Title 27
Insurance

Chapter 18.2
Medicare Supplement Insurance Policies

§ 27-18.2-1. Definitions.

(1) “Applicant” means:

(i) In the case of an individual Medicare supplement policy, the person who seeks to contract for insurance benefits; and

(ii) In the case of a group Medicare supplement policy, the proposed certificate holder.

(2) “Certificate” means, for the purposes of this chapter, any certificate delivered or issued for delivery in this state under a group Medicare supplement policy.

(3) “Certificate form” means the form on which the certificate is delivered or issued for delivery by the issuer.

(4) “Director” or “Commissioner” means the commissioner for the office of the health insurance commissioner.

(5) “Issuer” includes insurance companies, fraternal benefit societies, healthcare service plans, health maintenance organizations, and any other entity delivering or issuing for delivery in this state Medicare supplement policies or certificates.

(6) “Medicare” means the “Health Insurance for the Aged Act,” 42 U.S.C. § 1395 et seq.

(7) “Medicare supplement policy” means a group or individual policy of accident and sickness insurance, as defined in § 27-18-1, or a subscriber contract of a nonprofit hospital service corporation or of a nonprofit medical service corporation or an evidence of coverage of a health maintenance organization as defined in § 42-62-4 or as licensed under chapter 41 of this title, other than a policy issued pursuant to a contract under Section 1876 of the federal Social Security Act, 42 U.S.C. § 1395mm, or an issued policy under a demonstration project specified in 42 U.S.C. § 1395ss(g)(1), 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.

(8) “Policy form” means the form on which the policy is delivered or issued for delivery by the issuer.