Code of the District of Columbia

§ 31–3701. Definitions.

For the purposes of this subchapter, the term:

(1) “Applicant” means:

(A) In the case of an individual Medicare supplement policy, the person who seeks to contract for insurance benefits; and

(B) In the case of a group Medicare supplement policy, the proposed certificate holder.

(2) “Certificate” means any certificate delivered or issued for delivery in the District of Columbia under a group Medicare supplement policy.

(3) “Certificate form” means the form on which the certificate is delivered or issued for delivery by the insurer.

(4) “Issuer” means an insurance company, a fraternal benefit association, a health care service plan, a health maintenance organization, and any other entity delivering or issuing for delivery in the District of Columbia Medicare supplement policies or certificates. The term “issuer” includes Group Hospitalization and Medical Services, Incorporated.

(5) “Medicare” means the health insurance program established pursuant to the Health Insurance for the Aged Act (42 U.S.C. § 303 et seq.).

(6) “Medicare supplement policy” 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, other than a policy issued pursuant to a contract under § 1876 of the Social Security Act (42 U.S.C. § 1395mm), or an issued policy under a demonstration project specified in 42 U.S.C. § 1395ss(g)(1), which 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.

(7) “Policy form” means the form on which the policy is delivered or issued for delivery by the issuer.