Terms Used In Montana Code > Title 3 > Chapter 1 - Courts and Judicial Officers Generally

• Abstract: means a written representation, provided pursuant to a contract and expected to be relied upon by the person who has contracted for the receipt of that representation, listing all recorded conveyances, instruments, or documents which, under the laws of this state, impart constructive notice regarding the chain of title to real property described in the abstract. See Montana Code 33-25-105
• Acceptable collateral: means :

  (a)(i) as to securities lending transactions and for the purpose of calculating the counterparty exposure amount, cash, cash equivalents, letters of credit, or direct obligations of or securities that are fully guaranteed as to principal and interest by the government of the United States, by any agency of the United States, by the federal national mortgage association, or by the federal home loan mortgage corporation; and

  (ii)as to lending foreign securities, sovereign debt rated 1 by the SVO;

  (b)as to repurchase transactions, cash, cash equivalents, and direct obligations of or securities that are fully guaranteed as to principal and interest by the government of the United States, by an agency of the United States, by the federal national mortgage association, or by the federal home loan mortgage corporation; and

  (c)as to reverse repurchase transactions, cash and cash equivalents. See Montana Code 33-12-102

• Acceptable private mortgage insurance: means insurance written by a private insurer protecting a mortgage lender against loss occasioned by a mortgage loan default and issued by a licensed mortgage insurance company, with an SVO 1 designation or a rating issued by a nationally recognized statistical rating organization equivalent to an SVO 1 designation, that covers losses up to an 80% loan-to-value ratio. See Montana Code 33-12-102
• Accepted actuarial standards: means the standards adopted by the casualty actuarial society in its Statement of Principles Regarding Property and Casualty Insurance Ratemaking and the Standards of Practice adopted by the actuarial standards board. See Montana Code 33-16-1008
• Accident and health insurance: means insurance protection that provides payment of benefits for covered sickness or accidental injury, excluding credit insurance, disability insurance, accidental death and dismemberment insurance, and long-term care insurance. See Montana Code 33-12-102
• Accident and health insurer: means a licensed life or health insurer or health service corporation whose insurance premiums and required statutory reserves for accident and health insurance constitute at least 95% of total premium considerations or total statutorily required reserves. See Montana Code 33-12-102
• Account: means either of the two accounts created under 33-10-203. See Montana Code 33-10-202
• Accountable care organization: means a group of health care providers that are willing and capable of accepting accountability for the total cost and quality of care for a defined population. See Montana Code 33-31-102
• Acquittal:
  1. Judgement that a criminal defendant has not been proved guilty beyond a reasonable doubt.
  2. A verdict of "not guilty."
   
• Activities of daily living: means :

  (a)eating;

  (b)toileting;

  (c)transferring;

  (d)bathing;

  (e)dressing; and

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

• Adjourn: A motion to adjourn a legislative chamber or a committee, if passed, ends that day's session.
• Adjuster: means a person who, on behalf of the insurer, for compensation as an independent contractor or as the employee of an independent contractor or for a fee or commission investigates and negotiates the settlement of claims arising under insurance contracts or otherwise acts on behalf of the insurer. See Montana Code 33-17-102
• Adjuster license: means a document issued by the commissioner that authorizes a person to act as an adjuster or a public adjuster. See Montana Code 33-17-102
• Administrator: means a person who collects charges or premiums from residents of this state in connection with life, disability, property, or casualty insurance or annuities or who adjusts or settles claims on these coverages. See Montana Code 33-17-102
• Admitted assets: means , subject to subsection (5)(b), assets determined in accordance with the requirements of 33-2-501. See Montana Code 33-12-102
• Adverse underwriting decision: means any of the following actions with respect to insurance transactions involving insurance coverage that are individually underwritten:

  (i)a declination of insurance coverage;

  (ii)a termination of insurance coverage;

  (iii)failure of an insurance producer to apply for insurance coverage with a specific insurance institution that the insurance producer represents and that is requested by an applicant;

  (iv)in the case of a property or casualty insurance coverage:

  (A)placement by an insurance institution or insurance producer of a risk with a residual market mechanism, an unauthorized insurer, or an insurance institution that specializes in substandard risks; or

  (B)the charging of a higher rate on the basis of information that differs from that which the applicant or policyholder furnished;

  (v)in the case of a life, health, or disability insurance coverage, an offer to insure at higher than standard rates. See Montana Code 33-19-104

• Advisory organization: means a person or organization that either has two or more member insurers or is controlled either directly or indirectly by two or more insurers and that assists insurers in ratemaking-related activities. See Montana Code 33-16-1008
• Affidavit: A written statement of facts confirmed by the oath of the party making it, before a notary or officer having authority to administer oaths.
• Affidavit: means a sworn written declaration made before an officer authorized to administer oaths or an unsworn written declaration made under penalty of perjury as provided in 1-6-105. See Montana Code 1-1-203
• Affiliate: has the meaning provided in 33-2-1101. See Montana Code 33-12-102
• Affiliated company: means any company in the same corporate system as a parent, an industrial insured, or a member by virtue of common ownership, control, operation, or management. See Montana Code 33-28-101
• Affiliation period: means a period that, under the terms of the health insurance coverage offered by a health maintenance organization, must expire before the health insurance coverage becomes effective. See Montana Code 33-31-102
• Affirmed: In the practice of the appellate courts, the decree or order is declared valid and will stand as rendered in the lower court.
• Agency: means an office, position, commission, committee, board, department, council, division, bureau, section, or any other entity or instrumentality of the executive department of state government. See Montana Code 2-8-102
• Agency: means an office, position, commission, committee, board, department, council, division, bureau, section, or any other entity or instrumentality of the executive, legislative, or judicial branch of state government. See Montana Code 2-8-301
• Aggregator site: means a website that provides access to information regarding insurance products from more than one insurer, including product and insurer information, for use in comparison shopping. See Montana Code 33-17-1401
• Ambulatory review: means a utilization review of health care services performed or provided in an outpatient setting. See Montana Code 33-32-102
• 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.
• Amortization: Paying off a loan by regular installments.
• Anniversary date: means the month and day that rates, rating plans, and rating systems are initially applied to a policy in effect. See Montana Code 33-15-1102
• Annuity: A periodic (usually annual) payment of a fixed sum of money for either the life of the recipient or for a fixed number of years. A series of payments under a contract from an insurance company, a trust company, or an individual. Annuity payments are made at regular intervals over a period of more than one full year.
• Annuity issuer: means an insurer that has issued a contract to fund periodic payments under a structured settlement. See Montana Code 33-20-1402
• Answer: The formal written statement by a defendant responding to a civil complaint and setting forth the grounds for defense.
• 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.
• Applicant: means a person who seeks to contract for insurance coverage other than a person seeking group insurance that is not individually underwritten. See Montana Code 33-19-104
• Applicant: means a person, whether or not a prospective insured, who applies to a title insurer or title insurance producer for a title insurance policy, but does not include a title insurance producer. See Montana Code 33-25-105
• Applicant: means :

  (a)in the case of an individual medicare supplement policy, the person who seeks to contract for insurance benefits; and

  (b)in the case of a group medicare supplement policy, the proposed certificate holder. See Montana Code 33-22-903

• 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

• Appraisal: A determination of property value.
• 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
• Appropriation: 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
• Approved attorney: means an attorney authorized to practice law in this state, except an agent or employee of a title insurer, whose certification as to the status of the title to real property a title insurer is willing to accept as the basis for issuance of a title insurance policy. See Montana Code 33-25-105
• Arraignment: A proceeding in which an individual who is accused of committing a crime is brought into court, told of the charges, and asked to plead guilty or not guilty.
• 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 with a certificate of authority under this title. See Montana Code 33-35-103
• Arrest: Taking physical custody of a person by lawful authority.
• Asset-backed security: means a security or other instrument, excluding a mutual fund, evidencing an interest in or the right to receive payments from or payable from distributions on an asset, a pool of assets, or specifically divisible cash flows that are legally transferred to a trust or another special purpose bankruptcy-remote business entity, on the following conditions:

  (i)the trust or other business entity is established solely for the purpose of acquiring specific types of assets or rights to cash flows, issuing securities and other instruments representing an interest in or right to receive cash flows from those assets or rights, and engaging in activities required to service the assets or rights and any credit enhancement or support features held by the trust or other business entity; and

  (ii)the assets of the trust or other business entity consist solely of interest-bearing obligations or other contractual obligations representing the right to receive payment from the cash flows from the assets or rights. See Montana Code 33-12-102

• Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
• Associate: means a:

  (a)corporation, partnership, or other business entity organized for profit, of which a producer of title business is a director, officer, partner, employee, or owner of 5% or more of its equity or capital;

  (b)franchisor or franchisee of a producer of title business;

  (c)spouse, parent, or child of a producer of title business;

  (d)corporation, partnership, or other business entity that controls, is controlled by, or is under common control with a producer of title business; or

  (e)person with whom a producer of title business or an associate has an agreement, arrangement, understanding, or course of conduct having the purpose or substantial effect of evading the provisions of this title. See Montana Code 33-25-105

• Association: means any legal association of sole proprietorships or business entities that has been in continuous existence for at least 1 year unless the 1-year requirement is waived by the commissioner and the members of which collectively, or the association itself:

  (a)owns, controls, or holds with power to vote all of the outstanding voting securities of an association captive insurance company incorporated as a stock insurer;

  (b)has complete voting control over an association captive insurance company incorporated as a mutual insurer;

  (c)constitutes all of the subscribers of an association captive insurance company formed as a reciprocal insurer; or

  (d)owns, controls, or holds with power to vote all of the outstanding ownership interests of an association captive insurance company organized as a limited liability company. See Montana Code 33-28-101

• Association: means the Montana insurance guaranty association created under 33-10-103. See Montana Code 33-10-102
• Association: means the Montana life and health insurance guaranty association created under 33-10-203. See Montana Code 33-10-202
• Association captive insurance company: means any company that insures risks of the members and the affiliated companies of members. See Montana Code 33-28-101
• Attachment: A procedure by which a person's property is seized to pay judgments levied by the court.
• Attorney: as used in this chapter , refers to the attorney-in-fact of a reciprocal insurer. See Montana Code 33-5-104
• Attorney-in-fact: A person who, acting as an agent, is given written authorization by another person to transact business for him (her) out of court.
• authorized: when used in the context of assessments means a specified amount of money authorized for collection from member insurers by a resolution of the board of directors established in 33-10-204. See Montana Code 33-10-202
• Authorized representative: means :

  (a)a person to whom a covered person has given express written consent to represent the covered person;

  (b)a person authorized by law to provided substituted consent for a covered person; or

  (c)a family member of the covered person, or the covered person's treating health care provider, only if the covered person is unable to provide consent. See Montana Code 33-32-102

• Authorized representative: means an individual authorized by an operator to sell or offer self-storage insurance coverage in accordance with this part. See Montana Code 33-24-302
• Bail: Security given for the release of a criminal defendant or witness from legal custody (usually in the form of money) to secure his/her appearance on the day and time appointed.
• 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.
• Baseline: Projection of the receipts, outlays, and other budget amounts that would ensue in the future without any change in existing policy. Baseline projections are used to gauge the extent to which proposed legislation, if enacted into law, would alter current spending and revenue levels.
• Basic health care services: means :

  (a)consultative, diagnostic, therapeutic, and referral services by a provider;

  (b)inpatient hospital and provider care;

  (c)outpatient medical services;

  (d)medical treatment and referral services;

  (e)accident and sickness services by a provider to each newborn infant of an enrollee pursuant to 33-31-301(3)(e);

  (f)care and treatment of mental illness, alcoholism, and drug addiction;

  (g)diagnostic laboratory and diagnostic and therapeutic radiologic services;

  (h)preventive health services, including:

  (i)immunizations;

  (ii)well-child care from birth;

  (iii)periodic health evaluations for adults;

  (iv)voluntary family planning services;

  (v)infertility services; and

  (vi)children's eye and ear examinations conducted to determine the need for vision and hearing correction;

  (i)minimum mammography examination, as defined in 33-22-132;

  (j)outpatient self-management training and education for the treatment of diabetes along with certain diabetic equipment and supplies as provided in 33-22-129; and

  (k)treatment and medical foods for inborn errors of metabolism. See Montana Code 33-31-102

