Montana Title 33. Insurance and Insurance Companies § 33-22-1303. Definitions

(1) “Association” means the Montana reinsurance association provided for in this part.

(2) “Attachment point” means the threshold amount for claims costs incurred by an eligible health insurer for an enrolled individual's covered benefits in a benefit year, beyond which the claims costs for benefits are eligible for reinsurance payments.

(3) “Benefit year” means the calendar year for which an eligible health insurer provides coverage through an individual health insurance policy.

(4) “Board” means the association's board of directors provided for in 33-22-1306.

(5) “Coinsurance rate” means the rate at which the association will reimburse an eligible health insurer for claims incurred for an enrolled individual's covered benefits in a benefit year above the attachment point and below the reinsurance cap.

(6) “Eligible health insurer” means a health insurer, health service corporation, or health maintenance organization that:

(7) “Major medical” health insurance includes individual market and employer group health insurance that:

(8) “Payment parameters” means the attachment point, reinsurance cap, and coinsurance rate for the Montana reinsurance program.

(9) “Program” means the Montana reinsurance program operated by the Montana reinsurance association.

(10) “Reinsurance cap” means the maximum amount of each claim incurred by an eligible health insurer for an enrolled individual's covered benefits in a benefit year, after which the claims costs for benefits are no longer eligible for reinsurance payments.

(11) “Reinsurance payments” means an amount paid by the association to an eligible health insurer under the program.