Terms Used In Delaware Code > Title 19 > Chapter 31 > Subchapter I - General Provisions

• Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
• Basic health benefit plan: means a lower cost health benefit plan developed pursuant to § 7211 of this title. See Delaware Code Title 18 Sec. 7202
• Board: means the board of directors of the program established pursuant to § 7210 of this title [repealed]. See Delaware Code Title 18 Sec. 7202
• Carrier: means any entity that provides health insurance in this State. See Delaware Code Title 18 Sec. 7202
• Case characteristics: means demographic or other objective characteristics of a small employer that are considered by the small employer carrier in the determination of premium rates for the small employer, provided that claim experience, health status and duration of coverage shall not be case characteristics for the purposes of this chapter. See Delaware Code Title 18 Sec. 7202
• Class of business: means all of a carrier's business unless more than 1 class is established pursuant to § 7204 of this title. See Delaware Code Title 18 Sec. 7202
• Commissioner: means the Insurance Commissioner of this State. See Delaware Code Title 18 Sec. 7202
• Committee: means the Health Benefit Plan Committee created pursuant to § 7211 of this title. See Delaware Code Title 18 Sec. 7202
• Contract: A legal written agreement that becomes binding when signed.
• Established geographic service area: means a geographic area, as approved by the Commissioner and based on the carrier's certificate of authority to transact insurance in this State, within which the carrier is authorized to provide coverage. See Delaware Code Title 18 Sec. 7202
• Health benefit plan: means any hospital or medical expense policy or certificate, hospital or medical service corporation contract, health maintenance organization or health service corporation subscriber contract or any other similar health contract, including a high deductible medical expense policy used in conjunction with a medical savings account, subject to the jurisdiction of the Commissioner available for use, offered or sold to an individual in the State of Delaware. See Delaware Code Title 18 Sec. 7202
• Plan of operation: means the plan of operation of the program established pursuant to § 7210 of this title [repealed]. See Delaware Code Title 18 Sec. 7202
• Premium: means all moneys paid by a small employer and eligible employees as a condition of receiving coverage from a small employer carrier, including any fees or other contributions associated with the health benefit plan. See Delaware Code Title 18 Sec. 7202
• Producer: means agent and/or broker. See Delaware Code Title 18 Sec. 7202
• Program: means the Delaware Small Employer Reinsurance Program created by § 7210 of this title [repealed]. See Delaware Code Title 18 Sec. 7202
• Quorum: The number of legislators that must be present to do business.
• 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.
• Restricted network provision: means any provision of a health benefit plan that conditions the payment of benefits, in whole or in part, on the use of health-care providers that have entered into a contractual arrangement with the carrier pursuant to Chapter 64 of this title or otherwise to provide health-care services to covered individuals. See Delaware Code Title 18 Sec. 7202
• Small employer: means any person, firm, corporation, partnership or association that is actively engaged in business that, on at least 50% of its working days during the preceding calendar quarter, employed no more than 50 eligible employees, the majority of whom were employed within this State. See Delaware Code Title 18 Sec. 7202
• Small employer carrier: means a carrier that offers health benefit plans covering eligible employees of 1 or more small employers in this State. See Delaware Code Title 18 Sec. 7202
• Standard health benefit plan: means a health benefit plan developed pursuant to § 7211 of this title. See Delaware Code Title 18 Sec. 7202
• State: means the State of Delaware; and when applied to different parts of the United States, it includes the District of Columbia and the several territories and possessions of the United States. See Delaware Code Title 1 Sec. 302
• Statute: A law passed by a legislature.
• Year: means a calendar year, and is equivalent to the words "year of our Lord. See Delaware Code Title 1 Sec. 302