• 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}
• Beneficiary: has the meaning given the term by 29 U. See Montana Code 33-22-140
• Benefit contract: means the agreement for provision of authorized benefits described in 33-7-520. See Montana Code 33-7-108
• Benefit member: means an adult member who is designated by the laws or rules of the society to be a benefit member under a benefit contract. See Montana Code 33-7-108
• Benefit plan: means a benefit plan for a specific employee, union, or association of natural persons. See Montana Code 33-10-202
• benefits: means those health care services to which a covered person is entitled under the terms of a health plan. See Montana Code 33-32-102
• Bequest: Property gifted by will.
• Blanket travel insurance: means a policy of travel insurance issued to any eligible group providing coverage for specific classes of persons defined in the policy with coverage provided to all members of the eligible group without a separate charge to individual members of the eligible group. See Montana Code 33-17-1401
• Bona fide association: means an association of employers that has been in existence for a period of not less than 5 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. See Montana Code 33-35-103
• Branch business: means any insurance business transacted by a branch captive insurance company in this state. See Montana Code 33-28-101
• Branch captive insurance company: means any foreign captive insurance company authorized by the commissioner to transact the business of insurance in this state through a business unit with a principal place of business in this state. See Montana Code 33-28-101
• Branch operations: means any business operations of a branch captive insurance company in this state. See Montana Code 33-28-101
• Business entity: includes a sole proprietorship, corporation, limited liability company, association, partnership, joint-stock company, joint venture, mutual fund, trust, joint tenancy, or other similar form of business organization, whether organized for profit or not for profit. See Montana Code 33-12-102
• Business entity: means a corporation, association, partnership, limited liability company, limited liability partnership, or other legal entity. See Montana Code 33-17-102
• Business entity: means a corporation, limited liability company, or other legal entity formed by an organizational document. See Montana Code 33-28-101
• Called: when used in the context of assessments, means that the association has issued a notice to member insurers requiring that an authorized assessment be paid within the timeframe set forth within the notice. See Montana Code 33-10-202
• Cancellation: means the decision by the insurer to terminate an insurance policy prior to the expiration of its term. See Montana Code 33-15-1102
• Cancellation fee waiver: means a contractual agreement between a supplier of travel services and its customer to waive some or all of the non-refundable cancellation fee provisions of the supplier's underlying travel contract with or without regard to the reason for the cancellation or form of reimbursement. See Montana Code 33-17-1401
• Cap: means an agreement obligating the seller to make payments to the buyer, with each payment based on the amount by which a reference price or level or the performance or value of one or more underlying interests exceeds a predetermined number. See Montana Code 33-12-102
• Capital and surplus: means the sum of the capital and surplus of the insurer required to be shown on the most recent statutory financial statement of the insurer required to be filed with the commissioner. See Montana Code 33-12-102
• Captive insurance company: means any pure captive insurance company, association captive insurance company, protected cell captive insurance company, special purpose captive insurance company, or industrial insured captive insurance company formed or authorized under the provisions of this chapter. See Montana Code 33-28-101
• Captive reinsurance company: means a captive insurance company authorized in this state that reinsures the risk ceded by any other insurer. See Montana Code 33-28-101
• Captive risk retention group: means a captive insurance risk retention group formed under the laws of this chapter and pursuant to Title 33, chapter 11. See Montana Code 33-28-101
• Case management: means a coordinated set of activities conducted for individual patient management of serious, complicated, protracted, or otherwise complex health conditions. See Montana Code 33-32-102
• Cash equivalent: means any short-term, highly liquid investment that is:

  (a)readily convertible to known amounts of cash; and

  (b)so near to its maturity that it presents insignificant risk of changes in value because of changes in interest rates. See Montana Code 33-28-101

• Cash equivalents: means short-term, highly rated, and highly liquid investments or securities readily convertible to known amounts of cash without penalty and so near maturity that they present insignificant risk of change in value. See Montana Code 33-12-102
• Certificate: means the document issued as written evidence of the benefit contract. See Montana Code 33-7-108
• Certificate: means a certificate delivered or issued for delivery in this state under a group medicare supplement policy. See Montana Code 33-22-903
• 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
• Certification: means a determination by a health insurance issuer or its designated utilization review organization that an admission, availability of care, continued stay, or other health care service has been reviewed and, based on the information provided, satisfies the health insurance issuer's requirements for medical necessity, appropriateness, health care setting, level of care, and level of effectiveness. See Montana Code 33-32-102
• Chambers: A judge's office.
• Charity: An agency, institution, or organization in existence and operating for the benefit of an indefinite number of persons and conducted for educational, religious, scientific, medical, or other beneficent purposes.
• Church plan: has the meaning given the term by 29 U. See Montana Code 33-22-140
• Claims liability: means the total of all incurred and unpaid claims for allowable benefits under a self-funded multiple employer welfare arrangement that are not reimbursed or reimbursable by excess of loss insurance, subrogation, or other sources. See Montana Code 33-35-103
• Class one bond mutual fund: means a mutual fund that at all times qualifies for investment using the bond class one reserve factor under the Purposes and Procedures of the Securities Valuation Office or any successor publication. See Montana Code 33-12-102
• Class one money market mutual fund: means a money market mutual fund that at all times qualifies for investment using the bond class one reserve factor under the Purposes and Procedures of the Securities Valuation Office or any successor publication. See Montana Code 33-12-102
• Classification: means an arrangement of insurance risks into an underwriting or rating group according to a classification system used by an insurer as a basis for tabulating statistical experience and determining premium rates. See Montana Code 33-15-1102
• Classification system: means the plan, system, or arrangement for recognizing differences in exposure to hazards among industries, occupations, or operations of insurance policyholders. See Montana Code 33-16-1008
• Clerk of court: An officer appointed by the court to work with the chief judge in overseeing the court's administration, especially to assist in managing the flow of cases through the court and to maintain court records.
• Clinical peer: means a physician or other health care provider who:

  (a)holds a nonrestricted license in a state of the United States; and

  (b)is trained or works in the same or a similar specialty to the specialty that typically manages the medical condition, procedure, or treatment under review. See Montana Code 33-32-102

• Clinical review criteria: means the written policies, written screening procedures, decision abstracts, determination rules, clinical and medical protocols, practice guidelines, or any other criteria or rationale used by a health insurance issuer or its designated utilization review organization to determine the medical necessity of health care services. See Montana Code 33-32-102
• Closed plan: means a managed care plan that requires covered persons to use only participating providers under the terms of the managed care plan. See Montana Code 33-36-103
• COBRA continuation provision: means :

  (a)section 4980B of the Internal Revenue Code, 26 U. See Montana Code 33-22-140

• Combination plan: means an open plan with a closed component. See Montana Code 33-36-103
• Commission: means the commission on courts of limited jurisdiction established by the supreme court. See Montana Code 3-1-1501
• Commissioner: means the commissioner of insurance of the state of Montana. See Montana Code 33-31-102
• Commissioner: means the commissioner of insurance of the state of Montana. See Montana Code 33-17-1401
• Common law: The legal system that originated in England and is now in use in the United States. It is based on judicial decisions rather than legislative action.
• Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
• Completed operations liability: means :

  (a)liability arising out of the installation, maintenance, or repair of any product at a site that is not owned or controlled by:

  (i)a person who performs that work; or

  (ii)a person who hires an independent contractor to perform that work; and

  (b)liability for activities that are completed or abandoned before the date of the occurrence giving rise to the liability. See Montana Code 33-11-102

• Concurrent review: means a utilization review conducted during a patient's stay or course of treatment in a facility, the office of a health care professional, or another inpatient or outpatient health care setting. See Montana Code 33-32-102
• Consideration: has the meaning provided in 28-2-801. See Montana Code 33-20-1402
• Consultant: means an individual who for a fee examines, appraises, reviews, evaluates, makes recommendations, or gives advice regarding an insurance policy, annuity, or pension contract, plan, or program. See Montana Code 33-17-102
• Consultant license: means a document issued by the commissioner that authorizes an individual to act as an insurance consultant. See Montana Code 33-17-102
• Consumer report: means any written, oral, or other communication of information bearing on a natural person's credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics, or mode of living that is used or expected to be used in connection with an insurance transaction. See Montana Code 33-19-104
• Consumer reporting agency: means a person who:

  (a)regularly engages, in whole or in part, in the practice of assembling or preparing consumer reports for a monetary fee;

  (b)obtains information primarily from sources other than insurance institutions; and

  (c)furnishes consumer reports to other persons. See Montana Code 33-19-104

• Contingencies: means provisions in rates to recognize the uncertainty of the estimates of losses, loss adjustment expenses, other operating expenses, and investment income and profit that comprise those rates. See Montana Code 33-16-1008
• Continuance: Putting off of a hearing ot trial until a later time.
• Contract: A legal written agreement that becomes binding when signed.
• Contract owner: means the owner named in the annuity contract or a certificate holder in the case of a group annuity contract. See Montana Code 33-20-904
• Contractual obligation: means an obligation under any of the following for which coverage is provided in this part:

  (a)a policy or contract;

  (b)a certificate under a group policy or contract; or

  (c)a portion of a policy or contract or a portion of a certificate. See Montana Code 33-10-202

• Control: means the possession, directly or indirectly, of the power to direct or cause the direction of the management and policies of a person, whether through the ownership of voting securities, by contract (other than a commercial contract for goods or nonmanagement services), or otherwise, unless the power is the result of an official position with a corporation or a corporate office held by the person. See Montana Code 33-12-102
• Controlled business: means that portion of the business of title insurance in this state of a title insurer or title insurance producer that is referred to it by a producer or associate having a financial interest in the title insurer or title insurance producer. See Montana Code 33-25-105
• Controlled unaffiliated business entity: means a business entity or sole proprietorship:

  (i)that is not in a parent's corporate system consisting of the parent and affiliated companies;

  (ii)that has an existing, controlling contractual relationship with the parent or an affiliated company; and

  (iii)whose risks are managed by a pure captive insurance company. See Montana Code 33-28-101

• Conviction: A judgement of guilt against a criminal defendant.
• 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.
• Counterclaim: A claim that a defendant makes against a plaintiff.
• Counterparty exposure amount: means the net amount of credit risk attributable to a derivative instrument, pursuant to 33-12-109, entered into with a business entity other than through a qualified exchange or qualified foreign exchange or cleared through a qualified clearinghouse. See Montana Code 33-12-102
• Covered: means that an insurer:

  (a)owns or can immediately acquire, through the exercise of options, warrants, or already-owned conversion rights, the underlying interest in order to fulfill or secure its obligations under a call option, cap, or floor it has written; or

  (b)has set aside, under a custodial or escrow agreement, cash or cash equivalents with a market value equal to the amount required to fulfill its obligations under a put option it has written in an income generation transaction. See Montana Code 33-12-102

• Covered claim: means an unpaid claim, including one for unearned premiums, that arises out of and is within the coverage and not in excess of the applicable limits of an insurance policy to which this part applies issued by an insurer, if the insurer becomes an insolvent insurer after July 1, 1971, and:

  (i)the claimant or insured is a resident of this state at the time of the insured event; or

  (ii)the property from which the claim arises is permanently located in this state. See Montana Code 33-10-102

• Covered person: means a policyholder, a certificate holder, a member, a subscriber, an enrollee, or another individual participating in a health plan. See Montana Code 33-32-102
• Covered person: means a policyholder, subscriber, or enrollee or other individual participating in a health benefit plan. See Montana Code 33-36-103
• Covered policy: means any policy or contract or portion of a policy or contract for which coverage is provided within the scope of this part. See Montana Code 33-10-202
• Credit disability insurance: means insurance on a debtor or joint debtors to provide indemnity for payments becoming due on a specific loan or other credit transaction while the debtor or either of the joint debtors is disabled as defined in the policy. See Montana Code 33-21-103
• Credit life insurance: means insurance on the life of a debtor or the lives of joint debtors pursuant to or in connection with a specific loan or other credit transaction. See Montana Code 33-21-103
• Credit report: A detailed report of an individual's credit history prepared by a credit bureau and used by a lender in determining a loan applicant's creditworthiness. ^{Source: OCC}
• Credit tenant loan: means a mortgage loan that is made primarily in reliance on the credit standing of a major tenant, structured with an assignment of the rental payments to the lender with real estate pledged as collateral in the form of a first lien. See Montana Code 33-12-102
• Credit transaction: means a transaction by the terms of which, at a future date:

  (a)repayment of money loaned is made;

  (b)a loan commitment is made; or

  (c)payment for goods, services, or property sold or leased is made. See Montana Code 33-21-103

• Creditable coverage: means coverage of the individual under any of the following:

  (i)a group health plan;

  (ii)health insurance coverage;

  (iii)Title XVIII, part A or B, of the Social Security Act, 42 U. See Montana Code 33-22-140

• Creditor: means :

  (a)a lender of money or vendor or lessor of goods, services, property, rights, or privileges, for which payment is arranged through a credit transaction;

  (b)any successor to the right, title, or interest of a lender, vendor, or lessor;

  (c)an affiliate, associate, or subsidiary of a lender, vendor, or lessor;

  (d)a director, officer, or employee of a lender, vendor, or lessor; or

  (e)any other person in any way associated with a lender, vendor, or lessor. See Montana Code 33-21-103

• Customary: means according to usage. See Montana Code 1-1-206
• Customer: means a person who purchases portable electronics or services related to the use of portable electronics. See Montana Code 33-24-202
• Customer service representative: means an employee of a rental vehicle entity. See Montana Code 33-17-1501
• Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
• Debtor: means a borrower of money or a purchaser or lessee of goods, services, property, rights, or privileges for which payment is arranged through a credit transaction. See Montana Code 33-21-103
• Decedent: A deceased person.
• Declination of insurance coverage: means a denial, in whole or in part, by an insurance institution or insurance producer of requested insurance coverage. See Montana Code 33-19-104
• Deed: The legal instrument used to transfer title in real property from one person to another.
• Defendant: In a civil suit, the person complained against; in a criminal case, the person accused of the crime.
• Dependent: A person dependent for support upon another.
• Dependent: means :

