§ 27-20.4-3 — § 27-20.4-3. Definitions.

Rhode Island § 27-20.4-3

• Jurisdiction: Rhode Island
• Title 27: Insurance
• Ch. 27-20.4: Insurance Continuation Act

Text

§ 27-20.4-3. Definitions.

As used in this chapter, the following terms have the following meaning:

(1) "Director� means the director of the department of business regulation.

(2) "Individual contract� means any health benefit contract that is not a group contract.

(3) "Insurerâ€� means every medical service corporation, hospital service corporation, health maintenance organization licensed under chapter 41 of this title or as defined in § 42-62-4, or insurance company offering and/or insuring health services.

(4) "Late enrollee� means a person who requests enrollment in a group plan following the initial enrollment period provided under the terms of the plan, except that a person is not a late enrollee if:

(i) The request for enrollment is made within thirty (30) days after the termination of coverage under a prior contract or policy and the individual did not request coverage initially under the succeeding contract because that individual was covered under a prior contract and coverage under that contract ceased due to termination of employment, death of a spouse, or divorce; or

(ii) A court has ordered that coverage be provided for a spouse or minor child under a covered employee's plan and the request for coverage is made within thirty (30) days after issuance of the court order.

(5) "Prior contract� means the group or individual health benefit contract or health benefit plan that previously covered the person.

(6) "Replacement contract� means a total group health benefit contract that replaces another total group health benefit contract.

(7) "Succeeding contract� means the group health benefit contract under which the person is seeking coverage or a different health benefit plan under the same group health benefit contract.

(8) "Total group contract� means a health benefit contract for the coverage of all eligible members of the employer health plan.

Legislative History

P.L. 1991, ch. 321, § 1; P.L. 1992, ch. 387, § 1.