26.1-38.1-02. Definitions

26.1-38.1-02. Definitions

As used in this chapter:

1. "Account" means either of the two accounts created under section 26.1-38.1-03.

2. "Association" means the North Dakota life and health insurance guaranty association

created under section 26.1-38.1-03.

3. "Authorized assessment" or the term "authorized" when used in the context of

assessments means a resolution by the board of directors has been passed under

which an assessment will be called immediately or in the future from member insurers

for a specified amount. An assessment is authorized when the resolution is passed.

4. "Benefit plan" means a specific employee, union, or association of natural persons

benefit plan.

5. "Called assessment" or "called" when used in the context of assessments means that

a notice was issued by the association to member insurers requiring that an authorized

assessment be paid within the time frame set forth within the notice. An authorized

assessment becomes a called assessment when notice is mailed by the association to

member insurers.

6. "Commissioner" means the insurance commissioner of this state.

7. "Contractual obligation" means any obligation under a policy or contract or certificate

under a group policy or contract, or portion thereof for which coverage is provided

under section 26.1-38.1-01.

8. "Covered contract" or "covered policy" means any policy or contract or portion of a

policy or contract for which coverage is provided under this chapter.

9. "Extracontractual claims" include claims relating to bad faith in the payment of claims,

punitive or exemplary damages, or attorney's fees and costs.

10. "Health benefit plan" means any hospital or medical expense policy or certificate, any

health maintenance organization subscriber contract, or any other similar health

contract. The term does not include:

a. Accident only insurance;

b. Credit insurance;

c. Dental only insurance;

d. Vision only insurance;

e. Medicare supplement insurance;

f. Benefits for long-term care, home health care, community-based care, or any

combination of these benefits;

g. Disability income insurance;

h. Coverage for onsite medical clinics; or

i. Specified disease, hospital confinement indemnity, or limited health insurance, if

the types of coverage do not provide coordination of benefits and are provided

under separate policies or certificates.

11. "Impaired insurer" means a member insurer that, after July 1, 1989, is not an insolvent

insurer, and is placed under an order of rehabilitation or conservation by a court of

competent jurisdiction.

12. "Insolvent insurer" means a member insurer which, after July 1, 1989, is placed under

an order of liquidation by a court of competent jurisdiction with a finding of insolvency.

13. "Member insurer" means any insurer or health maintenance organization licensed or

which holds a certificate of authority to transact in this state any kind of insurance or

health maintenance organization business for which coverage is provided under

section 26.1-38.1-01. The term includes any insurer or health maintenance

organization whose license or certificate of authority in this state may have been

suspended, revoked, not renewed, or voluntarily withdrawn, but does not include:

a. A fraternal benefit society;

b. A mandatory state pooling plan;

c. A mutual assessment company or other person that operates on an assessment

basis;

d. An insurance exchange;

e. An organization that has a certificate or license limited to the issuance of

charitable gift annuities under sections 26.1-34.1-01 through 26.1-34.1-07; or

f. Any entity similar to any of the above.

14. "Moody's corporate bond yield average" means the monthly average corporates as

published by Moody's investors service, incorporated, or any successor thereto.

15. "Owner" of a policy or contract and "policyholder", "policy owner", and "contract owner"

o the issuance of

charitable gift annuities under sections 26.1-34.1-01 through 26.1-34.1-07; or

f. Any entity similar to any of the above.

14. "Moody's corporate bond yield average" means the monthly average corporates as

published by Moody's investors service, incorporated, or any successor thereto.

15. "Owner" of a policy or contract and "policyholder", "policy owner", and "contract owner"

mean the person who is identified as the legal owner under the terms of the policy or

contract or who is otherwise vested with legal title to the policy or contract through a

valid assignment completed in accordance with the terms of the policy or contract and

properly recorded as the owner on the books of the member insurer. The terms owner,

contract owner, policyholder, and policy owner do not include persons with a mere

beneficial interest in a policy or contract.

16. "Person" means any individual, corporation, limited liability company, partnership,

association, governmental entity, or voluntary organization.

17. "Plan sponsor" means:

a. The employer in the case of a benefit plan established or maintained by a single

employer;

b. The employee organization in the case of a benefit plan established or

maintained by an employee organization; or

c. In the case of a benefit plan established or maintained by two or more employers

or jointly by one or more employers and one or more employee organizations, the

association, committee, joint board of trustees, or other similar group of

representatives of the parties who establish or maintain the benefit plan.

