Terms Used In Kentucky Statutes > Chapter 39G

• agent: includes managing general agent unless the context requires otherwise. See Kentucky Statutes 304.9-085
• Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
• Base premium rate: means , for each class of business as to a rating period, the lowest premium rate charged or that could have been charged under the rating system for that class of business by the insurer to the individual or small group, or employer as defined in KRS 304. See Kentucky Statutes 304.17A-005
• Church plan: means a church plan as defined in 29 U. See Kentucky Statutes 304.17A-005
• City: includes town. See Kentucky Statutes 446.010
• COBRA: means any of the following:
  (a) 26 U. See Kentucky Statutes 304.17A-005
• Company: may extend and be applied to any corporation, company, person, partnership, joint stock company, or association. See Kentucky Statutes 446.010
• Contract: A legal written agreement that becomes binding when signed.
• Eligible individual: means an individual:
  (a) For whom, as of the date on which the individual seeks coverage, the aggregate of the periods of creditable coverage is eighteen (18) or more months and whose most recent prior creditable coverage was under a group health plan, governmental plan, or church plan. See Kentucky Statutes 304.17A-005
• Employee benefit plan: means an employee welfare benefit plan or an employee pension benefit plan or a plan which is both an employee welfare benefit plan and an employee pension benefit plan as defined by ERISA. See Kentucky Statutes 304.17A-005
• Employer-organized association: means any of the following:
  (a) Any entity that was qualified by the commissioner as an eligible association prior to April 10, 1998, and that has actively marketed a health insurance program to its members since September 8, 1996, and which is not insurer- controlled. See Kentucky Statutes 304.17A-005
• Excepted benefits: means benefits under one (1) or more, or any combination of the following:
  (a) Coverage only for accident, including accidental death and dismemberment, or disability income insurance, or any combination thereof. See Kentucky Statutes 304.17A-005
• Federal: refers to the United States. See Kentucky Statutes 446.010
• Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006.
• Foreign: when applied to a corporation, partnership, limited partnership, business trust, statutory trust, or limited liability company, includes all those incorporated or formed by authority of any other state. See Kentucky Statutes 446.010
• Fraud: Intentional deception resulting in injury to another.
• Governmental plan: means a governmental plan as defined in 29 U. See Kentucky Statutes 304.17A-005
• Group health plan: means a plan, including a self-insured plan, of or contributed to by an employer, including a self-employed person, or employee organization, to provide health care directly or otherwise to the employees, former employees, the employer, or others associated or formerly associated with the employer in a business relationship, or their families. See Kentucky Statutes 304.17A-005
• Guaranteed acceptance plan supporting insurer: means either an insurer, on or before December 31, 2000, that is not a guaranteed acceptance plan participating insurer or is a stop loss carrier, on or before December 31, 2000, provided that a guaranteed acceptance plan supporting insurer shall not include an employer- sponsored self-insured health benefit plan exempted by ERISA. See Kentucky Statutes 304.17A-005
• Guaranteed acceptance program qualified individual: means an individual who, on or before December 31, 2000:
  (a) Is not an eligible individual. See Kentucky Statutes 304.17A-005
• Health care service: means health care procedures, treatments, or services
  rendered by a provider within the scope of practice for which the provider is licensed. See Kentucky Statutes 304.17A-005
• Individual market: means the market for the health insurance coverage offered to individuals other than in connection with a group health plan. See Kentucky Statutes 304.17A-005
• insured: as used in this subtitle , shall not be construed as preventing a person other than the insured with a proper insurable interest from making application for and owning a policy covering the insured or from being entitled under such a policy to any indemnities, benefits, and rights provided therein. See Kentucky Statutes 304.17-320
• Insurer: means any insurance company. See Kentucky Statutes 304.17A-005
• Insurer-controlled: means that the commissioner has found, in an administrative hearing called specifically for that purpose, that an insurer has or had a substantial involvement in the organization or day-to-day operation of the entity for the principal purpose of creating a device, arrangement, or scheme by which the insurer segments employer groups according to their actual or anticipated health status or actual or projected health insurance premiums. See Kentucky Statutes 304.17A-005
• Joint committee: Committees including membership from both houses of teh legislature. Joint committees are usually established with narrow jurisdictions and normally lack authority to report legislation.
• Kentucky Access: has the meaning provided in KRS 304. See Kentucky Statutes 304.17A-005
• Large group: means :
  (a) An employer with fifty-one (51) or more employees. See Kentucky Statutes 304.17A-005
• Month: means calendar month. See Kentucky Statutes 446.010
• Participant: means any employee or former employee of an employer, or any member or former member of an employee organization, who is or may become eligible to receive a benefit of any type from an employee benefit plan which covers employees of the employer or members of the organization, or whose beneficiaries may be eligible to receive any benefit as established in Section 3(7) of ERISA. See Kentucky Statutes 304.17A-005
• provider: means any:
  (a) Advanced practice registered nurse licensed under KRS Chapter 314. See Kentucky Statutes 304.17A-005
• Rating period: means the calendar period for which premium rates are in effect. See Kentucky Statutes 304.17A-005
• Self-insured plan: means a group health insurance plan in which the sponsoring organization assumes the financial risk of paying for covered services provided to its enrollees. See Kentucky Statutes 304.17A-005
• Small employer: means , in connection with a group health plan with respect to a calendar year and a plan year, an employer who employed an average of at least two (2) but not more than fifty (50) employees on business days during the preceding calendar year and who employs at least two (2) employees on the first day of the plan year. See Kentucky Statutes 304.17A-005
• Small group: means :
  (a) A small employer with two (2) to fifty (50) employees. See Kentucky Statutes 304.17A-005
• Treatment: when used in a criminal justice context, means targeted interventions that focus on criminal risk factors in order to reduce the likelihood of criminal behavior. See Kentucky Statutes 446.010
• uniformed services: means the Armed Forces and the Commissioned Corps of the National Oceanic and Atmospheric Administration and of the Public Health Service. See Kentucky Statutes 304.17A-005