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| 5.__Health maintenance organization.__"Health maintenance | | organization" means an organization authorized under chapter 56 to | | operate a health maintenance organization in this State. |
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| | | 6.__Insurer.__"Insurer" means an entity that is authorized to | | write medical insurance or that provides medical insurance in | | this State. For the purposes of this chapter, "insurer" includes | | an insurance company, a nonprofit hospital and medical service | | organization, a fraternal benefit society, a health maintenance | | organization, a self-insurance arrangement that provides health | | care benefits in this State to the extent allowed under the | | federal Employee Retirement Income Security Act of 1974, a 3rd- | | party administrator, a multiple-employer welfare arrangement, | | another entity providing medical insurance or health benefits | | subject to state insurance regulation and a reinsurer that | | reinsures health insurance in this State. |
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| | | 7.__Medical insurance.__"Medical insurance" means a hospital | | and medical expense-incurred policy, nonprofit hospital and | | medical service plan, health maintenance organization subscriber | | contract or 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. | | "Medical insurance" does not include accidental injury, specified | | disease, hospital indemnity, dental, vision, disability income, | | Medicare supplement, long-term care or other limited benefit | | health insurance or credit insurance; coverage issued as a | | supplement to liability insurance; insurance arising out of | | workers' compensation or similar law; automobile medical payment | | insurance; or insurance under which benefits are payable with or | | without regard to fault and that is statutorily required to be | | contained in any liability insurance policy or equivalent self- | | insurance. |
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| | | 8.__Medicare.__"Medicare" means coverage under both Parts A | | and B of Title XVIII of the federal Social Security Act, 42 | | United States Code, Section 1395 et seq., as amended. |
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| | | 9.__Plan.__"Plan" means the health insurance plan adopted by | | the board pursuant to this chapter. |
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| | | 10.__Producer.__"Producer" means a person who is licensed to | | sell health insurance in this State. |
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| | | 11.__Resident.__"Resident" means an individual who: |
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| | | A.__Is legally located in the United States and has been | | legally domiciled in this State for a period to be | | established by the board, not to exceed one year, subject to | | the approval of the superintendent; |
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