18 Del. Admin. Code § 1407-3.0

Current through Register Vol. 28, No. 5, November 1, 2024

Section 1407-3.0 - Definitions

"Carrier" means any entity that provides health insurance in this State. For the purposes of this section, carrier includes an insurance company, health service corporation, managed care organization, health maintenance organization, and any other entity providing a plan of health insurance or health benefits subject to state insurance regulation. "Carrier" also includes any third party administrator or other entity that adjusts, administers, or settles claims in connection with health benefit plans.

"Covered person" means a person who claims to be entitled to receive benefits from a carrier.

"Dependent" means a covered person's child by blood or by law who:

a. is less than 24 years of age;

b. is unmarried;

c. has no dependents of his or her own;

d. is a resident of Delaware or is enrolled as a full-time student at an accredited public or private institution of higher education; and

e. is not actually provided coverage as a named subscriber, insured, enrollee, or covered person under any other group or individual health benefits plan, group health plan, or church plan, or entitled to benefits under 42 U.S.C. 1395 et. seq.

18 Del. Admin. Code § 1407-3.0