R590. Insurance, Administration.R590-273. Continuing Care Provider Rule.
R590-273-1. Authority.
This rule is promulgated by the commissioner pursuant to Sections 31A-2-201, 31A-44-202, 31A-44-203, 31A-44-401, 31A-44-402, 31A-44-502, 31A-44-503, 31A-44-601, and 31A-44-602.
R590-273-2. Purpose and Scope.
(1) The purpose of this rule is to:
(a) define financial hardship;
(b) establish procedures to register or renew as a provider;
(c) determine when an additional reserve fund is necessary;
(d) determine market value of land and infrastructure improvements of a facility in liquidation;
(e) set forth conditions when a lien is superior to a property lease; and
(f) establish enforcement procedures.
(2) This rule applies to a provider that markets a continuing care facility project.
R590-273-3. Definitions.
Terms used in this rule are defined in Sections 31A-1-301 and 31A-44-102. Additional terms are defined as follows:
(1) "Financial hardship," under Subsection 31A-44-401(3), means a resident of a continuing care facility:
(a) with regular monthly expenses exceeding the resident's regular monthly income; and
(b) with net assets of less than $25,000, over and above the resident's entrance fee at the continuing care facility.
(2) "Qualified actuary" means:
(a) a member of the American Academy of Actuaries;
(b) a member of the Society of Actuaries; or
(c) a person recognized by the commissioner as having comparable training or experience.
R590-273-4. Registration.
(1) Thirty days before entering into a continuing care contract or reservation agreement, a provider shall complete and submit electronically to the commissioner:
(a) an initial registration form, supporting documentation, and all attachments; and
(b) payment of the initial registration fee, in an amount annually established by the Utah Legislature under Section 63J-1-504, using the department's secure payment portal.
(2) Registration forms are available on the department's website, https://insurance.utah.gov.
R590-273-5. Registration Renewal.
(1) By September 30 of each year, a provider shall complete and submit electronically to the commissioner:
(a) a registration renewal form; and
(b) payment of the registration renewal fee, in an amount annually established by the Utah Legislature under Section 63J-1-504, using the department's secure payment portal.
(2) Registration renewal forms are available on the department's website, https://insurance.utah.gov.
R590-273-6. Additional Reserve Fund.
(1) A provider shall create an additional reserve fund if directed to do so by the commissioner.
(2) The additional reserve fund amount shall be determined by a qualified actuary.
(3) An independent actuarial review shall determine the adequacy of an additional reserve fund.
(4) A provider shall pay the reasonable costs of the actuarial review under Subsection 31A-44-603(4).
R590-273-7. Market Value of Land and Infrastructure Improvements in Rehabilitation or Liquidation.
To determine the market value of land and infrastructure improvements under an order of rehabilitation or liquidation pursuant to Subsection 31A-44-502(2)(d) or 31A-44-503(4)(e), the commissioner shall:
(1) consider the most probable price, as of a specified date, that the land and infrastructure improvements owned in fee by the ground lesser should sell for:
(a) after reasonable exposure in a competitive market;
(b) under all conditions of a fair sale;
(c) with the buyer and seller each acting prudently, knowledgeably, and in their self-interest; and
(d) assuming neither buyer nor seller acts under duress;
(2) disregard the existence or terms of the ground lease; and
(3) determine if a commercial appraisal is required to assign the market value.
R590-273-8. Lien Held by the Commissioner in Favor of a Resident or a Group of Residents.
The lien amount on a provider's property that is superior to the lien described in Subsection 31A-44-601(1) is limited to the portion of the funds secured by the lien used by the provider, including:
