N.Y. Insurance Law § 7705: Definitions

§ 7705. Definitions. As used in this article:

(a) "Account" means any of the two accounts created under section

seven thousand seven hundred six of this article.

(b) "Contractual obligations" means any obligation under covered

policies, but shall not include any obligation with respect to

policyholder dividends unpaid or unapplied, retrospective rate credits

or similar benefits or provisions.

(c) "Corporation" means The Life and Health Insurance Company Guaranty

Corporation of New York created under section seven thousand seven

hundred six of this article unless the context otherwise requires.

(d) "Covered policy" means any of the kinds of insurance specified in

paragraph one, two or three of subsection (a) of section one thousand

one hundred thirteen of this chapter, any supplemental contract, or any

funding agreement referred to in section three thousand two hundred

twenty-two of this chapter, or any portion or part thereof, within the

scope of this article under section seven thousand seven hundred three

of this article, except that any certificate issued to an individual

under any group or blanket policy or contract shall be considered to be

a separate covered policy for purposes of section seven thousand seven

hundred eight of this article.

(e) "Health insurance" means the kinds of insurance specified under

items (i) and (ii) of paragraph three and paragraph thirty-one of

subsection (a) of section one thousand one hundred thirteen of this

chapter, and section one thousand one hundred seventeen of this chapter;

medical expense indemnity, dental expense indemnity, hospital service,

or health service under article forty-three of this chapter; and

comprehensive health services under article forty-four of the public

health law. "Health insurance" shall not include hospital, medical,

surgical, prescription drug, or other health care benefits pursuant to:

(1) part C of title XVIII of the social security act (42 U.S.C. §

1395w-21 et seq.) or part D of title XVIII of the social security act

(42 U.S.C. § 1395w-101 et seq.), commonly known as Medicare parts C and

D, or any regulations promulgated thereunder; (2) titles XIX and XXI of

the social security act (42 U.S.C. § 1396 et seq.), commonly known as

the Medicaid and child health insurance programs, or any regulations

promulgated thereunder; (3) the basic health program under section three

hundred sixty-nine-gg of the social services law; (4) chapter 55 of part

II of subtitle A of title X (10 U.S.C §§ 1071-1110(b)), commonly known

as TRICARE, or any regulations promulgated thereunder; or (5) subpart G

of part III of title V (5 U.S.C. §§ 8101-9009), commonly known as the

Federal Employees Program, or any regulations promulgated thereunder.

(f) "Impaired insurer" means a member insurer which after the

effective date of this article is found to be impaired for the purposes

of section one thousand three hundred ten or one thousand three hundred

eleven of this chapter and is consequently placed under an order of

liquidation, rehabilitation or conservation under article seventy-four

of this chapter.

(g) "Insolvent insurer" means a member insurer which after the

effective date of this article becomes insolvent for the purposes of

section one thousand three hundred nine of this chapter and is placed

under a final order of liquidation, rehabilitation or conservation by a

court of competent jurisdiction.

(h) (1) "Member insurer" means:

(A) any life insurance company licensed to transact in this state any

kind of insurance to which this article applies under section seven

thousand seven hundred three of this article; provided, however, that

the term "member insurer" also means any life insurance company formerly

licensed to transact in this state any kind of insurance to which this

article applies under section seven thousand seven hundred three of this

article; and

(B) an insurer licensed or formerly licensed to write accident and

health insurance or salary protection insurance in this state,

corporation organized pursuant to article forty-three of this chapter,

reciprocal insurer organized pursuant to article sixty-one of this

chapter, cooperative property/casualty insurance company operating under

or subject to article sixty-six of this chapter, nonprofit

property/casualty insurance company organized pursuant to article

sixty-seven of this chapter, and health maintenance organization

certified pursuant to article forty-four of the public health law.

(2) "Member insurer" shall not include a municipal cooperative health

benefit plan established pursuant to article forty-seven of this

chapter, an employee welfare fund registered under article forty-four of

this chapter, a fraternal benefit society organized under article

forty-five of this chapter, an institution of higher education with a

certificate of authority under section one thousand one hundred

twenty-four of this chapter, or a continuing care retirement community

with a certificate of authority under article forty-six or forty-six-A

of the public health law.

(i) "Premiums" means direct gross insurance premiums and annuity and

funding agreement considerations received on covered policies, less

return premiums and considerations thereon and dividends paid or

credited to policyholders or contract holders on such direct business,

subject to such modifications as the superintendent may establish by

regulation or order as necessary to facilitate the equitable

administration of this article. Premiums do not include premiums and

considerations on contracts between insurers and reinsurers. For the

purposes of determining the assessment for an insurer under this

article, the term "premiums", with respect to a group annuity contract

(or portion of any such contract) that does not guarantee annuity

benefits to any specific individual identified in the contract and with

respect to any funding agreement issued to fund benefits under any

employee benefit plan, means the lesser of one million dollars or the

premium attributable to that portion of such group contract that does

not guarantee benefits to any specific individuals or such agreements

that fund benefits under any employee benefit plan.

(j) "Person" means any individual or legal entity, including a

corporation, partnership, association, limited liability company, trust,

or voluntary organization.

(k) "Resident" means a person to whom a contractual obligation is owed

and who either: (1) resides in this state on the date of entry of a

court order of liquidation or rehabilitation with respect to a member

insurer that is an impaired or insolvent insurer; or (2) resided in this

state at the time a member insurer issued a covered policy to such

person.

(l) "Supplemental contract" means an agreement or any other mechanism

for the distribution of proceeds under a life insurance policy, health

insurance policy, annuity contract, or funding agreement.

(m) "Long-term care insurance" means an insurance policy, rider, or

certificate advertised, marketed, offered, or designed to provide

coverage, subject to eligibility requirements, for not less than

twenty-four consecutive months for each covered person on an expense

incurred, indemnity, prepaid or other basis and provides at least the

benefits set forth in part fifty-two of title eleven of the official

compilation of codes, rules and regulations of this state.