New Jersey Statutes Title 17B. Insurance 17B § 27-51.11

a. “Group policy” means a group health insurance policy issued by an insurer pursuant to Title 17B of the New Jersey Statutes.

b. “Insurer” means the entity issuing a group policy or an individual policy or converted policy.

c. “Insurance”, “Insures” and “Insured” refer to coverage under a group policy on a premium-paying basis.

d. “Premium” includes any premium or other consideration payable for coverage under a group or individual policy.

e. “Medicare” means Title XVIII of the United States Social Security Act  1 as amended or superseded.

f. “Total disability of the employee or member” exists only while the employee or member (1) is not engaged in any gainful occupation, and (2) is completely unable, due to sickness or injury or both, to engage in any and every gainful occupation for which the person is reasonably fitted by education, training or experience.