  (a)a spouse;

  (b)an unmarried child under 25 years of age:

  (i)who is not an employee eligible for coverage under a group health plan offered by the child's employer for which the child's premium contribution amount is no greater than the premium amount for coverage as a dependent under a parent's individual or group health plan;

  (ii)who is not a named subscriber, insured, enrollee, or covered individual under any other individual health insurance coverage, group health plan, government plan, church plan, or group health insurance;

  (iii)who is not entitled to benefits under 42 U. See Montana Code 33-22-140

• Dependent: has the meaning provided in 33-22-140. See Montana Code 33-31-102
• Derivative instrument: means an agreement, an option, an instrument, or a series or combination of agreements, options, or instruments:

  (i)to make or take delivery of or assume or relinquish a specified amount of one or more underlying interests or to make a cash settlement in lieu of delivery; or

  (ii)that has a price, level, performance, value, or cash flow based primarily upon the actual or expected price, level, performance, value, or cash flow of one or more underlying interests. See Montana Code 33-12-102

• Derivative transaction: means a transaction involving the use of one or more derivative instruments. See Montana Code 33-12-102
• Determinable elements: means elements that are derived from processes or methods that are guaranteed at issue and are not subject to insurer discretion, but the values or amounts cannot be determined until some point after issue. See Montana Code 33-20-904
• Developed losses: means adjusted losses, including loss adjustment expenses, using accepted actuarial standards to eliminate the effect of differences between current payment or reserve estimates and those needed to provide actual ultimate loss payments, including loss adjustment expense payments. See Montana Code 33-16-1008
• Devise: To gift property by will.
• directly: when used in connection with an obligation, means that the designated obligor is primarily liable on the instrument representing the obligation. See Montana Code 33-12-102
• Discharge planning: means the formal process for determining, prior to discharge from a facility, the coordination and management of the care that a patient receives after discharge from a facility. See Montana Code 33-32-102
• Discounted present value: means the present value of future payments determined by discounting the future payments to the present using the most recently published applicable federal rate for determining the present value of an annuity, as issued by the United States internal revenue service. See Montana Code 33-20-1402
• Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
• Dismissal: The dropping of a case by the judge without further consideration or hearing. ^Source:
• Docket: A log containing brief entries of court proceedings.
• Dollar roll transaction: means two simultaneous transactions with different settlement dates that are no more than 96 days apart, so that in the transaction with the earlier settlement date, an insurer sells to a business entity, and in the other transaction, the insurer is obligated to purchase from the same business entity, substantially similar securities of the following types:

  (a)asset-backed securities issued, assumed, or guaranteed by the government national mortgage association, the federal national mortgage association, or the federal home loan mortgage corporation or their successors; and

  (b)other asset-backed securities referred to in section 106 of Title I of the Secondary Mortgage Market Enhancement Act of 1984 (15 U. See Montana Code 33-12-102

• Domestic jurisdiction: means the United States, any state, Canada, any province of Canada, or any political subdivision of a state or province. See Montana Code 33-12-102
• Donor: The person who makes a gift.
• electronic delivery: means :

  (a)delivery to an electronic mail address at which a party has consented to receive notices or documents; or

  (b)(i) posting on an electronic network or site accessible by the internet through use of a mobile application, computer, mobile device, tablet, or any other electronic device; and

  (ii)sending separate notice of the posting to the electronic mail address at which the party has consented to receive notice of the posting or using any other delivery method to which the party has consented. See Montana Code 33-15-601

• Eligible group: means , for the purpose of travel insurance, two or more persons who are engaged in a common enterprise or have an economic, educational, or social affinity or relationship, including but not limited to any of the following:

  (a)any entity engaged in the business of providing travel or travel services, including but not limited to tour operators, lodging providers, vacation property owners, hotels and resorts, travel clubs, travel agencies, property managers, cultural exchange programs, and common carriers or the operator, owner, or lessor of a means of transportation of passengers, including but not limited to airlines, cruise lines, railroads, steamship companies, and public bus carriers, wherein with regard to any particular travel or type of travel or travelers, all members or customers of the group must have a common exposure to risk attendant to the travel;

  (b)any college, school, or other institution of learning, covering students, teachers, employees, or volunteers;

  (c)any employer covering any group of employees, volunteers, contractors, board of directors, dependents, or guests;

  (d)any sports team, camp, or sponsor thereof, covering participants, members, campers, employees, officials, supervisors, or volunteers;

  (e)any religious, charitable, recreational, educational, or civic organization or branch thereof covering any group of members, participants, or volunteers;

  (f)any financial institutions or financial institution vendor or parent holding company, trustee, or agent of or designated by one or more financial institutions or financial institution vendors, including accountholders, credit card holders, debtors, guarantors, or purchasers;

  (g)any incorporated or unincorporated association, including labor unions, having a common interest, constitution, and bylaws and organized and maintained in good faith for purposes other than obtaining insurance for members or participants of the association covering its members;

  (h)any trust or the trustees of a fund established, created, or maintained for the benefit of and covering members, employees, or customers, subject to the commissioner's permitting the use of a trust and the state's premium tax provisions in 33-2-705 of one or more associations meeting the requirements in subsection (5)(g);

  (i)any entertainment production company covering any group of participants, volunteers, audience members, contestants, or workers;

  (j)any volunteer fire department, ambulance, rescue, police, or court or any first aid, civil defense, or other volunteer group;

  (k)preschools, daycare institutions for children or adults, and senior citizen clubs;

  (l)any automobile or truck rental or leasing company covering a group of individuals who may become renters, lessees, or passengers defined by their travel status on the rented or leased vehicles. See Montana Code 33-17-1401

• Elimination rider: means a provision attached to a policy that excludes coverage for a specific condition that would otherwise be covered under the policy. See Montana Code 33-22-140
• Emergency medical condition: means a condition manifesting itself by symptoms of sufficient severity, including severe pain, that the absence of immediate medical attention could reasonably be expected to result in any of the following:

  (a)the covered person's health would be in serious jeopardy;

  (b)the covered person's bodily functions would be seriously impaired; or

  (c)a bodily organ or part would be seriously damaged. See Montana Code 33-36-103

• Emergency services: has the meaning provided in 33-36-103. See Montana Code 33-32-102
• Enrolled customer: means a customer who elects coverage under a portable electronics insurance policy issued to a vendor of portable electronics. See Montana Code 33-24-202
• Enrollee: means a person:

  (a)who enrolls in or contracts with a health maintenance organization;

  (b)on whose behalf a contract is made with a health maintenance organization to receive health care services; or

  (c)on whose behalf the health maintenance organization contracts to receive health care services. See Montana Code 33-31-102

• Enrollment date: means , with respect to an individual covered under a group health plan or health insurance coverage, the date of enrollment of the individual in the plan or coverage or, if earlier, the first day of the waiting period for enrollment. See Montana Code 33-22-140
• 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.
• Entity: means an insurer as defined in 33-1-201, a health service corporation as defined in 33-30-101, and a health maintenance organization as defined in 33-31-102. See Montana Code 33-22-903
• Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. ^{Source: U.S. Courts}
• Equity interest: means any of the following that are not rated credit instruments:

  (a)common stock;

  (b)preferred stock;

  (c)trust certificate;

  (d)equity investment in an investment company other than a money market mutual fund or a class one bond mutual fund;

  (e)investment in a common trust fund of a bank regulated by a federal or state agency;

  (f)an ownership interest in minerals, oil, or gas, the rights to which have been separated from the underlying fee interest in the real estate where the minerals, oil, or gas is located;

  (g)instruments that are mandatorily, or at the option of the issuer, convertible to equity;

  (h)limited partnership interests and those general partnership interests authorized under 33-12-104(4);

  (i)member interests in limited liability companies;

  (j)warrants or other rights to acquire equity interests that are created by the person that owns or would issue the equity to be acquired; or

  (k)instruments that would be rated credit instruments except for the provisions of subsection (70)(b). See Montana Code 33-12-102

• Equivalent securities: means :

  (a)in a securities lending transaction, securities that are identical to the loaned securities in all features including the amount of the loaned securities, except as to certificate number if held in physical form, but if any different security is exchanged for a loaned security by recapitalization, merger, consolidation, or other corporate action, the different security is considered to be the loaned security;

  (b)in a repurchase transaction, securities that are identical to the purchased securities in all features including the amount of the purchased securities, except as to the certificate number if held in physical form; or

  (c)in a reverse repurchase transaction, securities that are identical to the sold securities in all features including the amount of the sold securities, except as to the certificate number if held in physical form. See Montana Code 33-12-102

• Escrow: Money given to a third party to be held for payment until certain conditions are met.
• 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.
• Evidence of coverage: means a certificate, agreement, policy, or contract issued to an enrollee setting forth the coverage to which the enrollee is entitled. See Montana Code 33-31-102
• Ex officio: Literally, by virtue of one's office.
• Excepted benefits: means :

  (a)coverage only for accident or disability income insurance, or both;

  (b)coverage issued as a supplement to liability insurance;

  (c)liability insurance, including general liability insurance and automobile liability insurance;

  (d)workers' compensation or similar insurance;

  (e)automobile medical payment insurance;

  (f)credit-only insurance;

  (g)coverage for onsite medical clinics;

  (h)other similar insurance coverage under which benefits for medical care are secondary or incidental to other insurance benefits, as approved by the commissioner;

  (i)if offered separately, any of the following:

  (i)limited-scope dental or vision benefits;

  (ii)benefits for long-term care, nursing home care, home health care, community-based care, or any combination of these types of care; or

  (iii)other similar, limited benefits as approved by the commissioner;

  (j)if offered as independent, noncoordinated benefits, any of the following:

  (i)coverage only for a specified disease or illness; or

  (ii)hospital indemnity or other fixed indemnity insurance;

  (k)if offered as a separate insurance policy:

  (i)medicare supplement coverage;

  (ii)coverage supplemental to the coverage provided under Title 10, chapter 55, of the United States Code; and

  (iii)similar supplemental coverage provided under a group health plan. See Montana Code 33-22-140

• Exchange: means a health benefit exchange established by the state of Montana or an exchange established by the United States department of health and human services in accordance with 42 U. See Montana Code 33-17-102
• Executor: A male person named in a will to carry out the decedent
• Expenses: means the portion of a rate that is attributable to acquisition, filed supervision and collection expenses, general expenses and taxes, licenses, or fees. See Montana Code 33-16-1008
• Experience rating: means a rating procedure using past insurance experience of the individual policyholder to forecast future losses by measuring the policyholder's loss experience against the loss experience of policyholders in the same classification to produce a prospective premium credit, debit, or unity modification. See Montana Code 33-16-1008
• External review: describes the set of procedures provided for in Title 33, chapter 32, part 4. See Montana Code 33-32-102
• Facility: means an institution providing health care services or a health care setting, including but not limited to a hospital, medical assistance facility, critical access hospital, or rural emergency hospital, as those terms are defined in 50-5-101, or other licensed inpatient center, an outpatient center for surgical services, a treatment center, a skilled nursing center, a residential treatment center, a diagnostic laboratory, a diagnostic imaging center, or a rehabilitation or other therapeutic health setting. See Montana Code 33-36-103
• Fair Credit Reporting Act: A federal law, established in 1971 and revised in 1997, that gives consumers the right to see their credit records and correct any mistakes. ^{Source: OCC}
• Fair market value: The price at which an asset would change hands in a transaction between a willing, informed buyer and a willing, informed seller.
• Federal Reserve System: The central bank of the United States. The Fed, as it is commonly called, regulates the U.S. monetary and financial system. The Federal Reserve System is composed of a central governmental agency in Washington, D.C. (the Board of Governors) and twelve regional Federal Reserve Banks in major cities throughout the United States. ^{Source: OCC}
• Federally defined eligible individual: means an individual:

  (a)for whom, as of the date on which the individual seeks coverage in the group market or individual market, the aggregate of the periods of creditable coverage is 18 months or more;

  (b)whose most recent prior creditable coverage was under a group health plan, governmental plan, church plan, or health insurance coverage offered in connection with any of those plans;

  (c)who is not eligible for coverage under:

  (i)a group health plan;

  (ii)Title XVIII, part A or B, of the Social Security Act, 42 U. See Montana Code 33-22-140

