Iowa Admin. Code r. 191-37.52

Current through Register Vol. 46, No. 20, April 3, 2024
Rule 191-37.52 - Definitions

In addition to the definitions in Iowa Code section 507B2. and rule 191-152. (5-107B), the following definitions shall apply to 191-Chapter 37, Division II. When there is a definition for a term in this rule and also in Iowa Code section 507B2. or rule 191-152. (507B), the definition in this rule shall take precedence.

"Advertisement" includes:

1. The definition of "advertisement" in rule 191-152. (507B).
2. Advertising material included with a policy when the policy is delivered and material used in the solicitation of renewals and reinstatements.
3. The definition of "advertisement" does not include:

* Items excluded in the definition of "advertisement" in rule 191-15.2(507B).

* Correspondence between a prospective group or blanket policyholder and an insurer in the course of negotiating a group or blanket contract.

* Court-approved material ordered by a court to be disseminated to policyholders.

"Certificate" means any certificate issued under a group Medicare supplement policy, which certificate has been delivered or issued for delivery in this state.

"Institutional advertisement" means an advertisement having as its sole purpose the promotion of the reader's, viewer's or listener's interest in the concept of Medicare supplement insurance, or the promotion of the insurer as a seller of Medicare supplement insurance.

"Lead-generating device" means any communication directed to the public that, regardless of form, content or stated purpose, is intended to result in the compilation or qualification of a list containing names and other personal information to be used to solicit residents of this state for the purchase of Medicare supplement insurance.

"Limitation" means any provision other than an exception or a reduction that restricts coverage under the policy.

"Medicare" means "The Health Insurance for the Aged Act, Title XVIII of The Social Security Amendments of 1965 as Then Constituted or Later Amended," or Title I, Part I, of Public Law 89-97, as enacted by the Eighty-Ninth Congress of the United States of America, and also known as the "Health Insurance for the Aged Act, as then constituted and any later amendments or substitutes thereof," or words of similar import.

"Medicare supplement insurance" means a group or individual policy of accident and sickness insurance or a subscriber contract of hospital and medical service associations or health maintenance organizations that is advertised, marketed or designed primarily as a supplement to reimbursements under Medicare for the hospital, medical or surgical expenses of persons eligible for Medicare by reason of age.

"Person" means a natural person, association, organization, partnership, trust, group, discretionary group, corporation or any other entity.

"Reduction" means any provision that reduces the amoimt of the benefit; a risk of loss is assumed but payment upon the occurrence of the loss is limited to some amount or period less than would be otherwise payable had the reduction not been used.

Iowa Admin. Code r. 191-37.52

ARC 7964B, lAB 7/15/09, effective 8/19/09