§ 27-20.4-3. Definitions.
As used in this chapter, the following terms have the following meaning:
(1) “Director” means the director of the department of business regulation.
(2) “Individual contract” means any health benefit contract that is not a group contract.
(3) “Insurer” means every medical service corporation, hospital service corporation, health maintenance organization licensed under chapter 41 of this title or as defined in § 42-62-4, or insurance company offering and/or insuring health services.
(4) “Late enrollee” means a person who requests enrollment in a group plan following the initial enrollment period provided under the terms of the plan, except that a person is not a late enrollee if:
(i) The request for enrollment is made within thirty (30) days after the termination of coverage under a prior contract or policy and the individual did not request coverage initially under the succeeding contract because that individual was covered under a prior contract and coverage under that contract ceased due to termination of employment, death of a spouse, or divorce; or
(ii) A court has ordered that coverage be provided for a spouse or minor child under a covered employee’s plan and the request for coverage is made within thirty (30) days after issuance of the court order.
(5) “Prior contract” means the group or individual health benefit contract or health benefit plan that previously covered the person.
(6) “Replacement contract” means a total group health benefit contract that replaces another total group health benefit contract.
(7) “Succeeding contract” means the group health benefit contract under which the person is seeking coverage or a different health benefit plan under the same group health benefit contract.
(8) “Total group contract” means a health benefit contract for the coverage of all eligible members of the employer health plan.
History of Section.
P.L. 1991, ch. 321, § 1; P.L. 1992, ch. 387, § 1.