• 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

• Female: means a member of the human species who, under normal development, has XX chromosomes and produces or would produce relatively large, relatively immobile gametes, or eggs, during her life cycle and has a reproductive and endocrine system oriented around the production of those gametes. See Montana Code 1-1-201
• Fiduciary: A trustee, executor, or administrator.
• Final adverse determination: means an adverse determination involving a covered benefit that has been upheld by a health insurance issuer or its designated utilization review organization at the completion of the health insurance issuer's internal grievance process as provided in Title 33, chapter 32, part 3. See Montana Code 33-32-102
• Finance charge: The total cost of credit a customer must pay on a consumer loan, including interest. The Truth in Lending Act requires disclosure of the finance charge. ^{Source: OCC}
• Financial interest: means a legal or beneficial interest that entitles the holder, directly or indirectly, to 1% or more of the net profits or net worth of the entity in which the interest is held. See Montana Code 33-25-105
• Financing entity: means an underwriter, placement agent, lender, or any entity, other than a nonaccredited investor, that has a direct ownership in a policy or certificate that is the subject of a viatical settlement contract, whose sole activity related to the transaction is the provision of funds to effect the viatical settlement contract, and who has an agreement in writing with one or more licensed viatical settlement providers. See Montana Code 33-20-1302
• 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.
• Floor: means an agreement obligating the seller to make payments to the buyer in which each payment is based on the amount by which a predetermined number, sometimes called the floor rate or price, exceeds a price, level, performance, or value of one or more underlying interests. See Montana Code 33-12-102
• Foreign captive insurance company: means any captive insurance company formed under the laws of any jurisdiction other than this state. See Montana Code 33-28-101
• Foreign currency: means a currency other than that of a domestic jurisdiction. See Montana Code 33-12-102
• Foreign jurisdiction: means a jurisdiction other than a domestic jurisdiction. See Montana Code 33-12-102
• Fraud: Intentional deception resulting in injury to another.
• Fulfillment materials: means documentation sent to the purchaser of a travel protection plan confirming the purchase and providing the travel protection plan's coverage and assistance details. See Montana Code 33-17-1401
• Future: means an agreement, traded on a qualified exchange or qualified foreign exchange, to make or take delivery of or effect a cash settlement based on the actual or expected price, level, performance, or value of one or more underlying interests. See Montana Code 33-12-102
• Garnishment: Generally, garnishment is a court proceeding in which a creditor asks a court to order a third party who owes money to the debtor or otherwise holds assets belonging to the debtor to turn over to the creditor any of the debtor
• Generic name: means a short title descriptive of the annuity contract being applied for, such as "single premium deferred annuity". See Montana Code 33-20-904
• Germane: On the subject of the pending bill or other business; a strict standard of relevance.
• Gift: A voluntary transfer or conveyance of property without consideration, or for less than full and adequate consideration based on fair market value.
• Government money market mutual fund: means a money market mutual fund that at all times:

  (a)invests only in obligations issued, guaranteed, or insured by the federal government of the United States or collateralized repurchase agreements composed of these obligations; and

  (b)qualifies for investment without a reserve under the Purposes and Procedures of the Securities Valuation Office or any successor publication. See Montana Code 33-12-102

• Government-sponsored enterprise: means a:

  (a)governmental agency; or

  (b)corporation, limited liability company, association, partnership, joint-stock company, joint venture, trust, or other entity or instrumentality organized under the laws of any domestic jurisdiction to accomplish a public policy or other governmental purpose. See Montana Code 33-12-102

• Grace period: The number of days you'll have to pay your bill for purchases in full without triggering a finance charge. ^{Source: Federal Reserve}
• Grievance: means a written complaint or an oral complaint if the complaint involves an urgent care request submitted by or on behalf of a covered person regarding:

  (a)availability, delivery, or quality of health care services, including a complaint regarding an adverse determination made pursuant to utilization review;

  (b)claims payment, handling, or reimbursement for health care services; or

  (c)matters pertaining to the contractual relationship between a covered person and a health insurance issuer. See Montana Code 33-32-102

• Gross advance amount: means the sum payable to the payee or to the payee's account as consideration for a transfer of a structured settlement payment right before any reduction for a transfer expense or any other deduction is made from the sum. See Montana Code 33-20-1402
• Group health insurance coverage: means health insurance coverage offered in connection with a group health plan or health insurance coverage offered to an eligible group as described in 33-22-501. See Montana Code 33-22-140
• Group health plan: means an employee welfare benefit plan, as defined in 29 U. See Montana Code 33-22-140
• 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

• Guaranteed elements: means the premiums, credited interest rates (including any bonus), benefits, values, noninterest-based credits, and charges or elements of formulas used to determine any of these items that are guaranteed and determined at issue. See Montana Code 33-20-904
• Guaranteed or insured: when used in connection with an obligation acquired under this chapter, means that the guarantor or insurer has agreed to:

  (a)perform or insure the obligation of the obligor or purchase the obligation; or

  (b)be unconditionally obligated until the obligation is repaid to maintain in the obligor a minimum net worth, fixed charge coverage, stockholders' equity, or sufficient liquidity to enable the obligor to pay the obligation in full. See Montana Code 33-12-102

• Guarantor: A party who agrees to be responsible for the payment of another party's debts should that party default. ^{Source: OCC}
• 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.
• Habeas corpus: A writ that is usually used to bring a prisoner before the court to determine the legality of his imprisonment. It may also be used to bring a person in custody before the court to give testimony, or to be prosecuted.
• Hazardous financial condition: means that, based on its present or reasonably anticipated financial condition, a risk retention group, although not yet financially impaired or insolvent, is unlikely to be able to:

  (a)meet obligations to policyholders with respect to known claims and reasonably anticipated claims; or

  (b)pay other obligations in the normal course of business. See Montana Code 33-11-102

• Health benefit plan: means a policy, contract, certificate, or agreement entered into, offered, or issued by a health carrier to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services. See Montana Code 33-36-103
• Health care professional: means a physician or other health care practitioner licensed, accredited, or certified pursuant to the laws of this state to perform specified health care services consistent with state law. See Montana Code 33-36-103
• Health care provider: means any person, corporation, facility, or institution of a governmental unit of any state licensed by that state to provide health care, including but not limited to physician, osteopath, registered nurse, licensed practical nurse, dentist, optometrist, podiatrist, hospital, hospital-related facility, or long-term care facility. See Montana Code 33-9-101
• Health care services: means :

  (a)the services included in furnishing medical or dental care to a person;

  (b)the services included in hospitalizing a person;

  (c)the services incident to furnishing medical or dental care or hospitalization; or

  (d)the services included in furnishing to a person other services for the purpose of preventing, alleviating, curing, or healing illness, injury, or physical disability. See Montana Code 33-31-102

• Health care services: means services for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease, including the provision of pharmaceutical products or services or durable medical equipment. See Montana Code 33-32-102
• Health care services: means services for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease. See Montana Code 33-36-103
• Health care services agreement: means an agreement for health care services between a health maintenance organization and an enrollee. See Montana Code 33-31-102
• Health carrier: means an entity subject to the insurance laws and rules of this state that contracts, offers to contract, or enters into an agreement to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services, including a disability insurer, health maintenance organization, or health service corporation or another entity providing a health benefit plan. See Montana Code 33-36-103
• Health insurance coverage: means benefits consisting of medical care, including items and services paid for as medical care, that are provided directly, through insurance, reimbursement, or otherwise, under a policy, certificate, membership contract, or health care services agreement offered by a health insurance issuer. See Montana Code 33-22-140
• Health insurance issuer: means an insurer, a health service corporation, or a health maintenance organization. See Montana Code 33-22-140
• Health insurance issuer: has the meaning provided in 33-22-140. See Montana Code 33-32-102
• Health maintenance organization: means a person who provides or arranges for basic health care services to enrollees on a prepaid basis, either directly through provider employees or through contractual or other arrangements with a provider or a group of providers. See Montana Code 33-31-102
• Health service corporation: means a nonprofit corporation organized or operating for the purposes of establishing and operating a nonprofit plan or plans under which prepaid hospital care, medical-surgical care, and other health care and services, or reimbursement for the preceding care and services, may be furnished to a member or beneficiary. See Montana Code 33-30-101
• Health services: means the health care and services provided by hospitals or other health care institutions, organizations, associations, or groups and by doctors of medicine, osteopathy, dentistry, chiropractic, optometry, and podiatry; nursing services; licensed acupuncturist services; licensed social worker, licensed professional counselor, or psychologist services; medical appliances, equipment, and supplies; and drugs, medicines, ambulance services, and other therapeutic services and supplies. See Montana Code 33-30-101
• Hedging transaction: means a derivative transaction that is entered into and maintained to reduce:

  (a)the risk of a change in the value, yield, price, cash flow, or quantity of assets or liabilities that the insurer has acquired or incurred or anticipates acquiring or incurring; or

  (b)the currency exchange rate risk or the degree of exposure as to assets or liabilities that an insurer has acquired or incurred or anticipates acquiring or incurring. See Montana Code 33-12-102

• Highly rated: means an investment rated "P-1" by Moody's investors service, inc. See Montana Code 33-12-102
• Home state: means the District of Columbia or any state or territory of the United States in which a person licensed under this chapter maintains a principal place of residence or a principal place of business. See Montana Code 33-17-102
• Impaired insurer: means a member insurer that is not an insolvent insurer and that is placed under an order of rehabilitation or supervision by a court of competent jurisdiction. See Montana Code 33-10-202
• Impeachment: (1) The process of calling something into question, as in "impeaching the testimony of a witness." (2) The constitutional process whereby the House of Representatives may "impeach" (accuse of misconduct) high officers of the federal government for trial in the Senate.
• Income: means , as to a security, interest, accrual of discount, dividends, or other distributions, such as rights, tax or assessment credits, warrants, and distributions in kind. See Montana Code 33-12-102
• Indebtedness: means the total amount payable by a debtor to a creditor in connection with a loan or other credit transaction. See Montana Code 33-21-103
• Indemnification: In general, a collateral contract or assurance under which one person agrees to secure another person against either anticipated financial losses or potential adverse legal consequences. ^{Source: FDIC}
• Independent professional advice: means advice of an attorney, a certified public accountant, an actuary, or any licensed professional adviser. See Montana Code 33-20-1402
• Indictment: The formal charge issued by a grand jury stating that there is enough evidence that the defendant committed the crime to justify having a trial; it is used primarily for felonies.
• Individual: means a natural person. See Montana Code 33-17-102
• Individual: means a natural person who:

  (a)regarding property or casualty insurance, is a past, present, or proposed named insured or certificate holder;

  (b)regarding life, health, or disability insurance, is a past, present, or proposed principal insured or certificate holder;

  (c)is a past, present, or proposed policyowner;

  (d)is a past or present applicant;

  (e)is a past or present claimant; or

  (f)derived, derives, or is proposed to derive insurance coverage under an insurance policy or certificate subject to this chapter. See Montana Code 33-19-104

• Individual health insurance coverage: means health insurance coverage offered to individuals in the individual market, but does not include short-term limited duration insurance. See Montana Code 33-22-140
• Individual market: means the market for health insurance coverage offered to individuals other than in connection with group health insurance coverage. See Montana Code 33-22-140
• Industrial insured: means an insured:

  (a)who procures the insurance of any risk or risks by use of the services of a full-time employee acting as an insurance manager or buyer;

  (b)whose aggregate annual premiums for insurance on all risks total at least $25,000; and

  (c)who has at least 25 full-time employees. See Montana Code 33-28-101

• Industrial insured captive insurance company: means any company that insures risks of the industrial insureds that comprise the industrial insured group and their affiliated companies. See Montana Code 33-28-101
• Industrial insured group: means any group that meets either of the following:

  (a)the group collectively:

  (i)owns, controls, or holds with power to vote all of the outstanding voting securities of an industrial insured captive insurance company incorporated as a stock insurer; or

  (ii)has complete voting control over an industrial insured captive insurance company incorporated as a mutual insurer; or

  (b)the group is a captive risk retention group. See Montana Code 33-28-101

• Injunction: An order of the court prohibiting (or compelling) the performance of a specific act to prevent irreparable damage or injury.
• Insolvent insurer: means an insurer:

  (a)authorized to transact insurance in this state either at the time the policy was issued or when the insured event occurred; and

  (b)against whom an order of liquidation has been entered with a finding of insolvency by a court of competent jurisdiction in the insurer's state of domicile. See Montana Code 33-10-102

• Insolvent insurer: means a member insurer that is placed under an order of liquidation by a court of competent jurisdiction upon a finding of insolvency. See Montana Code 33-10-202
• Institutional source: means a person or governmental entity that provides information about an individual to an insurance producer, insurance institution, or insurance-support organization, other than:

  (a)an insurance producer;

  (b)the individual who is the subject of the information; or

  (c)a natural person acting in a personal capacity rather than a business or professional capacity. See Montana Code 33-19-104

• Insurance: means primary insurance, excess insurance, reinsurance, surplus line insurance, and any other arrangement for shifting and distributing risk that is determined to be insurance under the laws of this state. See Montana Code 33-11-102
• Insurance function: means claims administration, claims adjustment and management, fraud investigation, fraud prevention, underwriting, loss control, ratemaking functions, reinsurance, risk management, case management, disease management, quality assessment, quality improvement, provider credentialing verification, utilization review, peer review activities, subrogation, grievance procedures, insurance transactions, internal administration of compliance and policyholder service functions, and technical, administrative, or professional services related to the provision of the functions described in this subsection. See Montana Code 33-19-104
• Insurance future: means a future relating to an index or pool that is based on insurance-related items. See Montana Code 33-12-102
• Insurance futures option: means an option on an insurance future. See Montana Code 33-12-102
• Insurance institution: means a corporation, association, partnership, reciprocal exchange, interinsurer, Lloyd's insurer, fraternal benefit society, or other person engaged in the business of insurance, including health maintenance organizations, and health service corporations as defined in 33-30-101. See Montana Code 33-19-104
• Insurance premium finance company: means a person engaged in the business of entering into premium finance agreements with insureds or of acquiring such premium finance agreements from insurance producers, brokers, or other premium finance companies. See Montana Code 33-14-102
• insurance producer: as used in this chapter , means any authorized or acknowledged insurance producer of a society who acts as an insurance producer in the solicitation, negotiation, or sale of a life insurance, accident and health insurance, or annuity contract. See Montana Code 33-7-525
• Insurance producer: means an insurance producer as defined in 33-17-102 and 33-30-311. See Montana Code 33-19-104
• Insurance producer: means an individual or business entity appointed or authorized by a health maintenance organization to solicit applications for health care services agreements on its behalf. See Montana Code 33-31-102
• Insurance transaction: means a transaction involving insurance primarily for personal, family, or household needs, rather than for business or professional needs, that entails:

  (a)the determination of an individual's eligibility for an insurance coverage, benefit, or payment; or

  (b)the servicing of an insurance application, policy, contract, or certificate. See Montana Code 33-19-104

• Insurance-support organization: means a person who assembles or collects information about natural persons for the purpose of providing the information to an insurance institution or insurance producer for insurance transactions, including:

  (i)the furnishing of consumer reports or investigative consumer reports to an insurance institution or insurance producer for use in connection with an insurance transaction; or

  (ii)the collection of personal information from insurance institutions, insurance producers, or other insurance-support organizations for the purpose of detecting or preventing fraud, material misrepresentation, or material nondisclosure in connection with insurance underwriting or insurance claim activity. See Montana Code 33-19-104

• Insurer: means an insurer authorized to transact property or casualty insurance in this state or an unauthorized insurer transacting surplus lines insurance in this state. See Montana Code 33-15-1102
• Insurer: means a person licensed to write workers' compensation insurance as a plan No. See Montana Code 33-16-1008
• 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}
• Interested party: means , with respect to a structured settlement, the payee, any beneficiary irrevocably designated under the annuity contract to receive a payment after the payee's death, the annuity issuer, the structured settlement obligor, or any other party that has a continuing right or obligation under the structured settlement. See Montana Code 33-20-1402
• Intermediary: means a person authorized to negotiate, execute, and be a party to a contract between a health carrier and a provider or between a health carrier and a network. See Montana Code 33-36-103
• Interrogatories: Written questions asked by one party of an opposing party, who must answer them in writing under oath; a discovery device in a lawsuit.
• Intestate: Dying without leaving a will.
• Investigative consumer report: means a consumer report or portion of a consumer report containing information about a natural person's character, general reputation, personal characteristics, or mode of living obtained through personal interviews with the person's neighbors, friends, associates, acquaintances, or others who may have knowledge concerning this type of information. See Montana Code 33-19-104
• Investment company: means an investment company as defined in section 80a-3 of the Investment Company Act of 1940 (15 U. See Montana Code 33-12-102
• Investment company series: means an investment portfolio of an investment company that is organized as a series company and to which assets of the investment company have been specifically allocated. See Montana Code 33-12-102
• Investment practices: means transactions of the types described in 33-12-208, 33-12-210, 33-12-308, or 33-12-310. See Montana Code 33-12-102
• Investment strategies: means the techniques and methods used by an insurer to meet its investment objectives, such as active bond portfolio management, passive bond portfolio management, interest rate anticipation, growth investing, and value investing. See Montana Code 33-12-102
• Investment subsidiary: means a subsidiary of an insurer engaged or organized to engage exclusively in the ownership and management of assets authorized as investments for the insurer if each subsidiary agrees to limit its investment in any asset so that its investments will not cause the amount of the total investment of the insurer to exceed any of the investment limitations or avoid any other provisions of this chapter applicable to the insurer. See Montana Code 33-12-102
• Issuer: includes insurance companies, fraternal benefit societies, health care service plans, health maintenance organizations, and any entity delivering or issuing for delivery in this state medicare supplement policies or certificates. See Montana Code 33-22-903
• Joint committee: Committees including membership from both houses of teh legislature. Joint committees are usually established with narrow jurisdictions and normally lack authority to report legislation.
• Joint tenancy: A form of property ownership in which two or more parties hold an undivided interest in the same property that was conveyed under the same instrument at the same time. A joint tenant can sell his (her) interest but not dispose of it by will. Upon the death of a joint tenant, his (her) undivided interest is distributed among the surviving joint tenants.
• Judge: means :

  (a)a municipal court judge;

  (b)a justice of the peace; or

  (c)a city judge. See Montana Code 3-1-1501

• Judicial officers: means justices of the supreme court, judges of the district courts, justices of the peace, municipal judges, and city judges. See Montana Code 1-1-202
• 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.
• Juror: A person who is on the jury.
• 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
• Lapse: means the expiration of the license for failure to renew by the biennial renewal date. See Montana Code 33-17-102
• Large employer: means , in connection with a group health plan, with respect to a calendar year and a plan year, an employer who employed an average of at least 51 employees on business days during the preceding calendar year and who employs at least two employees on the first day of the plan year. See Montana Code 33-22-140
• Large group market: means the health insurance market under which individuals obtain health insurance coverage directly or through any arrangement on behalf of themselves and their dependents through a group health plan or group health insurance coverage issued to a large employer. See Montana Code 33-22-140
• Late enrollee: means an eligible employee or dependent, other than a special enrollee under 33-22-523, who requests enrollment in a group health plan following the initial enrollment period during which the individual was entitled to enroll under the terms of the group health plan if the initial enrollment period was a period of at least 30 days. See Montana Code 33-22-140
• Laws: means the society's articles of incorporation, charter, constitution, and bylaws. See Montana Code 33-7-108
• Lawsuit: A legal action started by a plaintiff against a defendant based on a complaint that the defendant failed to perform a legal duty, resulting in harm to the plaintiff.
• 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}
• Legislative session: That part of a chamber's daily session in which it considers legislative business (bills, resolutions, and actions related thereto).
• Letter of credit: means a clean, irrevocable, and unconditional letter of credit issued or confirmed by and payable and presentable at a financial institution on the list of financial institutions meeting the standards for issuing letters of credit under the Purposes and Procedures of the Securities Valuation Office or any successor publication. See Montana Code 33-12-102
• Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
• Liability: means legal liability for damages, including costs of defense, legal costs and fees, and other claims expenses, because of injuries to other persons, damage to their property, or other damage or loss to other persons resulting from or arising out of:

  (i)a business, whether profit or nonprofit, trade, product, service (including professional service), premises, or operation; or

  (ii)an activity of any state or local government or an agency or political subdivision of state or local government. See Montana Code 33-11-102

• License: means a document issued by the commissioner that authorizes a person to act as an insurance producer for the lines of authority specified in the document. See Montana Code 33-17-102
• Licensee: means a premium finance company holding a license issued by the commissioner under this chapter. See Montana Code 33-14-102
• Licensee: means :

  (a)an insurance institution, insurance producer, or other person who is licensed or required to be licensed, authorized or required to be authorized, or registered or required to be registered pursuant to this title; or

  (b)a surplus lines insurer. See Montana Code 33-19-104

• Lien: A claim against real or personal property in satisfaction of a debt.
• Limited liability company: means a business organization, excluding partnerships and ordinary business corporations, organized or operating under the laws of the United States or any state that limits the personal liability of investors to the equity investment of the investor in the business entity. See Montana Code 33-12-102
• Limited line credit insurance: includes credit life insurance, credit disability insurance, credit property insurance, credit unemployment insurance, involuntary unemployment insurance, mortgage life insurance, mortgage guaranty insurance, mortgage disability insurance, gap insurance, and any other form of insurance offered in connection with an extension of credit that is limited to partially or wholly extinguishing the credit obligation and that the commissioner determines should be designated as a form of limited line credit insurance. See Montana Code 33-17-102
• Limited lines insurance: means those lines of insurance that the commissioner finds necessary to recognize for the purposes of complying with 33-17-401(3). See Montana Code 33-17-102
• Limited lines producer: means a person authorized by the commissioner to sell, solicit, or negotiate limited lines insurance. See Montana Code 33-17-102
• Limited lines travel insurance producer: means a:

  (a)managing general agent or third-party administrator;

  (b)licensed insurance producer, including a limited lines producer, designated by an insurer as the travel insurance supervising entity as set forth in 33-17-1404; or

  (c)travel administrator. See Montana Code 33-17-1401

• Lines of authority: means any kind of insurance as defined in Title 33. See Montana Code 33-17-102
• Litigation: A case, controversy, or lawsuit. Participants (plaintiffs and defendants) in lawsuits are called litigants.
• Location: means any physical location in this state or any website, call center site, or similar location directed to residents of this state. See Montana Code 33-24-202
• Location: means any physical location in this state. See Montana Code 33-24-302
• Lodge: means subordinate member units of the society, known as camps, courts, councils, or branches or by any other designation. See Montana Code 33-7-108
• Loss trending: means a procedure for projecting developed losses to the average date of loss for the period during which the policies are to be effective, including loss ratio trending. See Montana Code 33-16-1008
• Lower-grade investment: means a rated credit instrument rated 4, 5, or 6 by the SVO. See Montana Code 33-12-102
• Managed care plan: means a health benefit plan that either requires or creates incentives, including financial incentives, for a covered person to use health care providers managed, owned, under contract with, or employed by a health carrier, but not preferred provider organizations or other provider networks operated in a fee-for-service indemnity environment. See Montana Code 33-36-103
• Market: means the interaction in this state between buyers and plan No. See Montana Code 33-16-1008
• Market value: means :

  (a)as to cash and letters of credit, the amounts of cash or a letter of credit; and

  (b)as to a security, as of any date, the price for the security on that date obtained from a generally recognized source or the most recent quotation from a generally recognized source or, to the extent that a generally recognized source does not exist, the price for the security as determined in good faith by the parties to a transaction, plus accrued but unpaid income on a security to the extent not included in the price as of that date. See Montana Code 33-12-102

• Medical care: means :

  (a)the diagnosis, cure, mitigation, treatment, or prevention of disease or amounts paid for the purpose of affecting any structure or function of the body;

  (b)transportation primarily for and essential to medical care referred to in subsection (19)(a); or

  (c)insurance covering medical care referred to in subsections (19)(a) and (19)(b). See Montana Code 33-22-140

• Medical care institution: means a facility or institution that is licensed to provide health care services to natural persons, including but not limited to health maintenance organizations, home health agencies, hospitals, medical clinics, public health agencies, rehabilitation agencies, and skilled nursing facilities. See Montana Code 33-19-104
• Medical necessity: means health care services that a health care provider exercising prudent clinical judgment would provide to a patient for the purpose of preventing, evaluating, diagnosing, treating, curing, or relieving a health condition, illness, injury, or disease or its symptoms and that are:

  (a)in accordance with generally accepted standards of practice;

  (b)clinically appropriate in terms of type, frequency, extent, site, and duration and are considered effective for the patient's illness, injury, or disease; and

  (c)not primarily for the convenience of the patient or health care provider and not more costly than an alternative service or sequence of services at least as likely to produce equivalent therapeutic or diagnostic results as to the diagnosis or treatment of the patient's illness, injury, or disease. See Montana Code 33-32-102

• Medical professional: means a person who is licensed or certified to provide health care services to natural persons, including but not limited to a chiropractor, clinical dietitian, clinical psychologist, dentist, nurse, occupational therapist, optometrist, pharmacist, physical therapist, physician, podiatrist, psychiatric social worker, or speech-language pathologist. See Montana Code 33-19-104
• Medical record information: means personal information that:

  (a)relates to an individual's physical or mental condition, medical history, medical claims history, or medical treatment; and

  (b)is obtained from a medical professional or medical care institution, from the individual, or from the individual's spouse, parent, or legal guardian. See Montana Code 33-19-104

• Medicare: means Health Insurance for the Aged, Title XVIII of the Social Security Amendments of 1965, as then constituted or later amended. See Montana Code 33-22-903
• Medicare supplement policy: means a group or individual policy of disability insurance or a subscriber contract of a health service corporation, other than a policy issued pursuant to a contract under 42 U. See Montana Code 33-22-903
• Medium-grade investment: means a rated credit instrument rated 3 by the SVO. See Montana Code 33-12-102
• Member: means a sole proprietorship or business entity that belongs to an association. See Montana Code 33-28-101
• Member insurer: means a person who:

  (a)writes any kind of insurance to which this part applies under 33-10-101(3), including the exchange of reciprocal or interinsurance contracts; and

