Alaska Administrative Code
Title 3 - Commerce, Community, and Economic Development
Part 2 - Division of Insurance
Chapter 28 - Life, Health, Variable, and Related Insurance
Article 5 - Health Insurance Marketed as Medicare Supplements
3 AAC 28.510 - Definitions
Current through February 24, 2025
For purposes of 3 AAC 28.410 - 3 AAC 28.510,
(1) "applicant" means,
(2) "bankruptcy" means when a medicare+choice organization that is not an issuer has filed, or has had filed against it, a petition for declaration of bankruptcy and has ceased doing business in this state;
(3) "certificate" means a certificate delivered or issued for delivery in this state under a group medicare supplement policy;
(4) "certificate form" means the form on which the certificate is delivered or issued for delivery by the issuer;
(5) "claim reserves" include only those unpaid liabilities for claims that have already been incurred;
(6) "continuous period of creditable coverage" means the period during which an individual was covered by creditable coverage, if the individual had no breaks in coverage greater than 63 days during the period of the coverage;
(7) "creditable coverage" has the meaning given in AS 21.54.500;
(8) "director" means the director of insurance;
(9) "employee welfare benefit plan" means a plan, fund, or program of employee benefits as defined in 29 U.S.C. 1002 (Employee Retirement Income Security Act);
(10) "incurred claims" means paid claims plus the increase in claim reserves; "incurred claims" do not include policy (additional) reserves;
(11) "insolvency" means when an issuer who is licensed to transact the business of insurance in this state has had a final order of liquidation entered against it with a finding of insolvency by a court of competent jurisdiction in the issuer's state of domicile;
(12) "issuer" means an insurance company, fraternal benefit society, health care service plan, health maintenance organization, or other entity delivering or issuing for delivery in this state a medicare supplement policy or certificate;
(13) "medicare" means Title I, Part I of Public Law 89-97, as enacted by the 89th Congress of the United States of America (popularly known as the Health Insurance for the Aged Act);
(14) "medicare advantage plan" means a plan of coverage for health benefits under medicare Part C as defined in 42 U.S.C. 1395w-28; "medicare advantage plan" includes a
(15) "medicare supplement policy" means a group or individual policy of insurance or a subscriber contract, which is advertised, marketed, or designed primarily as a supplement to reimbursement under medicare for the hospital, medical, or surgical expenses of a person eligible for medicare; "medicare supplement policy" does not include
(16) "policy form" means the form on which a policy is delivered or issued for delivery by an issuer;
(17) "secretary" means the secretary of the United States Department of Health and Human Services;
(18) "pre-standardized medicare supplement benefit plan" or "pre-standardized plan" means a group or individual policy of medicare supplement insurance issued before July 1, 1992;
(19) "1990 standardized medicare supplement benefit plan" or "1990 plan" means a group or individual policy of medicare supplement insurance issued on or after July 1, 1992 and with an effective date of coverage before June 1, 2010 and includes medicare supplement insurance policies and certificates renewed on or after July 1, 1992 that are not replaced by the issuer at the request of the insured;
(20) "2010 standardized medicare supplement benefit plan" or "2010 plan" means a group or individual policy of medicare supplement insurance issued with an effective date of coverage on or after June 1, 2010.
(21) "newly eligible Medicare beneficiary" has the meaning given in 42 U.S.C. 1395ss(z) (section 401 of the Medicare Access and CHIP Reauthorization Act of 2015).
In 2010 the revisor of statutes, acting under AS 01.05.031, renumbered former AS 21.89.060 as AS 21.96.060. As of Register 196 (January 2011), the regulations attorney made a conforming technical revision under AS 44.62.125(b)(6), to the authority citation that follows 3 AAC 28.510, so that the citation to former AS 21.89.060 now refers to the renumbered statute, AS 21.96.060.
Authority:AS 21.06.090
AS 21.42.130
AS 21.96.060