As used in this article 20, unless the context
otherwise requires:
(1) Account means any of the three accounts created pursuant to section
10-20-106.
(2) Association means the life and health insurance protection association
as established by this article.
(2.5) Authorized assessment or authorized when used in the context of
assessments means a resolution passed by the board in which an assessment will
be called immediately or in the future from member insurers for a specified amount.
An assessment is authorized when the resolution pertaining to the assessment is
passed.
(3) Board means the board of the association.
(3.5) Called assessment or called when used in the context of
assessments means that a notice has been issued by the association to member
insurers requiring that an authorized assessment be paid by the date set in the
notice. An authorized assessment becomes a called assessment when notice is
mailed by the association to member insurers.
(4) Commissioner means the commissioner of insurance.
(5) Contractual obligation means any obligation under a policy, contract, or
certificate under a group policy or contract, or portion thereof, for which coverage
is provided pursuant to section 10-20-104.
(6) Covered policy, covered contract, or covered policy or contract
means a policy or contract, or a portion of a policy or contract, for which coverage is
provided under section 10-20-104.
(6.5) Extracontractual claims includes claims relating to bad faith in the
payment of claims, claims for punitive or exemplary damages, and claims for
attorney fees and costs.
(6.6) (a) Health benefit plan means any hospital or medical expense policy
or certificate, health maintenance organization subscriber contract, or other similar
health contract that is subject to the jurisdiction of the commissioner and available
for use, offered, or sold in Colorado.
(b) Health benefit plan does not include:
(I) An accident only plan;
(II) Credit insurance;
(III) Dental insurance;
(IV) Vision insurance;
(V) A medicare supplement plan;
(VI) Benefits for long-term care, home health care, community-based care, or
any combination of such benefits;
(VII) Disability income insurance;
(VIII) Liability insurance including general liability insurance and automobile
liability insurance;
(IX) Coverage for on-site medical clinics;
(X) Coverage issued as a supplement to liability insurance, workers'
compensation, or similar insurance;
(XI) Automobile medical payment insurance; or
(XII) Specified disease, hospital confinement indemnity, or limited benefit
health insurance if the type of coverage does not provide coordination of benefits
and is provided under a separate policy or certificate.
(6.7) Impaired insurer means a member insurer that is not an insolvent
insurer and is placed under an order of rehabilitation or conservation by a court of
competent jurisdiction.
(7) Insolvent insurer means a member insurer which after July 1, 1991, is
placed under an order of liquidation by a court of competent jurisdiction with a
finding of insolvency.
(8) Member insurer means any insurer or health maintenance organization
that is licensed or holds a certificate of authority in this state to write any kind of
insurance or health maintenance organization business for which coverage is
provided pursuant to section 10-20-104 and includes any insurer or health
maintenance organization whose license or certificate of authority in this state may
have been suspended, revoked, not renewed, or voluntarily withdrawn. Member
insurer does not include:
(a) A nonprofit hospital or medical service organization;
(b) Repealed.
(c) A fraternal benefit society;
(d) A mandatory state pooling plan;
(e) Repealed.
(f) A stipulated premium insurance company;
(g) A local mutual burial association;
(h) A mutual assessment company or any entity that operates on an
assessment basis;
(i) An interinsurance exchange;
(i.5) A health-care coverage cooperative with a certificate of authority issued
and operating under part 10 of article 16 of this title 10; or
(j) Any entity similar to those specified in subsections (8)(a) to (8)(i.5) of this
section.
(9) Moody's corporate bond yield average means the monthly average
corporates as published by Moody's Investors Service, Inc., or any successor
thereto.
(10) NAIC means the national association of insurance commissioners.
(10.5) Owner of a policy or contract, policy owner, policyholder,
contract holder, or contract owner means the person who is identified as the
legal owner under the terms of the policy or contract or who is otherwise vested
with legal title to the policy or contract through a valid assignment completed in
accordance with the terms of the policy or contract and properly recorded as the
owner on the books of the member insurer. The terms owner, contract owner,
policyholder, contract holder, and policy owner do not include persons with a
mere beneficial interest in a policy or contract.
(11) Person means any individual, corporation, limited liability company,
partnership, association, or voluntary organization.
(12) (a) Premiums means the amount of money or other consideration,
however designated, received on covered policies or contracts less returned
premiums, returned consideration, and returned deposits, and less dividends and
experience credits.
(b) Premiums does not include:
(I) Any amount of money or other consideration received for any policies or
contracts or for the portions of any policies or contracts for which coverage is not
provided under section 10-20-104 (2); except that assessable premiums shall not be
reduced on account of section 10-20-104 (2)(b)(III) relating to interest limitations
and section 10-20-104 (3)(b) relating to limitations with respect to any one life;
(II) Premiums on an unallocated annuity contract; or
(III) Premiums in excess of five million dollars with respect to multiple
nongroup policies of life insurance owned by one owner, regardless of:
(A) Whether the policy owner is an individual, firm, corporation, or other
person;
(B) Whether the persons insured are officers, managers, employees, or other
persons; or
(C) The number of policies or contracts held by the owner.
(12.5) (a) Principal place of business of a person other than an individual
means the single state in which the individuals who establish policy for the
direction, control, and coordination of the operation of the entity as a whole
primarily exercise that function, as determined by the association in its reasonable
judgment by considering the following factors:
(I) The state in which the primary executive and administrative headquarters
of the entity is located;
(II) The state in which the principal office of the chief executive officer of the
entity is located;
(III) The state in which the board of directors or similar governing person or
persons of the entity conducts the majority of its meetings;
(IV) The state in which the executive or management committee of the board
of directors or similar governing person or persons of the entity conducts the
majority of its meetings; and
(V) The state from which the overall operation of the entity is directed.
(b) In the case of plan sponsors, if more than fifty percent of the participants
in the benefit plan are employed in a single state, that state is the principal place of
business for the plan sponsor.
(c) The principal place of business of a plan sponsor of a benefit plan is the
principal place of business of the association, committee, joint board of trustees, or
similar group of representatives of the parties who establish or maintain the benefit
plan that, in lieu of a specific or clear designation of a principal place of business, is
the principal place of business of the employer or employee organization that has
the largest investment in the benefit plan.
(12.7) Receivership court means the court in an impaired or insolvent
insurer's state having jurisdiction over the conservation, rehabilitation, or liquidation
of the member insurer.
(13) Resident means any person to whom a contractual obligation is owed
and who resides in this state on the date of entry of a court order that determines a
member insurer to be an impaired insurer or a court order that determines a
member insurer to be an insolvent insurer. A person must be a resident of only one
state, which, in the case of a person other than a natural person, must be its
principal place of business. Citizens of the United States who are residents of a
foreign country, United States possession, United States territory, or United States
protectorate, which country, possession, territory, or protectorate does not have an
association similar to the association created by this article 20, are deemed
residents of the state of domicile of the member insurer that issued the policies or
contracts.
(13.3) State means a state, the District of Columbia, Puerto Rico, or a
possession, territory, or protectorate of the United States.
(13.5) Structured settlement annuity means an annuity purchased in order
to fund periodic payments for a plaintiff or other claimant in payment for or with
respect to personal injury suffered by the plaintiff or other claimant.
(14) Supplemental contract means any written agreement entered into for
the distribution of proceeds under a life, health, or annuity policy or a life, health, or
annuity contract.
(15) Unallocated annuity contract means an annuity contract or group
annuity certificate that is not issued to and owned by an individual, except to the
extent of any annuity benefits guaranteed to an individual by an insurer under the
contract or certificate.