§ 4702. Definitions. As used in this article:
(a)"Community rating"\nmeans a rating methodology in which the premium equivalent rate for all\npersons covered under a municipal cooperative health benefit plan is the\nsame, based upon the experience of the entire pool of risks covered\nunder the plan, without regard to age, sex, health status or occupation\nand such that refunds, rebates, credits or dividends based upon age,\nsex, health status or occupation are not permitted.\n (b) "Fully-insured" means that all benefits payable pursuant to a\nmunicipal cooperative health benefit plan are guaranteed under a\ncontract or policy of insurance delivered in this state and issued by an\ninsurance company authorized to do accident and health insurance\nbusiness in this state, an article forty-
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§ 4702. Definitions. As used in this article: (a) "Community rating"\nmeans a rating methodology in which the premium equivalent rate for all\npersons covered under a municipal cooperative health benefit plan is the\nsame, based upon the experience of the entire pool of risks covered\nunder the plan, without regard to age, sex, health status or occupation\nand such that refunds, rebates, credits or dividends based upon age,\nsex, health status or occupation are not permitted.\n (b) "Fully-insured" means that all benefits payable pursuant to a\nmunicipal cooperative health benefit plan are guaranteed under a\ncontract or policy of insurance delivered in this state and issued by an\ninsurance company authorized to do accident and health insurance\nbusiness in this state, an article forty-three corporation, or a health\nmaintenance organization.\n (c) "Governing board" means the group of persons, designated in the\nmunicipal cooperation agreement establishing the municipal cooperative\nhealth benefit plan, to be responsible for administering the plan.\n (d) "Municipal cooperation agreement" means an appropriate cooperative\nagreement authorized by article five-G of the general municipal law.\n (e) "Municipal cooperative health benefit plan" or "plan" means any\nplan established or maintained by two or more municipal corporations\npursuant to a municipal cooperation agreement for the purpose of\nproviding medical, surgical or hospital services to employees or\nretirees of such municipal corporations and to the dependents of such\nemployees or retirees.\n (f) "Municipal corporation" means within the state of New York, a city\nwith a population of less than one million or a county outside the city\nof New York, town, village, board of cooperative educational services,\nschool district, a public library, as defined in section two hundred\nfifty-three of the education law, or district, as defined in section one\nhundred nineteen-n of the general municipal law.\n (g) "Plan document" means the group contract issued by the municipal\ncooperative health benefit plan to participating municipal corporations\ndescribing the terms and conditions of coverage.\n (h) "Premium equivalent" or "contribution" means the amount\ncontributed by participating municipal corporations to cover expected\nclaims and expenses thereon, required reserves, surplus, stop-loss\ninsurance, and other expenses associated with the operations of the\nmunicipal cooperative health benefit plan.\n (i) "Qualified actuary" means an actuary who is a member in good\nstanding of the American Academy of Actuaries or Society of Actuaries,\nwith experience in establishing rates for self-insured trusts providing\nhealth benefits or other similar experience.\n (j) "Summary plan description" means the certificate of coverage or\nbooklet delivered to employees or retirees enrolled in the plan,\nsummarizing the essential terms and conditions of coverage for employees\nor retirees and their dependents.\n