Definitions

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§ 4183. Definitions

As defined in this subchapter:

(1) "Association" means the Vermont Health Maintenance Organization Guaranty Association created under this subchapter.

(2) "Commissioner" means the Commissioner of Financial Regulation of this State.

(3) "Contractual obligation" means any obligation under covered health care plan certificates.

(4) "Covered person" means any member or person who is entitled to the protection of the Association as described in section 4181 of this title.

(5) "Covered health care plan certificate" means any health care plan certificate, contract, or other evidence of coverage within the scope of this subchapter.

(6) "Fund" means the Fund created under section 4184 of this title.

(7) "Impaired organization" means a member organization deemed by the Commissioner after May 21, 1993 to be unable or potentially unable to fulfill its contractual obligations, and not an insolvent organization.

(8) "Insolvent organization" means a member organization which becomes insolvent and is placed under a final order of liquidation or rehabilitation by a court of competent jurisdiction.

(9) "Member organization" means any person who holds a certificate of authority under chapter 139 of this title, and includes any person whose certificate of authority has been suspended, revoked, or nonrenewed.

(10) "Premiums" means direct gross premiums or subscriptions received on covered health care plan certificates.

(11) "Person" means any individual, corporation, partnership, association, or voluntary organization.

(12) "Resident" means any person who resides in this State at the time the organization is determined to be impaired or insolvent and to whom contractual obligations are owed. A person may be a resident of only one state. In the case of a person other than a natural person, residence shall be its principal place of business. (Added 1993, No. 30, § 15, eff. May 21, 1993; amended 1995, No. 180 (Adj. Sess.), § 38; 2011, No. 78 (Adj. Sess.), § 2, eff. April 2, 2012.)


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