18. "Premiums" means amounts or considerations, by whatever name called, received on

covered policies or contracts less returned premiums, considerations, and deposits,

and less dividends and experience credits. "Premiums" do not include any amounts or

considerations received for any policies or contracts or for the portions of any policies

or contracts for which coverage is not provided under subsections 2 and 3 of section

26.1-38.1-01 and except that assessable premium shall not be reduced on account of

subdivision c of subsection 3 of section 26.1-38.1-01, relating to interest limitations,

and subsection 3 of section 26.1-38.1-01, relating to limitations with respect to any one

individual, any one participant, and any one policy or contract owner. "Premiums" do

not include:

a. Premiums in excess of five million dollars on any unallocated annuity contract not

issued under a governmental retirement plan established under section 401(k),

403(b), or 457 of the United States Internal Revenue Code; or

b. With respect to multiple nongroup policies of life insurance owned by one owner,

whether the policy or contract owner is an individual, firm, corporation, or other

person, and whether the persons insured are officers, managers, employees, or

other persons, premiums in excess of five million dollars with respect to these

policies or contracts, regardless of the number of policies or contracts held by the

owner.

19. a. "Principal place of business" of a plan sponsor or a person other than a natural

person means the single state in which the natural persons who establish policy

for the direction, control, and coordination of the operations of the entity as a

whole primarily exercise that function, determined by the association in its

reasonable judgment by considering the following factors: the state in which the

primary executive and administrative headquarters of the entity is located; the

state in which the principal office of the chief executive officer of the entity is

located; the state in which the board of directors or similar governing person or

persons of the entity conducts the majority of its meetings; the state in which the

executive or management committee of the board of directors or similar

governing person or persons of the entity conducts the majority of its meetings;

in which the principal office of the chief executive officer of the entity is

located; the state in which the board of directors or similar governing person or

persons of the entity conducts the majority of its meetings; the state in which the

executive or management committee of the board of directors or similar

governing person or persons of the entity conducts the majority of its meetings;

the state from which the management of the overall operations of the entity is

directed; and in the case of a benefit plan sponsored by affiliated companies

comprising a consolidated corporation, the state in which the holding company or

controlling affiliate has its principal place of business as determined using the

above factors. However, in the case of a plan sponsor, if more than fifty percent of

the participants in the benefit plan are employed in a single state, that state is

deemed to be the principal place of business of the plan sponsor.

b. The principal place of business of a plan sponsor of a benefit plan described in

subdivision c of subsection 17 is deemed to be the principal place of business of

the association, committee, joint board of trustees, or other similar group of

representatives of the parties who establish or maintain the benefit plan that, in

lieu of a specific or clear designation of a principal place of business, is deemed

to be the principal place of business of the employer or employee organization

that has the largest investment in the benefit plan in question.

20. "Receivership court" means the court in the insolvent or impaired insurer's state having

jurisdiction over the conservation, rehabilitation, or liquidation of the member insurer.

21. "Resident" means any person to whom a contractual obligation is owed and who

resides in this state on the date of entry of a court order that determines a member

insurer to be an impaired insurer or a court order that determines a member insurer to

be an insolvent insurer, whichever occurs first. A person may be a resident of only one

state, which in the case of a person other than a natural person must be its principal

place of business. Citizens of the United States who are residents of foreign countries,

or residents of United States possessions, territories, or protectorates that do not have

an association similar to the association created under this chapter, are deemed

residents of the state of domicile of the member insurer that issued the policies or

contracts.

22. "State" means a state, the District of Columbia, Puerto Rico, and a United States

possession, territory, or protectorate.

23. "Structured settlement annuity" means an annuity purchased in order to fund periodic

payments for a plaintiff or other claimant in payment for or with respect to personal

injury suffered by the plaintiff or other claimant.

24. "Supplemental contract" means any written agreement entered into for the distribution

of proceeds under a life, health, or annuity policy or a life, health, or annuity contract.

25. "Unallocated annuity contract" means any annuity contract or group annuity certificate

which is not issued to and owned by an individual, except to the extent of any annuity

benefits guaranteed to an individual by an insurer under such contract or certificate.