044-4 Wyo. Code R. §§ 4-2 - Definitions
For purposes of this chapter:
(a) "Affiliate" or "affiliated" means a
person who directly or indirectly through one or more intermediaries, controls
or is controlled by, or is under common control with, another specified
person.
(b) "Entity" means a
corporation, association, partnership, limited liability company or other legal
entity that is not an individual.
(c) "Collateral" means funds, letters of
credit or any item with economic value owned by the payor but held by an entity
or Third Party Administrator (TPA) in case it needs to be used to fulfill
premium, plan contributions, or loss reimbursement obligations in accordance
with a contract between the entity or TPA and the payor. "Collateral" shall
include anticipated loss prepayments made prior to the payment of losses,
pursuant to arrangements where reimbursement is not due until after losses have
been paid.
(d) "Control" (including
the terms "controlled by" and "under common control with") means the
possession, direct or indirect, of the power to direct or cause the direction
of the management and policies of a person, whether through the ownership of
voting securities, by contract other than a commercial contract for goods or
non-management services, or otherwise, unless the power is the result of an
official position with or corporate office held by the person. Control shall be
presumed to exist if any person, directly or indirectly, owns, controls, holds
with the power to vote, or holds proxies representing, ten percent (10%) or
more of the voting securities of any other person. This presumption may be
rebutted by a showing made in the manner provided by W.S. §
26-44-104
that control does not exist in fact.
(e) "GAAP" means United States generally
accepted accounting principles consistently applied.
(f) "Payor" means an entity that is required
to be licensed or registered under the Wyoming insurance code [title
26].
(g) "Stop-loss insurance"
means insurance protecting an employer, trust, or other person responsible for
an otherwise self-insured health or life benefit plan against obligations under
the plan, but "stop-loss insurance" does not include reinsurance written for an
insurance company.
(h) "Third party
administrator" or "TPA" is defined pursuant to W.S. §
26-53-101(a)(i).
(i) "Underwrites" or "underwriting" means,
but is not limited to, the acceptance of employer or individual applications
for coverage of individuals and the overall planning and coordination of a
benefits program.
Notes
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