§ 27-20.7-2 - Definitions.
SECTION 27-20.7-2
§ 27-20.7-2 Definitions. – As used in this chapter, the following terms have the following meanings:
(1) "Administrator" means a person who directly or indirectlysolicits or effects coverage of, underwrites, collects charges or premiumsfrom, or adjusts or settles claims on residents of this state, or residents ofanother state from offices in this state, in connection with life or healthinsurance coverage or annuities, except any of the following:
(i) An employer on behalf of its employees or the employeesof one or more subsidiaries or affiliated corporations of the employer;
(ii) A union on behalf of its members;
(iii) An insurer which is authorized to transact insurance inthis state with respect to a policy lawfully issued and delivered in andpursuant to the laws of this state or another state;
(iv) A producer licensed to sell life or health insurance inthis state, whose activities are limited exclusively to the sale of insurance;
(v) A creditor on behalf of its debtors with respect toinsurance covering a debt between the creditor and its debtors;
(vi) A trust and its trustees, agents and employees actingpursuant to the trust established in conformity with 29 U.S.C. § 186;
(vii) A trust exempt from taxation under § 501(a) of theInternal Revenue Code, 26 U.S.C. § 501(a), its trustees and employeesacting pursuant to the trust, or a custodian and the custodian's agents oremployees acting pursuant to a custodian account which meets the requirementsof § 401(f) of the Internal Revenue Code, 26 U.S.C. § 401(f);
(viii) A credit union or a financial institution which issubject to supervision or examination by federal or state banking authorities,or a mortgage lender, to the extent they collect and remit premiums to licensedinsurance producers or authorized insurers in connection with loan payments;
(ix) A credit card issuing company which advances for andcollects premiums or charges from its credit card holders who have authorizedcollection if the company does not adjust or settle claims;
(x) A person who adjusts or settles claims in the normalcourse of that person's practice or employment as an attorney at law and whodoes not collect charges or premiums in connection with life or healthinsurance coverage or annuities;
(xi) An adjuster licensed by this state whose activities arelimited to adjustment of claims;
(xii) A person who acts solely as an administrator of one ormore bona fide employee benefit plans established by an employer or an employeeorganization, or both, for which the insurance laws of this state are preemptedpursuant to the Employee Retirement Income Security Act of 1974 (ERISA), 29U.S.C. § 1001 et seq. That person shall comply with the requirements of§ 27-20.7-12(g); or
(xiii) A person licensed as a managing general agent in thisstate, whose activities are limited exclusively to the scope of activitiesconveyed under that license.
(2) "Affiliate" or "affiliated" means an entity or person whodirectly or indirectly through one or more intermediaries controls or iscontrolled by, or is under common control with, a specified entity or person.
(3) "Commissioner" means the commissioner of insurance.
(4) "Control" has the same meaning as that term is defined in§ 27-35-1(c).
(5) "Insurance" or "insurance coverage" means any coverageoffered or provided by an insurer.
(6) "Insurer" includes all persons, firms or corporationsoffering and/or insuring health services on a prepaid basis, including, but notlimited to, policies of accident and sickness insurance as defined by chapter18 of this title, nonprofit hospital or medical service plans as defined bychapters 19 and 20 of this title, or any other entity whose primary function isto provide diagnostic, therapeutic or preventive services to a definedpopulation on the basis of a periodic premium. It includes all persons, firmsor corporations providing health benefits coverage for employees on aself-insurance basis without the intervention of other entities. Insurer doesnot include a bona fide employee benefit plan established by an employer or anemployee organization, or both, for which the insurance laws of this state arepreempted pursuant to the Employee Retirement Income Security Act of 1974, 29U.S.C. § 1001 et seq.
(7) "Underwrites" or "underwriting" means, but is not limitedto, the acceptance of employer or individual applications for coverage ofindividuals in accordance with the written rules of the insurer; the overallplanning and coordinating of an insurance program; and the ability to procurebonds and excess insurance.