18 Del. Admin. Code § 1305-4.0

Current through Register Vol. 28, No. 5, November 1, 2024
Section 1305-4.0 - Definitions
4.1 For purposes of this regulation:

"Carrier" means any entity that provides health insurance in this state. For the purposes of this chapter, carrier includes an insurance company, health service corporation, health maintenance organization, and any other entity providing a plan of health insurance or health benefits subject to state insurance regulation.

"Certificate form" means the form on which the certificate is delivered or issued for delivery by the issuer.

"Collected Premium" means the amount of premium that is unadjusted to reflect any changes in the rate level (e.g. reported or actual premium).

"Commissioner" means the Insurance Commissioner of this State.

"Earned Premium" means the portion of the total premium that corresponds to the coverage provided during a given time period.

"Experience Period" means the number of years over which the adequacy of the rates presently in effect are tested.

"Health Benefit Plan" is an individual plan or group health plan that provides, or pays the cost of, medical care, including but not limited to group health plans, health insurance issuers, health maintenance organizations, managed care organizations and health service contractors, as well as any combination of them.

"Incurred Losses" means losses that are (1) paid losses, and (2) losses that are incurred but not yet reported to the insurance claimants.

"Policy Form" means the form on which the policy is delivered or issued for delivery by the insurer.

"Protected and Reserve Incurred Losses" means losses on claims that are still open.

"Supplemental Rate Information" shall mean any manual or plan of rates, statistical plan, classification system, minimum premium, policy fee, rating rule, rate-related underwriting rule and any other information needed to determine the applicable premium for an individual insured and not otherwise inconsistent with the purposes of this chapter, as prescribed by rule of the Commissioner.

18 Del. Admin. Code § 1305-4.0

13 DE Reg. 939 (01/01/10)