SEC. 83-9-205. Definitions.
As used in Sections 83-9-201 through 83-9-223, the following words shall have the meaning ascribed herein unless the context clearly requires otherwise:
(a) "Association" means the Comprehensive Health Insurance Risk Pool Association.
(b) "Board" means the board of directors of the association.
(c) "Dependent" means a resident spouse or resident unmarried child under the age of nineteen (19) years, a child who is a student under the age of twenty-three (23) years and who is financially dependent upon the parent or a child of any age who is disabled and dependent upon the parent.
(d) "Health insurance" means any hospital and medical expense incurred policy, nonprofit health care services plan contract, health maintenance organization subscriber contract or any other health care plan or arrangement that pays for or furnishes medical or health care services whether by insurance or otherwise, whether sold as an individual or group policy. The term does not include short-term, accident, dental-only, vision-only, fixed indemnity, limited benefit or credit insurance, coverage issued as a supplement to liability insurance, insurance arising out of a workers' compensation or similar law, automobile medical-payment insurance or insurance under which benefits are payable with or without regard to fault and which is statutorily required to be contained in any liability insurance policy or equivalent self-insurance.
(e) "Health maintenance organization" means any organization authorized under Section 41-7-401 to operate a health maintenance organization in this state.
(f) "Insurer" means any entity that provides health insurance in this state or any third party administrator. For the purposes of Sections 83-9-201 through 83-9-223, insurer includes an insurance company, nonprofit health care services plan, fraternal benefit society, health maintenance organization, to the extent consistent with federal law any self-insurance arrangement covered by the Employee Retirement Income Security Act of 1974, as amended, that provides health care benefits in this state, any other entity providing a plan of health insurance or health benefits subject to state insurance regulation and any reinsurer reinsuring health insurance in this state.
(g) "Medicare" means coverage under both Parts A and B of Title XVIII of the Social Security Act, 42 USC, Section 1395 et seq., as amended.
(h) "Plan" means the health insurance plan adopted by the board under Sections 83-9-201 through 83-9-223.
(i) "Resident" means an individual who has been legally domiciled in this state for a period to be established by the board and subject to the approval of the commissioner but in no event shall such residency requirement be less than six (6) months nor greater than one (1) year.
(j) "Agent" means a person who is licensed to sell health insurance in this state or a third party administrator.
(k) "Covered person" means any individual resident of this state (excluding dependents) who is eligible to receive benefits from any insurer.
(l) "Third party administrator" means any entity who is paying or processing health insurance claims for any Mississippi resident.
(m) "Reinsurer" means any insurer from whom any person providing health insurance for any Mississippi resident procures insurance for itself in the insurer, with respect to all or part of the health insurance risk of the person.
SOURCES: Laws, 1991, ch. 593, Sec. 3, eff from and after passage (approved April 15, 1991). Laws, 1995, ch. 490, Sec. 3, eff from and after July 1, 1995 and shall stand repealed as of December 31, 1997
1997 Amendment
SECTION 3. Section 83-9-205, Mississippi Code of 1972, is reenacted and amended as follows:
83-9-205. As used in Sections 83-9-201 through 83-9-222, the following words shall have the meaning ascribed herein unless the context clearly requires otherwise:
(a) "Association" means the Comprehensive Health Insurance Risk Pool Association.
(b) "Board" means the board of directors of the association.
(c) "Dependent" means a resident spouse or resident unmarried child under the age of nineteen (19) years, a child who is a student under the age of twenty-three (23) years and who is financially dependent upon the parent or a child of any age who is disabled and dependent upon the parent.
(d) "Health insurance" means any hospital and medical expense incurred policy, nonprofit health care services plan contract, health maintenance organization subscriber contract or any other health care plan or arrangement that pays for or furnishes medical or health care services whether by insurance or otherwise, whether sold as an individual or group policy. The term does not include short-term, accident, dental-only, vision-only, fixed indemnity, limited benefit or credit insurance, coverage issued as a supplement to liability insurance, insurance arising out of a workers' compensation or similar law, automobile medical-payment insurance or insurance under which benefits are payable with or without regard to fault and which is statutorily required to be contained in any liability insurance policy or equivalent self-insurance.
(e) "Health maintenance organization" means any organization authorized under the Health Maintenance Organization, Preferred Provider Organization and Other Prepaid Health Benefit Plans Protection Act, Section 83-41-301 et seq., to operate a health maintenance organization in this state.
(f) "Insurer" means any entity that is authorized in this state to write health insurance or that provides health insurance in this state or any third party administrator. For the purposes of Sections 83-9-201 through 83-9-222, insurer includes an insurance company, nonprofit health care services plan, fraternal benefit society, health maintenance organization, to the extent consistent with federal law any self-insurance arrangement covered by the Employee Retirement Income Security Act of 1974, as amended, that provides health care benefits in this state, any other entity providing a plan of health insurance or health benefits subject to state insurance regulation and any reinsurer reinsuring health insurance in this state.
(g) "Medicare" means coverage under both Parts A and B of Title XVIII of the Social Security Act, 42 USC, Section 1395 et seq., as amended.
(h) "Plan" means the health insurance plan adopted by the board under Sections 83-9-201 through 83-9-222.
(i) "Resident" means an individual who is legally located in the United States and has been legally domiciled in this state for a period to be established by the board and subject to the approval of the commissioner but in no event shall such residency requirement be * * * greater than one (1) year.
(j) "Agent" means a person who is licensed to sell health insurance in this state or a third party administrator.
(k) "Covered person" means any individual resident of this state (excluding dependents) who is eligible to receive benefits from any insurer.
(l) "Third party administrator" means any entity who is paying or processing health insurance claims for any Mississippi resident.
(m) "Reinsurer" means any insurer from whom any person providing health insurance for any Mississippi resident procures insurance for itself in the insurer, with respect to all or part of the health insurance risk of the person.
SOURCE: 1997 Laws, Chapter 311, Sec. 3, SB2480, Effective July 1, 1997.