02-031 C.M.R. ch. 580, § 4 - Definitions

For purposes of this Rule the following terms shall have the following meanings:

A. "Contract" means a policy, certificate, or other evidence of coverage issued by an insurer, health maintenance organization, or nonprofit service organization and includes certificates delivered in the State of Maine pursuant to out-of-state group policies. "Contract" includes both group and individual contracts and individual certificates of coverage unless stated otherwise.

B. "Insured" means the named insured, subscriber, member, or enrollee provided coverage by a contract, and includes the individual responsible for making premium payments on behalf of a small employer group or subgroup.

C. "Insurer" means an insurance company, health maintenance organization, or nonprofit service organization.

D. "Nonpayment of Premium" means the failure to remit any payment that the insured is required to make to an insurer, group policyholder, or plan sponsor or administrator.

E. "Subgroup" means an employer covered under a contract issued under a multiple-employer trust, association, or other group plan covering more than one employer.

Notes

02-031 C.M.R. ch. 580, § 4