Section 760 IAC 1-68-1 - DefinitionsAuthority: IC 27-1-34-9
Affected: IC 27-1-34-1; IC 27-16-2-13
Sec. 1.
The following definitions apply throughout this rule:
(1) "Affiliate of" or "affiliated with", a specific person, means a person that directly, or indirectly through one (1) or more intermediaries:(C) is under common control with; the person specified. (2) "Commissioner" means the commissioner of the department.(3) "Creditable coverage" has the meaning set forth in the federal Health Insurance Portability and Accountability Act of 1996 (26 U.S.C. 9801(c)(1)) .(4) "Department" means the Indiana department of insurance.(5) "Fund balance" means the total assets in excess of total liabilities, except that assets pledged to secure debts not reflected on the books of the multiple employer welfare arrangement are not included in the fund balance. The term includes other: (C) subordinated debt; and(D) supplemental contribution fund assets.(6) "Health benefit plan" means any plan that provides benefits for health care services. The term does not include the following:(A) Accident-only or disability income insurance or a combination of accident-only and disability income insurance.(B) Credit only insurance.(C) Disability insurance.(D) Coverage for a specified disease or illness.(E) Medicare supplement policies.(F) Long term care coverage.(G) Workers' compensation insurance.(H) A jointly managed trust authorized under 29 U.S.C. 141 et seq. with a plan of benefits for employees negotiated in a collective bargaining agreement governing wages, hours, and working conditions of the employees as authorized under 29 U.S.C. 157.(I) Hospital indemnity or fixed indemnity insurance.(J) Reinsurance contract issued on a stop-loss, quota-share, or similar basis.(K) Short term major medical contracts.(7) "Multiple employer welfare arrangement" or "MEWA" has the meaning set forth in IC 27-1-34-1. The term does not include a professional employer organization as defined by IC 27-16-1-13 and registered under IC 27-16.(8) "Participant criteria" means any criteria or rules established by an employer to determine the employees who are eligible for enrollment, including continued enrollment, under the terms of a health benefit plan.(9) "Participation agreement" means the document pursuant to which an employer undertakes and agrees to fulfill obligations as a member of the MEWA.(10) "Qualified actuary" means an actuary who:(A) is not an employee of the MEWA; and(B) is: (i) a fellow of the Society of Actuaries;(ii) a member of the American Academy of Actuaries; or(iii) an enrolled actuary under the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1001, et seq.).(11) "Qualified financial institution" means an institution that: (A) is organized or, in the case of a United States branch or agency office of a foreign banking organization, is licensed under the laws of the United States or any state;(B) has been granted authority to operate with fiduciary powers; and(C) is regulated, supervised, and examined by federal or state authorities having regulatory authority over banks and trust companies.(12) "Supplemental contribution fund" means a segregated fund consisting of cash or cash equivalents that may be utilized by the MEWA to satisfy 760 IAC 1-68-2(d)(8) [section 2(d)(8) of this rule]. A MEWA is permitted to access funds contained in its supplemental contribution fund during the fiscal year provided that the funds are utilized only to pay outstanding claims. Department of Insurance; 760 IAC 1-68-1; filed Apr 15, 2003, 2:20 p.m.: 26 IR 3035; filed Mar 7, 2006, 2:00 p.m.: 29 IR 2186; readopted filed Nov 24, 2009, 9:35 a.m.: 20091223-IR-760090791RFAReadopted filed 11/20/2015, 9:25 a.m.: 20151216-IR-760150341RFAReadopted filed 11/15/2021, 8:32 a.m.: 20211215-IR-760210419RFA