Mont. Admin. r. 24.29.813

Current through Register Vol. 23, December 6, 2024

Rule 24.29.813 - DEFINITIONS

For purposes of this subchapter, the following definitions apply:

(1) "Certified claims examiner" means a claims examiner who is in compliance with the requirements of 39-71-320, MCA.

(2) "Credit hours" means the value assigned to a course by the department, upon review and approval of course materials and content outline.

(3) "Hour," for the purposes of continuing education credits, means a 50-minute period.

(4) "Instructor" means an individual who meets the requirements set forth in ARM 24.29.844, is identified by a sponsoring organization in a course submission, participates in course presentations, activities and discussions, and who may monitor the attendance and conduct of course participants, or administer examinations.

(5) "New hire" means a person who has:

(a) not been previously employed by the insurer or third-party administrator as a claims examiner;

(b) been separated from employment with the insurer or third-party administrator for at least 60 days and is required to complete new hire paperwork such as a Form I-9 or Form W-4; or

(c) received an internal promotion or transfer to a claims examiner position. The term includes a temporary employee.

(6) "Significant change" means a change in two or more of the following course elements:

(a) course goals or objectives;

(b) major course topic(s);

(c) course length;

(d) syllabus or course outline;

(e) teaching method; or

(f) examination method.

(7) "Sponsoring organization" means any group(s) or organization(s) and their agent(s) that submit courses for department review and offer or provide approved courses for continuing education credit to allow claims examiner certification and are responsible for those course offerings.

(8) "Trainee" means an employee who has no prior claims examiner experience and is participating in a program by which the employer prepares the trainee to carry out the essential functions of a certified claims examiner.

Mont. Admin. r. 24.29.813

NEW, 2009 MAR p. 2019, Eff. 10/30/09; AMD, 2019 MAR p. 2119, Eff.12/1/2019; AMD, 2024 MAR p. 1066, Eff. 5/11/2024

AUTH: 39-71-203, 39-71-320, MCA; IMP: 39-71-105, 39-71-107, 39-71-320, MCA