Michigan Laws > Chapter 500 > Act 218 of 1956 > Chapter 38 – Medicare Supplement Policies and Certificates
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Terms Used In Michigan Laws > Chapter 500 > Act 218 of 1956 > Chapter 38 - Medicare Supplement Policies and Certificates
- Allied health degree: means an earned baccalaureate or master degree in nursing, medical technology, medical records administration, dietetics, physician's assistant, emergency medical technology, respiratory therapy, anesthesia, nuclear medicine technology, and other allied health programs which are determined by the state board of education to qualify for reimbursement. See Michigan Laws 390.1021
- Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
- Answer: The formal written statement by a defendant responding to a civil complaint and setting forth the grounds for defense.
- Applicant: means :
(i) For an individual Medicare supplement policy, the person who seeks to contract for benefits. See Michigan Laws 500.3801Appropriation: The provision of funds, through an annual appropriations act or a permanent law, for federal agencies to make payments out of the Treasury for specified purposes. The formal federal spending process consists of two sequential steps: authorization Bankruptcy: Refers to statutes and judicial proceedings involving persons or businesses that cannot pay their debts and seek the assistance of the court in getting a fresh start. Under the protection of the bankruptcy court, debtors may discharge their debts, perhaps by paying a portion of each debt. Bankruptcy judges preside over these proceedings. Bankruptcy: means , with respect to a Medicare advantage organization that is not an insurer, that the organization has filed, or has had filed against it, a petition for declaration of bankruptcy and has ceased doing business in this state. See Michigan Laws 500.3801 Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC Certificate: means any certificate delivered or issued for delivery in this state under a group Medicare supplement policy. See Michigan Laws 500.3801 Certificate form: means the form on which a certificate is delivered or issued for delivery by an insurer. See Michigan Laws 500.3801 Commissioner: means the director. See Michigan Laws 500.102 Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant. Continuous period of creditable coverage: means the period during which an individual was covered by creditable coverage, if during the period of the coverage the individual had no breaks in coverage greater than 63 days. See Michigan Laws 500.3801 Contract: A legal written agreement that becomes binding when signed. Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name. Creditable coverage: means coverage of an individual provided under any of the following:
(i) A group health plan. See Michigan Laws 500.3801Department: means the department of insurance and financial services. See Michigan Laws 500.102 Direct response solicitation: means solicitation in which an insurer representative does not contact the applicant in person and explain the coverage available, such as, but not limited to, solicitation through direct mail or through advertisements in periodicals and other media. See Michigan Laws 500.3801 Director: means , unless the context clearly implies a different meaning, the director of the department. See Michigan Laws 500.102 Employee welfare benefit plan: means a plan, fund, or program of employee benefits as defined in 29 USC 1002. See Michigan Laws 500.3801 Enrollee: means an individual who is entitled to receive health services under a health insurance contract, unless the context requires otherwise. See Michigan Laws 500.116 Entitlement: A Federal program or provision of law that requires payments to any person or unit of government that meets the eligibility criteria established by law. Entitlements constitute a binding obligation on the part of the Federal Government, and eligible recipients have legal recourse if the obligation is not fulfilled. Social Security and veterans' compensation and pensions are examples of entitlement programs. Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other. Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006. Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs. Health insurance policy: means an expense-incurred hospital, medical, or surgical policy, certificate, or contract. See Michigan Laws 500.608 Health maintenance organization: means that term as defined in section 3501. See Michigan Laws 500.106 in writing: shall be construed to include printing, engraving, and lithographing; except that if the written signature of a person is required by law, the signature shall be the proper handwriting of the person or, if the person is unable to write, the person's proper mark, which may be, unless otherwise expressly prohibited by law, a clear and classifiable fingerprint of the person made with ink or another substance. See Michigan Laws 8.3q Insolvency: means , with respect to an insurer licensed to transact the business of insurance in this state, that the insurer has had a final order of liquidation entered against it with a finding of insolvency by a court of competent jurisdiction in the insurer's state of domicile. See Michigan Laws 500.3801 Insurer: includes any person that delivers or issues for delivery in this state Medicare supplement policies. See Michigan Laws 500.3801 Interest rate: The amount paid by a borrower to a lender in exchange for the use of the lender's money for a certain period of time. Interest is paid on loans or on debt instruments, such as notes or bonds, either at regular intervals or as part of a lump sum payment when the issue matures. Source: OCC Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases. Lease: A contract transferring the use of property or occupancy of land, space, structures, or equipment in consideration of a payment (e.g., rent). Source: OCC Medicaid: means subchapter XIX of the social security act, 42 USC 1396 to 1396w-5. See Michigan Laws 500.3801 Medicare: means subchapter XVIII of the social security act, 42 USC 1395 to 1395lll. See Michigan Laws 500.3801 Medicare advantage: means a plan of coverage for health benefits under Medicare part C as described in 42 USC 1395w-28, and includes any of the following:
(i) Coordinated care plans that provide health care services, including, but not limited to, health maintenance organization plans with or without a point-of-service option, plans offered by provider-sponsored organizations, and preferred provider organization plans. See Michigan Laws 500.3801Medicare supplement policy: means an individual or group policy or certificate that is advertised, marketed, or designed primarily as a supplement to reimbursements under Medicare for the hospital, medical, or surgical expenses of persons eligible for Medicare and Medicare select policies and certificates under section 3817. See Michigan Laws 500.3801 month: means a calendar month; the word "year" a calendar year; and the word "year" alone shall be equivalent to the words "year of our Lord". See Michigan Laws 8.3j Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period. PACE: means a program of all-inclusive care for the elderly as described in the social security act. See Michigan Laws 500.3801 person: may extend and be applied to bodies politic and corporate, as well as to individuals. See Michigan Laws 8.3l Policy form: means the form on which the policy or certificate is delivered or issued for delivery by the insurer. See Michigan Laws 500.3801 Probable cause: A reasonable ground for belief that the offender violated a specific law. Public law: A public bill or joint resolution that has passed both chambers and been enacted into law. Public laws have general applicability nationwide. Quorum: The number of legislators that must be present to do business. Rate: means the cost of insurance per payroll before adjustment for an individual insured's size, exposure, or loss experience. See Michigan Laws 500.2402 Recourse: An arrangement in which a bank retains, in form or in substance, any credit risk directly or indirectly associated with an asset it has sold (in accordance with generally accepted accounting principles) that exceeds a pro rata share of the bank's claim on the asset. If a bank has no claim on an asset it has sold, then the retention of any credit risk is recourse. Source: FDIC Remainder: An interest in property that takes effect in the future at a specified time or after the occurrence of some event, such as the death of a life tenant. Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action. Secretary: means the secretary of the United States Department of Health and Human Services. See Michigan Laws 500.3801 Service area: means that term as defined in section 3501, unless the context requires otherwise. See Michigan Laws 500.116 Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims. Social security act: means the social security act, 42 USC 301 to 1397mm. See Michigan Laws 500.3801 state: when applied to the different parts of the United States, shall be construed to extend to and include the District of Columbia and the several territories belonging to the United States; and the words "United States" shall be construed to include the district and territories. See Michigan Laws 8.3o United States: shall be construed to include the district and territories. See Michigan Laws 8.3o User fees: Fees charged to users of goods or services provided by the government. In levying or authorizing these fees, the legislature determines whether the revenue should go into the treasury or should be available to the agency providing the goods or services.