Definitions

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As used in this subchapter:

  1. (1) “Applicant” means:

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

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

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

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

  4. (4) “Commissioner” means the Insurance Commissioner;

  5. (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. (6) “Medicare” means the Health Insurance for the Aged Act, Title XVIII of the Social Security Amendments of 1965, as then constituted or later amended;

  7. (7) “Medicare supplement policy” means a group or individual policy of accident and health insurance, a subscriber contract of a hospital and medical service corporation or health maintenance organization other than a policy issued pursuant to a contract under section 1876 or section 1833 of the Social Security Act, or an issued policy under a demonstration project authorized pursuant to amendments to the federal Social Security Act that 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; and

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


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