  (b)is licensed to transact insurance in this state. See Montana Code 33-10-102

• Member insurer: means an insurer, health service corporation, or health maintenance organization that is licensed or that holds a certificate of authority to transact any kind of insurance in this state for which coverage is provided under this part and includes any insurer, health service corporation, or health maintenance organization whose license or certificate of authority in this state may have been suspended, revoked, not renewed, or voluntarily withdrawn. See Montana Code 33-10-202
• Membership contract: means any agreement, contract, or certificate by which a health service corporation describes the health services or benefits provided to its members or beneficiaries. See Montana Code 33-30-101
• Minority party: means the party with the second most members in a house of the legislature, subject to subsection (2). See Montana Code 1-1-208
• Money market mutual fund: means a mutual fund that meets the conditions of 17 C. See Montana Code 33-12-102
• Mortgage: The written agreement pledging property to a creditor as collateral for a loan.
• Mortgage loan: A loan made by a lender to a borrower for the financing of real property. ^{Source: OCC}
• Mortgage loan: means an obligation secured by a mortgage, deed of trust, trust deed, or other consensual lien on real estate. See Montana Code 33-12-102
• Mortgagee: The person to whom property is mortgaged and who has loaned the money.
• Mortgagor: The person who pledges property to a creditor as collateral for a loan and who receives the money.
• Multilateral development bank: means an international development organization of which the United States is a member. See Montana Code 33-12-102
• Multiple employer welfare arrangement: means a multiple employer welfare arrangement as defined by 29 U. See Montana Code 33-35-103
• Mutual fund: means an investment company or an investment company series that is registered with the United States securities and exchange commission under the Investment Company Act of 1940 (15 U. See Montana Code 33-12-102
• Mutual insurer: means a business entity without capital stock and with a governing body elected by the policyholders. See Montana Code 33-28-101
• NAIC: means the national association of insurance commissioners. See Montana Code 33-12-102
• National Bank: A bank that is subject to the supervision of the Comptroller of the Currency. The Office of the Comptroller of the Currency is a bureau of the U.S. Treasury Department. A national bank can be recognized because it must have "national" or "national association" in its name. ^{Source: OCC}
• Navigator: means a person certified by the commissioner under 33-17-241 and selected to perform the activities and duties identified in 42 U. See Montana Code 33-17-102
• Negotiate: means the act of conferring directly with or offering advice directly to a purchaser or prospective purchaser of a particular contract of insurance concerning any of the substantive benefits, terms, or conditions of the contract if the person engaged in negotiation either sells insurance or obtains insurance from insurers for purchasers. See Montana Code 33-17-102
• Net advance amount: means the gross advance amount minus the aggregate amount of the actual and estimated transfer expenses required to be disclosed under 33-20-1403(5). See Montana Code 33-20-1402
• Net direct written premiums: means direct gross premiums written in this state on insurance policies to which this part applies, less return premiums on the policies and dividends paid or credited to policyholders of policies to which this part applies. See Montana Code 33-10-102
• Network: means the group of participating providers that provides health care services to a managed care plan. See Montana Code 33-36-103
• Network plan: means health insurance coverage offered by a health insurance issuer under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the issuer. See Montana Code 33-22-140
• Nolo contendere: No contest-has the same effect as a plea of guilty, as far as the criminal sentence is concerned, but may not be considered as an admission of guilt for any other purpose.
• Nonguaranteed elements: means the premiums, credited interest rates (including any bonus), benefits, values, noninterest-based credits, and charges or elements of formulas used to determine any of these items that are subject to insurer discretion and are not guaranteed at issue. See Montana Code 33-20-904
• Oath: A promise to tell the truth.
• Oath: includes an affirmation or declaration. See Montana Code 1-1-201
• 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.
• Obligation: means a bond, note, debenture, trust certificate including an equipment certificate, production payment, negotiable bank certificate of deposit, bankers' acceptance, credit tenant loan, loan secured by financing net leases, and other evidence of indebtedness for the payment of money (or participations, certificates, or other evidences of an interest in any of the foregoing), whether constituting a general obligation of the issuer or payable only out of certain revenue or certain funds pledged or otherwise dedicated for payment. See Montana Code 33-12-102
• Offer and disseminate: means providing general information, including a description of coverage and price, as well as processing applications, collecting premiums, and performing other activities not requiring licensure by the state. See Montana Code 33-17-1401
• Open plan: means a managed care plan other than a closed plan that provides incentives, including financial incentives, for covered persons to use participating providers under the terms of the managed care plan. See Montana Code 33-36-103
• Open-end credit: A credit agreement (typically a credit card) that allows a customer to borrow against a preapproved credit line when purchasing goods and services. The borrower is only billed for the amount that is actually borrowed plus any interest due. (Also called a charge account or revolving credit.) ^{Source: OCC}
• Operator: means a business entity that is the owner, operator, lessor, or sublessor of a self-storage facility or an agent or another person authorized to manage the facility or to receive rent from a renter under a rental agreement. See Montana Code 33-24-302
• Option: means an agreement giving the buyer the right to buy or receive (a "call option"), sell or deliver (a "put option"), enter into, extend or terminate, or effect a cash settlement based on the actual or expected price, level, performance, or value of one or more underlying interests. See Montana Code 33-12-102
• Organizational document: means articles of incorporation, articles of organization, a subscribers' agreement, a charter, or any other document that establishes a business entity. See Montana Code 33-28-101
• Other professional: means an attorney, certified public accountant, public accountant, architect, veterinarian, pharmacist, and professional engineer licensed or otherwise legally authorized by a state to render professional services. See Montana Code 33-9-101
• Oversight: Committee review of the activities of a Federal agency or program.
• PACE organization: means an organization, as defined in 42 C. See Montana Code 33-31-102
• Parent: means a sole proprietorship, business entity, or individual that directly or indirectly owns, controls, or holds with power to vote more than 50% of the outstanding voting securities of a captive insurance company. See Montana Code 33-28-101
• Participant: means a sole proprietorship or business entity and any affiliates that are insured by a protected cell captive insurance company in which the losses of the participant are limited through a participant contract to the participant's share of the assets of one or more protected cells identified in the participant contract. See Montana Code 33-28-101
• Participant contract: means a contract by which a protected cell captive insurance company insures the risks of a participant and limits the losses of each participant in the contract. See Montana Code 33-28-101
• Participating provider: means a provider who, under a contract with a health carrier or with the health carrier's contractor, subcontractor, or intermediary, has agreed to provide health care services to covered persons with an expectation of receiving payment, other than coinsurance, copayments, or deductibles, directly or indirectly from the health carrier. See Montana Code 33-36-103
• 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.
• Party: means a recipient of a notice or document required as part of an insurance transaction and includes an applicant, insured, policyholder, certificate holder, or annuity contract holder. See Montana Code 33-15-601
• Payee: means an individual who is receiving tax-free payments under a structured settlement and proposes to make a transfer of the payment rights. See Montana Code 33-20-1402
• Peace officer: has the meaning as defined in 46-1-202. See Montana Code 1-1-207
• Performance audit: means an examination of the effectiveness of administration and its efficiency and adequacy in terms of the program of a state agency authorized by law to be performed and the conformance of expenditures with legislative intent. See Montana Code 2-8-102
• Periodic payment: includes both a recurring payment and any scheduled future lump-sum payments. See Montana Code 33-20-1402
• Person: has the meaning provided in 33-1-202. See Montana Code 33-12-102
• Person: means an individual or a business entity. See Montana Code 33-17-102
• Person: means a natural person, corporation, association, partnership, or other legal entity. See Montana Code 33-19-104
• Person: means :

  (a)an individual;

  (b)a group of individuals;

  (c)an insurer, as defined in 33-1-201;

  (d)a health service corporation, as defined in 33-30-101;

  (e)a corporation, partnership, facility, association, or trust; or

  (f)an institution of a governmental unit of any state licensed by that state to provide health care, including but not limited to a physician, hospital, hospital-related facility, or long-term care facility. See Montana Code 33-31-102

• Person: means an individual, a corporation, a partnership, an association, a joint venture, a joint stock company, a trust, an unincorporated organization, or any similar entity or combination of entities in this subsection. See Montana Code 33-32-102
• Person: means any individual, corporation, partnership, association, or voluntary organization. See Montana Code 33-10-102
• Person: means any individual, corporation, limited liability company, partnership, association, governmental body or entity, or voluntary organization. See Montana Code 33-10-202
• Person: includes a corporation or other entity as well as a natural person. See Montana Code 1-1-201
• Personal information: means any individually identifiable information gathered in connection with an insurance transaction from which judgments can be made about an individual's character, habits, avocations, finances, occupation, general reputation, credit, health, or any other personal characteristics. See Montana Code 33-19-104
• Personal property: All property that is not real property.
• Personal property: means movable property not affixed to land. See Montana Code 33-24-302
• Personal property: means money, goods, chattels, things in action, and evidences of debt. See Montana Code 1-1-205
• personal risk liability: means liability for damages because of injury to any person, damage to property, or other loss or damage resulting from personal, familial, or household responsibilities or activities rather than from responsibilities or activities referred to in subsection (5)(a). See Montana Code 33-11-102
• Plaintiff: The person who files the complaint in a civil lawsuit.
• Plan: means a health maintenance organization operated by an insurer or health service corporation as an integral part of the corporation and not as a subsidiary. See Montana Code 33-31-102
• Plan of operation or a feasibility study: means an analysis that presents the expected activities and results of a risk retention group, including at a minimum:

  (a)the coverages, deductibles, coverage limits, rates, and rating classification systems for each line of insurance the group intends to offer;

  (b)historical and expected loss experience of the proposed members and national experience of similar exposures to the extent this experience is reasonably available;

  (c)pro forma financial statements and projections;

  (d)appropriate opinions by a qualified independent casualty actuary, including a determination of minimum premium or participation levels required to commence operations and to prevent a hazardous financial condition;

  (e)identification of management, underwriting procedures, managerial oversight methods, and investment policies; and

  (f)other matters as may be prescribed by the commissioner for liability insurance companies authorized by the insurance laws of the state where the risk retention group is chartered. See Montana Code 33-11-102

• Plan sponsor: has the meaning provided under section 3(16)(B) of the Employee Retirement Income Security Act of 1974, 29 U. See Montana Code 33-22-140
• Plan sponsor: means :

  (a)the employer in the case of a benefit plan established or maintained by a single employer;

  (b)the employee organization in the case of a benefit plan established or maintained by an employee organization; or

  (c)in the case of a benefit plan established or maintained by two or more employers or jointly by one or more employers and one or more employee organizations, the association, committee, joint board of trustees, or other similar group of representatives of the parties who establish or maintain the benefit plan. See Montana Code 33-10-202

• Plea: In a criminal case, the defendant's statement pleading "guilty" or "not guilty" in answer to the charges, a declaration made in open court.
• Plea agreement: An arrangement between the prosecutor, the defense attorney, and the defendant in which the defendant agrees to plead guilty in exchange for special considerations. ^Source:
• Point-of-service option: means a delivery system that permits an enrollee of a health maintenance organization to receive health care services from a provider who is, under the terms of the enrollee's contract for health care services with the health maintenance organization, not on the provider panel of the health maintenance organization. See Montana Code 33-31-102
• 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
• Policyholder: means a person who:

  (a)in the case of individual property or casualty insurance, is a present named insured;

  (b)in the case of individual life, health, or disability insurance, is a present policyowner; or

  (c)in the case of group insurance that is individually underwritten, is a present group certificate holder. See Montana Code 33-19-104

• Portable electronics: means electronic devices that are portable in nature and their accessories. See Montana Code 33-24-202
• Portable electronics insurance: means insurance providing coverage for the repair or replacement of portable electronics that may provide coverage for portable electronics against loss, theft, inoperability due to mechanical failure, malfunction, damage, or other similar causes of loss. See Montana Code 33-24-202
• Portable electronics transaction: means :

  (a)the sale or lease of portable electronics by a vendor to a customer; or

  (b)the sale of a service related to the use of portable electronics by a vendor to a customer. See Montana Code 33-24-202

• Potential exposure: means the amount determined in accordance with the NAIC Annual Statement Instructions. See Montana Code 33-12-102
• Power of attorney: A written instrument which authorizes one person to act as another's agent or attorney. The power of attorney may be for a definite, specific act, or it may be general in nature. The terms of the written power of attorney may specify when it will expire. If not, the power of attorney usually expires when the person granting it dies. ^{Source: OCC}
• Precedent: A court decision in an earlier case with facts and law similar to a dispute currently before a court. Precedent will ordinarily govern the decision of a later similar case, unless a party can show that it was wrongly decided or that it differed in some significant way.
• 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
• Preexisting condition exclusion: means , with respect to coverage, a limitation or exclusion of benefits relating to a condition based on presence of a condition before the enrollment date coverage, whether or not any medical advice, diagnosis, care, or treatment was recommended or received before the enrollment date. See Montana Code 33-22-140
• Preferred stock: means preferred, preference, or guaranteed stock of a business entity authorized to issue the stock that has a preference in liquidation over the common stock of the business entity. See Montana Code 33-12-102
• Preliminary report: means an offer to issue a title insurance policy subject to any exceptions stated in the report or other matters that may be incorporated by reference therein. See Montana Code 33-25-105
• Premium: means the contractual consideration charged to an insured for insurance for a specified period of time, regardless of the timing of actual charges. See Montana Code 33-15-1102
• Premium finance agreement: means an agreement by which an insured or prospective insured promises to pay to a premium finance company the amount advanced or to be advanced under the agreement to an insurer or to an insurance producer or broker in payment of premiums on an insurance contract, together with a finance charge as authorized by this chapter, and as security therefor the insurance premium finance company receives an assignment of the unearned premium. See Montana Code 33-14-102
• Premiums: means premiums, rates, dues, or other required contributions that are payable under the certificate. See Montana Code 33-7-108
• Premiums: means the amount or consideration received on covered policies or contracts less return premiums, considerations, and deposits, and less dividends and experience credits. See Montana Code 33-10-202
• Present rental vehicle insurance information: means to present the option to acquire rental vehicle insurance to a renter. See Montana Code 33-17-1501
• Preservice claim: means a request for benefits or payment from a health insurance issuer for health care services that, under the terms of the health insurance issuer's contract of coverage, requires authorization from the health insurance issuer or from the health insurance issuer's designated utilization review organization prior to receiving the services. See Montana Code 33-32-102
• Presiding officer: A majority-party Senator who presides over the Senate and is charged with maintaining order and decorum, recognizing Members to speak, and interpreting the Senate's rules, practices and precedents.
• Pretext interview: means an interview during which a person, in an attempt to obtain information about a natural person, performs one or more of the following acts:

  (a)pretends to be someone else;

  (b)pretends to represent a person not in fact being represented;

  (c)misrepresents the true purpose of the interview; or

  (d)refuses to provide identification upon request. See Montana Code 33-19-104

• Principal place of business: means :

  (a)in the case of a plan sponsor, the state in which more than 50% of the participants in the benefit plan are employed;

  (b)if 50% of the participants of a benefit plan are not employed in a single state and for a person other than an individual, the single state in which the individuals who establish policies for the direction, control, and coordination of the operations of the entity as a whole primarily exercise that function, as determined by the association in its reasonable judgment by considering the following factors:

  (i)the state in which the primary executive and administrative headquarters is located;

  (ii)the state in which the principal office of the chief executive officer is located;

  (iii)the state in which the board of directors or similar governing persons conduct its meetings;

  (iv)the state in which the executive or management committee of the board of directors or similar governing person or persons conduct the majority of their meetings;

  (v)the state from which the management of the overall operations is directed; and

  (vi)in the case of a benefit plan sponsored by affiliated companies comprising a consolidated corporation, the state in which the holding company or controlling affiliate has its principal place of business as determined using the above factors; or

  (c)with respect to a plan sponsor defined in subsection (17)(c), the principal place of business of the association, committee, joint board of trustees, or other similar group of representatives of the parties who establish or maintain the benefit plan that, in lieu of specific or clear designation of a principal place of business, is the principal place of business of the employer or employee organization that has the largest investment in the benefit plan in question. See Montana Code 33-10-202

• Printing: means the act of reproducing a design on a surface by any process. See Montana Code 1-1-203
• Private sector: means any entity or individual not principally a part of or associated with a governmental unit that is associated with or involved in commercial activity. See Montana Code 2-8-301
• Privatize: means an agency contracting with the private sector to provide services that are currently or normally conducted directly by the employees of the state. See Montana Code 2-8-301
• Privileged information: means any individually identifiable information that:

  (a)relates to a civil or criminal proceeding involving an individual; and

  (b)is collected in connection with or in reasonable anticipation of a claim for insurance benefits or civil or criminal proceeding involving an individual. See Montana Code 33-19-104

• Probable cause: A reasonable ground for belief that the offender violated a specific law.
• Probate: Proving a will
• Probation: A sentencing alternative to imprisonment in which the court releases convicted defendants under supervision as long as certain conditions are observed.
• Probation officers: Screen applicants for pretrial release and monitor convicted offenders released under court supervision.
• Process: means a writ or summons issued in the course of judicial proceedings. See Montana Code 1-1-202
• producer: means a person, corporation, partnership, or other business entity, including an officer, director, or owner of 5% or more of the equity or capital thereof, engaged in this state in the trade, business, occupation, or profession of:

  (a)buying or selling interests in real property;

  (b)making loans secured by interests in real property; or

  (c)acting as broker, insurance producer, or representative of a person described in subsection (8)(a) or (8)(b). See Montana Code 33-25-105

• product liability: means liability for damages because of any personal injury, death, emotional harm, consequential economic damage, or property damage, including damages resulting from the loss of use of property, arising out of the manufacture, design, importation, distribution, packaging, labeling, lease, or sale of a product but does not include the liability of any person for those damages if the product involved was in the possession of that person when the incident giving rise to the claim occurred. See Montana Code 33-11-102
• Program: means any legislatively or administratively created function, project, or duty of an agency. See Montana Code 2-8-102
• Program: means a legislatively or administratively created function, project, or duty of an agency. See Montana Code 2-8-301
• Property: means real and personal property. See Montana Code 1-1-205
• Prospective loss costs: means historical aggregate losses and loss adjustment expenses, including all assessments that are loss-based and excluding any separately stated policyholder surcharges, projected through development to their ultimate value and through trending to a future point in time and ascertained by accepted actuarial standards. See Montana Code 33-16-1008
• Prospective review: means a utilization review conducted of a preservice claim prior to an admission or a course of treatment. See Montana Code 33-32-102
• Protected cell: means a separate account established by a protected cell captive insurance company formed or authorized under the provisions of this chapter, in which an identified pool of assets and liabilities are segregated and insulated, as provided in this chapter, from the remainder of the protected cell captive insurance company's assets and liabilities in accordance with the terms of one or more participant contracts to fund the liability of the protected cell captive insurance company with respect to the participants as set forth in the participant contracts. See Montana Code 33-28-101
• Protected cell captive insurance company: means any captive insurance company:

  (a)in which the minimum capital and surplus required by applicable law are provided by one or more sponsors;

  (b)that is formed or authorized under the provisions of this chapter;

  (c)that insures the risks of separate participants through participant contracts;

  (d)that funds its liability to each participant through one or more protected cells and segregates the assets of each protected cell from the assets of other protected cells and from the assets of the protected cell captive insurance company's general account; and

  (e)that is incorporated or formed as a limited liability company. See Montana Code 33-28-101

• Provider: means a physician, hospital, hospital-related facility, long-term care facility, dentist, osteopath, chiropractor, optometrist, podiatrist, psychologist, licensed social worker, registered pharmacist, or advanced practice registered nurse, as specifically listed in 37-8-202, or registered nurse first assistant as defined by the board of nursing under Title 37, chapter 8, who treats any illness or injury within the scope and limitations of the provider's practice or any other person who is licensed or otherwise authorized in this state to furnish health care services. See Montana Code 33-31-102
• provider: means a person, corporation, facility, or institution licensed by the state to provide, or otherwise lawfully providing, health care services, including but not limited to:

  (a)a physician, physician assistant, advanced practice registered nurse, health care facility as defined in 50-5-101, osteopath, dentist, nurse, optometrist, chiropractor, podiatrist, physical therapist, psychologist, licensed social worker, speech pathologist, audiologist, licensed addiction counselor, or licensed professional counselor; and

  (b)an officer, employee, or agent of a person described in subsection (18)(a) acting in the course and scope of employment. See Montana Code 33-32-102

• provider: means a health care professional or a facility. See Montana Code 33-36-103
• Provider panel: means those providers with whom a health maintenance organization contracts to provide health care services to the health maintenance organization's enrollees. See Montana Code 33-31-102
• Public adjuster: means an adjuster retained by and representing the interests of the insured. See Montana Code 33-17-102
• Public defender: Represent defendants who can't afford an attorney in criminal matters.
• Public law: A public bill or joint resolution that has passed both chambers and been enacted into law. Public laws have general applicability nationwide.
• Purchaser: means the individual, employer, or other entity, but not the individual certificate holder in the case of group insurance, that enters into a health care services agreement. See Montana Code 33-31-102
• Purchasing group: means a group that:

  (a)has as one of its purposes the purchase of liability insurance on a group basis;

  (b)purchases liability insurance only for its group members and only to cover their similar or related liability exposure, as described in subsection (7)(c);

  (c)is composed of members whose businesses or activities are similar or related with respect to the liability to which members are exposed by virtue of any related, similar, or common business, trade, product, service, premises, or operation; and

  (d)is domiciled in any state. See Montana Code 33-11-102

• Pure captive insurance company: means any company that insures risks of its parent and affiliated companies and controlled unaffiliated business entities. See Montana Code 33-28-101
• Pure premium rate: means the portion of the rate that represents the loss cost per unit of exposure, including loss adjustment expense. See Montana Code 33-16-1008
• Qualified assignment agreement: means an agreement providing for a qualified assignment, as defined for federal tax purposes, of the liability to make periodic payments under a structured settlement. See Montana Code 33-20-1402
• Qualified bank: means :

  (a)a national bank, state bank, or trust company that at all times is adequately capitalized as determined by standards adopted by United States banking regulators and that is either regulated by state banking laws or is a member of the federal reserve system; or

  (b)a bank or trust company incorporated or organized under the laws of a country other than the United States that is regulated as a bank or trust company by that country's government or an agency of that government and that at all times is adequately capitalized as determined by the standards adopted by international banking authorities. See Montana Code 33-12-102

• Qualified business entity: means a business entity that is:

  (a)an issuer of obligations or preferred stock that is rated 1 or 2 by the SVO or an issuer of obligations, preferred stock, or derivative instruments that are rated the equivalent of 1 or 2 by the SVO or by a nationally recognized statistical rating organization recognized by the SVO; or

  (b)a primary dealer in United States government securities recognized by the federal reserve bank of New York. See Montana Code 33-12-102

• Qualified clearinghouse: means a clearinghouse for, and subject to the rules of, a qualified exchange or a qualified foreign exchange, which provides clearing services, including acting as a counterparty to each of the parties to a transaction so that the parties no longer have a credit risk as to each other. See Montana Code 33-12-102
• Qualified exchange: means :

  (a)a securities exchange registered as a national securities exchange or a securities market regulated under the Securities Exchange Act of 1934 (15 U. See Montana Code 33-12-102

• Qualified foreign exchange: means a foreign exchange, board of trade, or contract market located outside the United States or its territories or possessions:

  (a)that has received regulatory comparability relief under commodity futures trading commission rule 30. See Montana Code 33-12-102

• Qualified guarantor: means a guarantor against which an insurer has a direct claim for full and timely payment, evidenced by a contractual right for which an enforcement action can be brought in a domestic jurisdiction. See Montana Code 33-12-102
• Qualified primary credit source: means the credit source to which an insurer looks for payment as to an investment and against which an insurer has a direct claim for full and timely payment, evidenced by a contractual right for which an enforcement action can be brought in a domestic jurisdiction. See Montana Code 33-12-102
• Quality assessment: means the measurement and evaluation of the quality and outcomes of medical care provided to individuals, groups, or populations. See Montana Code 33-36-103
• Quality assurance: means quality assessment and quality improvement. See Montana Code 33-36-103
• Quality improvement: means an effort to improve the processes and outcomes related to the provision of health care services within a health plan. See Montana Code 33-36-103
• Quorum: The number of legislators that must be present to do business.
• Rate: means fees for:

  (a)issuing a title insurance policy, including any service charge or fee for the issuance;

  (b)abstracting, searching, and examining title to real property when prepared or issued in contemplation of or in conjunction with the issuance of a title insurance policy; and

  (c)preparing or issuing preliminary reports, commitments, binders, or similar products prepared or issued in contemplation of or in conjunction with the issuance of a title insurance policy. See Montana Code 33-25-105

• Rate: means a monetary amount applied to the units of exposure assigned to a classification and used by an insurer to determine the premium for an insured. See Montana Code 33-15-1102
• Rated credit instrument: means a contractual right to receive cash or another rated credit instrument from another entity if the instrument:

  (i)is rated or required to be rated by the SVO;

  (ii)in the case of an instrument with a maturity of 397 days or less, is issued, guaranteed, or insured by an entity that is rated by, or another obligation of the entity is rated by, the SVO or by a nationally recognized statistical rating organization recognized by the SVO;

  (iii)in the case of an instrument with a maturity of 90 days or less, is issued by a qualified bank;

  (iv)is a share of a class one bond mutual fund; or

  (v)is a share of a money market mutual fund. See Montana Code 33-12-102

• rates: means rate of premium, policy and membership fee, or any other charge made by an insurer for or in connection with a contract or policy of workers' compensation and employer's liability insurance, prior to application of individual risk variations based on loss or expense considerations. See Montana Code 33-16-1008
• Rating plan: means a rule used by an insurer to calculate:

  (a)the premium for an insured; and

  (b)the parameter values used in such calculation after application of classification premium rates to units of exposure. See Montana Code 33-15-1102

• Real estate: means :

  (i)real property;

  (ii)interests in real property, such as leaseholds, minerals, oil, and gas, that have not been separated from the underlying fee interest;

  (iii)improvements and fixtures located on or in real property; and

  (iv)the seller's equity in a contract providing for a deed of real estate. See Montana Code 33-12-102

• Real property: Land, and all immovable fixtures erected on, growing on, or affixed to the land.
• Real property: means lands, tenements, hereditaments, and possessory title to public lands. See Montana Code 1-1-205
• Receivership court: means the court in the insolvent or impaired insurer's state that has jurisdiction over the supervision, rehabilitation, or liquidation of the insurer. See Montana Code 33-10-202
• 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}
• Related provider trust: means a trust established by a licensed viatical settlement provider or a financing entity for the sole purpose of holding the ownership or beneficial interest in purchased policies in connection with a financing transaction. See Montana Code 33-20-1302
• 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.
• Renewal: means an agreement between an insurer and an insured to extend or continue an existing insurance policy for 90 days or more. See Montana Code 33-15-1102
• Rental agreement: means a written agreement setting forth the terms and conditions governing the use of a vehicle that is provided by a rental vehicle entity for the rental or lease of a rental vehicle for a period of not more than 90 days. See Montana Code 33-17-1501
• Rental agreement: means a written agreement or lease that establishes or modifies the terms, conditions, or rules concerning the use and occupancy of a leased space at a self-storage facility. See Montana Code 33-24-302
• Rental vehicle: means a motor vehicle that is designated as:

