Definitions

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  • (a) “Applicant” means:

    • (1) In the case of an individual Medicare Supplement policy the person who seeks to contract for insurance benefits; and

    • (2) In the case of a group Medicare Supplement policy the proposed certificate holder.

  • (b) “Certificate” means any certificate delivered or issued for delivery in the Territory under a group Medicare Supplement policy.

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

  • (d) “Issuer” includes insurance companies, fraternal benefit societies, health care service plans, health maintenance organizations, and any other entity delivering or issuing for delivery in the Territory Medicare Supplement policies or certificates.

  • (e) “Commissioner” means the Commissioner of Insurance.

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

  • (g) “Medicare Supplement Policy” means a group or individual accident and sickness insurance policy or a subscriber contract of hospital and medical service associations or health maintenance organizations, other than a policy issued pursuant to a contract under section 1876 or section 1833 of the federal Social Security Act (42 U.S.C. section 1395 et seq.), or an issued policy under a demonstration project authorized pursuant to amendments to the federal Social Security Act, which 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.

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


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