Delaware Code > Title 18 > Chapter 36 – Individual Health Insurance Minimum Standards
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Terms Used In Delaware Code > Title 18 > Chapter 36 - Individual Health Insurance Minimum Standards
- Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
- Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
- Bona fide association: means , with respect to health insurance coverage offered in Delaware, an association which:
- Carrier: means an entity subject to the insurance laws and regulations of this State, or subject to the jurisdiction of the Commissioner, that contracts or offers to contract to provide, deliver, arrange for, pay for or reimburse any of the costs of health-care services, including a sickness and accident insurance company, a health maintenance organization, a nonprofit hospital and health service corporation or any other entity providing a plan of health insurance, health benefits or health services. See Delaware Code Title 18 Sec. 3602
- Church plan: has the meaning given such term under § 3(33) of the Employee Retirement Income Security Act of 1974 [29 U. See Delaware Code Title 18 Sec. 3602
- Contract: A legal written agreement that becomes binding when signed.
- Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
- Corrective order: means an order issued by the Commissioner specifying corrective actions which the Commissioner has determined are required. See Delaware Code Title 18 Sec. 5801
- Creditable coverage: means , with respect to an individual, health benefits or coverage provided under any of the following:
- Dependent: means a spouse, an enrollee's child by blood or law who is less than 26 years of age and an unmarried child of any age who is medically certified as totally disabled and dependent upon the enrollee. See Delaware Code Title 18 Sec. 3602
- Dependent: A person dependent for support upon another.
- domestic health organization: means a health organization domiciled in this State. See Delaware Code Title 18 Sec. 5820
- Domestic insurer: means any insurance company domiciled in this State, except insurers not doing business with citizens or residents of the United States or organized or located within the United States. See Delaware Code Title 18 Sec. 5801
- Foreign insurer: means any insurance company which is licensed to do business in this State under § 516 of this title, but is not domiciled in this State. See Delaware Code Title 18 Sec. 5801
- Form: means policies, contracts, riders, endorsements and applications required to be filed with the Commissioner pursuant to §§ 2712 and 6306 of this title. See Delaware Code Title 18 Sec. 3602
- Fraud: Intentional deception resulting in injury to another.
- Governmental plan: has the meaning given such term under § 3(32) of the Employee Retirement Income Security Act of 1974 [29 U. See Delaware Code Title 18 Sec. 3602
- Health benefit plan: means any hospital or medical expense policy or certificate, major medical expense insurance policy or certificate, any hospital or medical service plan contract, health maintenance organization or health service corporation subscriber contract or any other similar health contract subject to the jurisdiction of the Commissioner. See Delaware Code Title 18 Sec. 3602
- Health insurance: means insurance permitted to be written in accordance with § 903 of this title, other than credit health insurance, and coverages written under Chapter 63 of this title, Health Service Corporations. See Delaware Code Title 18 Sec. 3602
- health organization: means a health maintenance organization, limited health service organization, health service corporation, dental or vision plan, hospital, medical and dental indemnity or service corporation or other managed care organization licensed under this title. See Delaware Code Title 18 Sec. 5820
- Health status-related factor: means any of the following factors:
- Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
- Medical care: means amounts paid for:
- NAIC: means the National Association of Insurance Commissioners. See Delaware Code Title 18 Sec. 5801
- Network plan: means health insurance coverage offered by a health carrier under which the financing and delivery of medical care including items and services paid for as medical care are provided, in whole or in part, through a defined set of providers under contract with the carrier. See Delaware Code Title 18 Sec. 3602
- Policy: means the entire contract between the insurer and the insured, including the policy riders, endorsements and the application, if attached, and also includes subscriber contracts issued by health service corporations. See Delaware Code Title 18 Sec. 3602
- Property and casualty insurer: means any insurance company licensed under § 516 of this title, but shall not include monoline mortgage guaranty insurers, financial guaranty insurers and title insurers. See Delaware Code Title 18 Sec. 5801
- RBC instructions: means the RBC report including risk-based capital instructions adopted by the NAIC; as such, RBC instructions may be amended by the NAIC from time to time in accordance with the procedures adopted by the NAIC. See Delaware Code Title 18 Sec. 5801
- RBC plan: means a comprehensive financial plan containing the elements specified in § 5803(b) of this title. See Delaware Code Title 18 Sec. 5801
- RBC report: means the report required in § 5802 of this title. See Delaware Code Title 18 Sec. 5801
- Rescission: The cancellation of budget authority previously provided by Congress. The Impoundment Control Act of 1974 specifies that the President may propose to Congress that funds be rescinded. If both Houses have not approved a rescission proposal (by passing legislation) within 45 days of continuous session, any funds being withheld must be made available for obligation.
- Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
- Subpoena: A command to a witness to appear and give testimony.
- subsidiaries: shall include , in addition to those such corporations where the insurer owns a majority of their stock, those corporations formed or acquired by an insurer where it owns less than a majority of such corporation's voting stock due to the laws of a foreign national which require the insurer to own less than a majority of the voting stock of such subsidiary insurance corporation if it is to operate in that nation. See Delaware Code Title 18 Sec. 1313
- Testify: Answer questions in court.
- Total adjusted capital: means the sum of:
- Under age: means an age of less than 18 years. See Delaware Code Title 1 Sec. 302
- Waiting period: means , with respect to an individual who is a potential participant or beneficiary in the plan, the period that must pass with respect to the individual before the individual is eligible for benefits under the terms of the plan. See Delaware Code Title 18 Sec. 3602