Rule 120-2-79-.03 - DefinitionsAs used in this Regulation Chapter, the term:
(1) "Employer-sponsored Health Benefit Arrangement" means any program of delivery, funding, or sponsorship of major medical, hospital, or medical and hospital expense coverage, or any type of coverage considered a health benefit plan as defined by O.C.G.A. § 33- 30A-1(3) offered by an employer for the benefit of its eligible employees and dependents(2) "Market Type" means any one of the following types of entities: (a) small employers as defined in O.C.G.A. § 33-30A-1(7);(b) large employers, which shall mean all employers which do not meet the definition of small employer in O.C.G.A. § 33-30A-1(7)because such employers employed more than 50 eligible employees during 50 percent or more of its working days during the previous calendar quarter; or(c) individuals offered membership in the health plan purchasing cooperative pursuant to O.C.G.A. § 33-30A-4(a)(4).(3) "Member" means any employer (or individual pursuant to O.C.G.A. § 33-30A-4(a)(4)) which has entered into a contract with a health plan purchasing cooperative, has met the membership criteria of the health plan purchasing cooperative, including payment of any applicable membership fees, and maintains at least one health benefit plan offered through the health plan purchasing cooperative as its employer-sponsored health benefit arrangement for its employees.(4) "Participating Carrier" means any insurer or carrier as defined in O.C.G.A. § 33-30A-1(2), with a certificate of authority to issue insurance in the State of Georgia, which has entered into a con- tract or agreement with a health plan purchasing cooperative to offer one or more health benefit plans to members of such purchasing cooperative.Ga. Comp. R. & Regs. R. 120-2-79-.03
O.C.G.A. Secs. 33-2-9, 33-30A-9.
Original Rule entitled "Definitions" adopted. F. Feb. 23, 2000; eff. Mar. 14, 2000.