) any possible conflict of interest between the ambulance membership organization and ambulance provider;
(b) the number of members in this state who are enrolled in an ambulance membership plan that the ambulance membership organization offers;
(c) a list of each ambulance membership plan currently active or entered into with a governmental entity that provides membership of the ambulance membership organization to each resident of the governmental entity; and
(d) any other information related to the ambulance membership organization that the commissioner requires to ensure compliance with this chapter.
(3)
(a) The commissioner may not renew an ambulance membership organization's certificate of authority if the ambulance membership organization fails to file a complete annual report in accordance with Subsection (1).
(b) If the commissioner does not renew an ambulance membership organization's certificate of authority in accordance with Subsection (3)(a), the ambulance membership organization may not enroll new members or do business in this state until:
(i) the ambulance membership organization submits a new application for a certificate of authority; and
(ii) the commissioner approves the application.
Enacted by Chapter 45, 2026 General Session
Utah Code § 31A-8-604 Ambulance membership restrictions -- Medicaid program.
31A-8-604. Ambulance membership restrictions -- Medicaid program.
(1) An ambulance membership organization may not knowingly sell, offer for sale, or provide an ambulance membership plan to an individual who is enrolled in the Medicaid program.
(2)
(a) If an individual who enters into an ambulance membership plan subsequently enrolls in the Medicaid program during the term of the ambulance membership plan, the individual shall notify the ambulance membership organization of the enrollment within 30 days of the day on which the individual enrolls in the Medicaid program.
(b) If the individual notifies the ambulance membership organization in accordance with Subsection (2)(a), the ambulance membership organization shall provide the individual a prorated refund of any consideration the individual pays for the period from the effective date of the Medicaid program enrollment through the day on which the ambulance membership plan expires.
(c) If the individual does not notify the ambulance membership organization in accordance with Subsection (2)(a):
(i) the individual is not entitled to a prorated refund; and
(ii) the ambulance membership organization shall unenroll the individual from the ambulance membership plan within 30 days of the day on which the ambulance membership organization receives notice of the individual's enrollment in the Medicaid program.
Enacted by Chapter 45, 2026 General Session
Utah Code § 31A-8-605 Marketing requirements -- Required disclosures.
31A-8-605. Marketing requirements -- Required disclosures.
(1) Each advertisement, marketing material, brochure, ambulance membership card, presentation, and any other communication of an ambulance membership organization shall be truthful and not misleading in fact or in implication.
(2) An ambulance membership organization advertising or marketing the ambulance membership organization's ambulance membership plan to residents of this state:
(a) shall file each written advertisement and marketing material to the commissioner for review in compliance with this chapter; and
(b) may not:
(i) use language in the ambulance membership organization's advertisements or marketing that could reasonably mislead a person into believing that the ambulance membership plan is insurance;
(ii) use language in the ambulance membership organization's advertisement, marketing material, brochure, or presentation in relation to the following that could reasonably mislead an individual into believing that the ambulance membership plan is insurance or has been endorsed by the state or a governmental entity:
(A) the ambulance membership organization's certificate of authority or registration with the department or other state department of insurance; or
(B) the ambulance membership organization's relationship to a governmental entity; or
(iii) have a restriction on access to the ambulance membership organization, including a waiting period or notification period.
(3) An ambulance membership organization shall make the following general disclosures in writing, in bold, and in at least 12-point font on the first content page of an advertisement, marketing material, or brochure the ambulance membership organization makes available to prospective members or the public:
(a) the ambulance membership plan is a membership plan and is not insurance coverage; and
(b) the toll-free phone number and website address where the ambulance membership organization's prospective members may obtain additional information about the services the ambulance membership organization offers.
(4) An ambulance membership organization shall provide the disclosures required by Subsection (3) orally to an individual who makes initial contact with the ambulance membership organization by telephone.
(5) Before a person enters into an ambulance membership plan with an ambulance membership organization, the ambulance membership organization shall mail, give, or, with consent of the person, email to the person a separate document that, in bold and in at least 12-point font, states the following disclosures:
(a) the ambulance membership plan is not insurance coverage;
(b) if eligible and covered under Medicare, the prospective enrollee may consult with a representative of the Medicare program to determine:
(i) the extent of applicable Medicare coverage; and
(ii) what the prospective member's payment obligations would be if the prospective enrollee were transported by ambulance;
(c) a detailed list of each one-time and periodic fee the ambulance membership organization charges or will charge to the prospective enrollee to join the ambulance membership organization and continue membership in the ambulance membership organization;
(d) the counties and areas in this state that the ambulance membership organization serves, including any restrictions to specific service areas;
(e) if, in an emergency, the prospective enrollee is outside of the ambulance membership organization's service area, that the prospective enrollee may be responsible for the entirety of the cost of the ambulance membership organization's services; and
(f) if an enrollee cancels the ambulance membership plan before 30 days after the day on which the enrollee purchases the ambulance membership plan, the ambulance membership organization shall refund to the member:
(i) any one-time charges the enrollee pays that exceed $25; and
(ii) all periodic charges or fees that the enrollee pays.
Enacted by Chapter 45, 2026 General Session
Source: Utah Office of Legislative Research and General Counsel (le.utah.gov)URL: https://le.utah.gov/xcode/Title31A/Chapter8/31A-8-P6.html?v=C31A-8-P6_2026050620260506Fetched: 10/26/2026