58-17A-1 Definition of terms.
Definition of terms.
Terms used in this chapter mean:
"Applicant," in the case of an individual medicare supplement policy or subscriber
contract, the person who seeks to contract for insurance benefits; and in the case of a
group medicare supplement policy or subscriber contract, the proposed certificate holder;
"Certificate," any certificate issued under a group medicare supplement policy, which
policy has been delivered or issued for delivery in this state;
"Certificate form," the form on which the certificate is delivered or issued for delivery by
"Issuer," includes insurance companies, fraternal benefit societies, health care service
plans, health maintenance organizations, and any other entity delivering or issuing for
delivery in this state medicare supplement policies or certificates;
"Medicare," the Health Insurance for the Aged Act, Title XVIII of the Social Security
Amendments of 1965 and as amended through December 31, 1991;
"Medicare supplement policy," a group or individual policy of health insurance or a
subscriber contract of nonprofit hospital, medical and surgical service plans, or health
maintenance organizations, which is advertised, marketed, or designed primarily as a
supplement to reimbursements under medicare for the hospital, medical or surgical
expenses of persons eligible for medicare. The term does not include insurance policies
or health care benefit plans, including group conversion policies, provided to medicare
eligible persons which policies are not marketed or held to be medicare supplement
policies or benefit plans, nor does it apply to a policy or contract of one or more
employers or labor organizations, or of the trustees of a fund established by one or more
employers or labor organizations, or combination thereof, for employees or former
employees or a combination thereof, or for members or former members, or a
combination thereof, of the labor organizations. The term does not include a policy issued
pursuant to a contract under Section 1876 of the federal Social Security Act, 42 U.S.C.
§ 1395 et seq., or a policy issued under a demonstration project specified in 42 U.S.C.
§ 1395ss(g)(i). The term does not include any medicare advantage plan established under
Medicare Part C, any outpatient prescription drug plan established under Medicare Part
D, or any health care prepayment plan that provides benefits pursuant to an agreement
under § 1833(a)(1)(A) of the Social Security Act;
"Policy form," the form on which the policy is delivered or issued for delivery by the
SL 1982, ch 360, § 1; SL 1989, ch 431, § 1; SL 1990, ch 396, § 1; SL 1992, ch 347, § 1;
SL 1996, ch 293, § 1; SL 2005, ch 267, § 1.