The definitions in this
section apply throughout this chapter unless the context clearly
requires otherwise.
(1) "Bona fide association" means an association of
employers that has been in existence for a period of not less
than ten years prior to sponsoring a self-funded multiple
employer welfare arrangement, during which time the association
has engaged in substantial activities relating to the common
interests of member employers, and that continues to engage in
substantial activities in addition to sponsoring an arrangement.
However, an association that was formed and began sponsoring an
arrangement prior to October 1, 1995, is not subject to the
requirement that the association be in existence for ten years
prior to sponsoring an arrangement.
(2) "Employer" means any person, firm, corporation,
partnership, business trust, legal representative, or other
business entity which engages in any business, industry,
profession, or activity in this state and employs one or more
other persons or who contracts with one or more persons, the
essence of which is the personal labor of that person or persons.
(3) "Health care service" means that service offered or
provided by health care facilities and health care providers
relating to the prevention, cure, or treatment of illness,
injury, or disease.
(4) "Incurred claims" means the value of all amounts paid or
payable under a multiple employer welfare arrangement determined
by contract to be a liability with an incurred claims date during
the valuation period. It includes all payments during the
valuation period plus a reasonable estimate of unpaid claims
liabilities.
(5) "Multiple employer welfare arrangement" means a multiple
employer welfare arrangement as defined by 29 U.S.C. Sec. 1002,
but does not include an arrangement, plan, program, or interlocal
agreement of or between any political subdivisions of this state,
any federal agencies, or any contractors or subcontractors with
federal agencies at a federal government facility within this
state.
(6) "Qualified actuary" means an individual who:
(a) Is a member in good standing of the American academy of
actuaries; and
(b) Is qualified to sign statements of actuarial opinion for
health annual statements in accordance with the American academy
of actuaries qualification standards for actuaries signing the
statements.
(7) "Self-funded multiple employer welfare arrangement" or
"arrangement" means a multiple employer welfare arrangement that
does not provide for payment of benefits under the arrangement
solely through a policy or policies of insurance issued by one or
more insurance companies licensed under this title.
(8) "Surplus" means the excess of the assets of a
self-funded multiple employer welfare arrangement over the
liabilities of the arrangement. The assets and liabilities
should be determined in accordance with the accounting practices
and procedures manuals as adopted by the national association of
insurance commissioners, unless otherwise provided by law.
[2004 c 260 § 3.]