Terms Used In Montana Code > Title 33 > Chapter 22 > Part 11 - Long-Term Care Insurance Act

• Activities of daily living: means :

  (a)eating;

  (b)toileting;

  (c)transferring;

  (d)bathing;

  (e)dressing; and

  (f)continence. See Montana Code 33-22-1107

• Applicant: means :

  (a)in the case of an individual long-term care insurance policy, the person who seeks to contract for benefits; and

  (b)in the case of a group long-term care insurance policy, the proposed certificate holder. See Montana Code 33-22-1107

• Appropriate sale criteria: means the set of conditions that an insurance company is required to address with an applicant that help to determine whether or not a particular insurance policy or contract offered for sale is appropriate to the applicant. See Montana Code 33-22-1107
• Certificate: means a certificate issued under a group long-term care insurance policy that has been delivered or issued for delivery in this state. See Montana Code 33-22-1107
• 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.
• 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.
• federally tax-qualified long-term care insurance contract: means :

  (a)an individual or group insurance contract that meets the requirement of section 7702B of the Internal Revenue Code, 26 U. See Montana Code 33-22-1107

• Group long-term care insurance: means a long-term care insurance policy that is delivered or issued for delivery in this state and issued to:

  (a)(i) one or more employers;

  (ii)a labor organization;

  (iii)a trust established by an employer or labor organization; or

  (iv)a trustee of a fund established by one or more employers or labor organizations or a combination of employers and labor organizations for:

  (A)employees or former employees or a combination of employees and former employees; or

  (B)members or former members of the labor organization or a combination of members and former members;

  (b)any professional, trade, or occupational association for its current, former, or retired members or a combination of current, former, and retired members if the association:

  (i)is composed of individuals all of whom are or were actively engaged in the same profession, trade, or occupation; and

  (ii)has been maintained in good faith for purposes other than obtaining insurance; or

  (c)an association, a trust, or the trustee of a fund established, created, or maintained for the benefit of members of one or more associations. See Montana Code 33-22-1107

• 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.
• Knowingly: means only a knowledge that the facts exist which bring the act or omission within the provisions of this code. See Montana Code 1-1-204
• Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
• Person: includes a corporation or other entity as well as a natural person. See Montana Code 1-1-201
• Policy: means any policy, certificate, contract, membership contract, subscriber agreement, health care services agreement, rider, or endorsement delivered or issued for delivery in this state by an insurer, fraternal benefit society, health service corporation, prepaid health plan, health maintenance organization, or similar organization. See Montana Code 33-22-1107
• Preexisting condition: means a condition for which medical advice or treatment was recommended by or received from a provider of health care services within 6 months preceding the effective date of coverage of an insured person. See Montana Code 33-22-1107
• Process: means a writ or summons issued in the course of judicial proceedings. See Montana Code 1-1-202
• State: when applied to the different parts of the United States, includes the District of Columbia and the territories. See Montana Code 1-1-201
• Trustee: A person or institution holding and administering property in trust.
• Waiting period: means , with respect to a group health plan and an individual who is a potential participant or beneficiary in the group health plan, the period that must pass with respect to the individual before the individual is eligible to be covered for benefits under the terms of the group health plan. See Montana Code 33-22-140