  (a)a private passenger motor vehicle, including an automobile, a passenger van, a minivan, or a sport utility vehicle; or

  (b)a cargo vehicle, including a cargo van, a pickup truck, or a truck with a gross weight of less than 26,000 pounds that does not require the operator to possess a commercial driver's license. See Montana Code 33-17-1501

• Rental vehicle entity: means an entity in the business of providing rental vehicles to the public under a rental agreement. See Montana Code 33-17-1501
• Rental vehicle insurance: means insurance that a renter purchases from a rental vehicle entity as part of the rental agreement in conjunction with the use of a rental vehicle. See Montana Code 33-17-1501
• Renter: means a person who obtains the use of a rental vehicle from a rental vehicle entity under the terms of a rental agreement. See Montana Code 33-17-1501
• Renter: means a person entitled to the use of a leased space at a self-storage facility under a rental agreement or the person's successors or assigns. See Montana Code 33-24-302
• Replication transaction: means a derivative transaction that is intended to replicate the performance of one or more assets that an insurer is authorized to acquire under this chapter. See Montana Code 33-12-102
• Reporter: Makes a record of court proceedings and prepares a transcript, and also publishes the court's opinions or decisions (in the courts of appeals).
• Repurchase transaction: means a transaction in which an insurer purchases securities from a business entity that is obligated to repurchase the purchased securities or equivalent securities from the insurer at a specified price, either within a specified period of time or upon demand. See Montana Code 33-12-102
• Required liabilities: means total liabilities required to be reported on the statutory financial statement of the insurer most recently required to be filed with the commissioner. See Montana Code 33-12-102
• Rescission: The cancellation of budget authority previously provided by Congress. The Impoundment Control Act of 1974 specifies that the President may propose to Congress that funds be rescinded. If both Houses have not approved a rescission proposal (by passing legislation) within 45 days of continuous session, any funds being withheld must be made available for obligation.
• Reserve estimates: means provisions for insurer obligations for future payments of loss or loss adjustment expenses. See Montana Code 33-16-1008
• Reserves: means the excess of the assets of a self-funded multiple employer welfare arrangement minus the liabilities of the arrangement. See Montana Code 33-35-103
• Resident: means a person to whom a contractual obligation is owed and who resides in this state on the date of entry of a court order that determines a member insurer to be an impaired insurer or a court order that determines a member insurer to be an insolvent insurer. See Montana Code 33-10-202
• Residential mortgage loan: means a loan primarily secured by a mortgage on real estate improved with a residence for no more than four families. See Montana Code 33-12-102
• Residual market mechanism: means an association, organization, or other entity defined or described in 61-6-144. See Montana Code 33-19-104
• Responsible administrative authority: means , with respect to a structured settlement, any government authority vested by law with exclusive jurisdiction over the settled claim resolved by the structured settlement. See Montana Code 33-20-1402
• Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.
• Retrospective review: means a review of medical necessity conducted after services have been provided to a covered person. See Montana Code 33-32-102
• Reverse repurchase transaction: means a transaction in which an insurer sells securities to a business entity and is obligated to repurchase the sold securities or equivalent securities from the business entity at a specified price, either within a specified period of time or upon demand. See Montana Code 33-12-102
• Risk retention group: means a corporation or other limited liability association formed under the laws of any state, Bermuda, or the Cayman Islands:

  (a)whose primary activity consists of assuming and spreading all or any portion of the liability exposure of its group members;

  (b)that is organized for the primary purpose of conducting the activity described under subsection (8)(a);

  (c)(i) that is chartered and licensed as a liability insurance company and authorized to engage in the business of insurance under the laws of any state; or

  (ii)that, before January 1, 1985, was chartered or licensed and authorized to engage in the business of insurance under the laws of Bermuda or the Cayman Islands and, before that date, had certified to the insurance regulatory official of at least one state that it satisfied the capitalization requirements of that state. See Montana Code 33-11-102

• Rules: means all rules, regulations, or resolutions that are adopted by the supreme governing body or board of directors and that are intended to have general application to the members of the society. See Montana Code 33-7-108
• Secured location: means the contiguous real estate owned by one person. See Montana Code 33-12-102
• Securities lending transaction: means a transaction in which securities are loaned by an insurer to a business entity that is obligated to return the loaned securities or equivalent securities to the insurer, either within a specified period of time or upon demand. See Montana Code 33-12-102
• Self-storage facility: means real property consisting of individual storage spaces in which a renter customarily stores and removes personal property on a self-service basis. See Montana Code 33-24-302
• Self-storage insurance: means insurance offered in connection with and incidental to the rental of a leased space at a self-storage facility and which provides coverage to renters for the loss of or damage to personal property occurring at the facility or when the property is in transit to or from the facility during the term of the rental agreement. See Montana Code 33-24-302
• Sell: means to exchange a contract of insurance by any means, for money or the equivalent, on behalf of an insurance company. See Montana Code 33-17-102
• Series company: means an investment company that is organized as a series company, as defined in rules adopted under the Investment Company Act of 1940 (15 U. See Montana Code 33-12-102
• Service of process: The service of writs or summonses to the appropriate party.
• Settled claim: means the original tort claim. See Montana Code 33-20-1402
• 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.
• Several: means two or more. See Montana Code 1-1-201
• Sex: means the organization of the body parts and gametes for reproduction in human beings and other organisms. See Montana Code 1-1-201
• Shell business entity: means a business entity having no economic substance, except as a vehicle for owning interests in assets issued, owned, or previously owned by a person domiciled in a foreign jurisdiction. See Montana Code 33-12-102
• Short-term: means investments with a remaining term to maturity of 90 days or less. See Montana Code 33-12-102
• Sinking fund stock: means preferred stock that:

  (a)is subject to a mandatory sinking fund or similar arrangement that will provide for the redemption or open market purchase of the entire issue over a period not longer than 40 years from the date of acquisition; and

  (b)provides for mandatory sinking fund installments or open market purchases commencing not more than 10 1/2 years from the date of issue, with the sinking fund installments providing for the purchase or redemption, on a cumulative basis commencing 10 years from the date of issue, of at least 2. See Montana Code 33-12-102

• Small group market: means the health insurance market under which individuals obtain health insurance coverage directly or through an arrangement, on behalf of themselves and their dependents, through a group health plan or group health insurance coverage maintained by a small employer as defined in 33-22-1803. See Montana Code 33-22-140
• Society: means a fraternal benefit society described in 33-7-105. See Montana Code 33-7-108
• Sole proprietorship: means an individual doing business in a noncorporate form. See Montana Code 33-28-101
• Solicit: means attempting to sell insurance or asking or urging a person to apply for a particular kind of insurance. See Montana Code 33-17-102
• Special purpose captive insurance company: means a captive insurance company that is formed or authorized under this chapter that does not meet the definition of any other type of captive insurance company defined in this section or is formed by, on behalf of, or for the benefit of a political subdivision of this state. See Montana Code 33-28-101
• Special purpose entity: means a corporation, partnership, trust, limited liability company, or other similar entity formed solely to provide, either directly or indirectly, access to institutional capital markets for a financing entity or licensed viatical settlement provider. See Montana Code 33-20-1302
• State: means a state, the District of Columbia, the Commonwealth of Puerto Rico, or a United States possession, territory, or protectorate. See Montana Code 33-10-202
• State: means any state of the United States or the District of Columbia. See Montana Code 33-11-102
• 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
• Statistical plan: means the plan, system, or arrangement that is used in collecting data. See Montana Code 33-16-1008
• Statute: A law passed by a legislature.
• Statute of limitations: A law that sets the time within which parties must take action to enforce their rights.
• Structured settlement: means an arrangement for periodic payment of damages for personal injuries or sickness established by settlement or judgment in resolution of a tort claim. See Montana Code 33-20-1402
• Structured settlement agreement: means the written agreement, judgment, stipulation, or release embodying the terms of a structured settlement. See Montana Code 33-20-1402
• Structured settlement annuity: means an annuity purchased in order to fund periodic payments for a plaintiff or other claimant in payment for or with respect to personal injury suffered by the plaintiff or other claimant. See Montana Code 33-10-202
• Structured settlement obligor: means , with respect to a structured settlement, the party that has the continuing obligation to make periodic payments to the payee under a structured settlement agreement or a qualified assignment agreement. See Montana Code 33-20-1402
• Structured settlement payment right: means the right to receive periodic payments under a structured settlement, whether from the structured settlement obligor or the annuity issuer, when:

  (a)(i) the payee is domiciled in this state; or

  (ii)the domicile or principal place of business of the structured settlement obligor or the annuity issuer is located in this state;

  (b)a court or responsible administrative authority in this state approved the structured settlement agreement; or

  (c)the structured settlement agreement is expressly governed by the laws of this state. See Montana Code 33-20-1402

• Subpoena: A command to a witness to appear and give testimony.
• Subscribing witness: means a person who sees a writing executed or hears it acknowledged and at the request of the party signs the person's name as a witness. See Montana Code 1-1-203
• subscription: includes the mark of a person who cannot write if the person's name is written near the mark by another person who also signs that person's own name as a witness. See Montana Code 1-1-203
• Substantially similar securities: means securities that meet all criteria for substantially similar specified in the NAIC Accounting Practices and Procedures Manual, as amended, and in an amount that constitutes good delivery form as determined from time to time by the public securities administration. See Montana Code 33-12-102
• Summons: Another word for subpoena used by the criminal justice system.
• Supervising entity: means a business entity that is a licensed insurer or insurance producer that is authorized by a licensed insurer to supervise the administration of a portable electronics insurance program. See Montana Code 33-24-202
• Supervising entity: means a business entity that is a licensed insurer or insurance producer that is authorized by a licensed insurer to supervise the administration of a self-storage insurance program. See Montana Code 33-24-302
• Supplementary rate information: means a manual or plan of rates, statistical plan, classification system, minimum premium, policy fee, rating rule, rate-related underwriting rule, and any other information needed to determine the applicable premium for an individual insured that is consistent with the purposes of this part and with rules prescribed by rule of the commissioner. See Montana Code 33-16-1008
• Supporting information: means the experience and judgment of the filer and the experience or data of other insurers or advisory organizations relied on by the filer, the interpretation of any statistical data relied on by the filer, descriptions of methods used in making the rates, and any other similar information required to be filed by the commissioner. See Montana Code 33-16-1008
• Suspend: means to bar the use of a person's license for a period of time. See Montana Code 33-17-102
• SVO: means the securities valuation office of the NAIC or any successor office established by the NAIC. See Montana Code 33-12-102
• Swap: means an agreement to exchange or to net payments at one or more times based on the actual or expected price, level, performance, or value of one or more underlying interests. See Montana Code 33-12-102
• Terms of the structured settlement: means , with respect to a structured settlement, the terms of the structured settlement agreement, the annuity contract, a qualified assignment agreement, or any order or other approval of a court or responsible administrative authority or other government authority that authorized or approved the structured settlement. See Montana Code 33-20-1402
• Testimony: Evidence presented orally by witnesses during trials or before grand juries.
• Title guarantee: means a contract by which, subject to its stated terms and conditions, a title insurer guarantees the assured against loss sustained by reason of the incorrectness of assurances set forth in the title guarantee with respect to the stated property. See Montana Code 33-25-105
• Title insurance business: means :

  (a)issuing or offering to issue a title insurance policy as an insurer;

  (b)transacting or proposing to transact any of the following as a title insurer or title insurance producer, in contemplation of or in conjunction with the issuance of a title insurance policy:

  (i)soliciting or negotiating the issuance of a title insurance policy;

  (ii)guaranteeing, warranting, or otherwise insuring the correctness of title searches;

  (iii)handling escrows, settlements, or closings;

  (iv)executing title insurance policies, reports, commitments, binders, and endorsements;

  (v)effecting contracts of reinsurance; or

  (vi)abstracting, searching, or examining titles;

  (c)transacting, as a title insurer or insurance producer, matters subsequent to the issuance of a title insurance policy and arising out of the policy; or

  (d)doing or proposing to do business that, in substance, is equivalent to any of the activities described in subsections (12)(a) through (12)(c) in a manner designed to evade the provisions of this title. See Montana Code 33-25-105

• Title insurance policy: means a contract by which, subject to its stated terms and conditions, a title insurer insures or indemnifies the insured against loss or damage sustained by reason of:

  (a)defects in or liens or encumbrances on the title to the stated property;

  (b)unmarketability of the title to the stated property; or

  (c)invalidity or unenforceability of liens or encumbrances on the stated property. See Montana Code 33-25-105

• Title insurance producer: means a person who holds a valid title insurance producer's license and is authorized in writing by a title insurer to:

  (i)solicit title insurance business;

  (ii)collect rates;

  (iii)determine insurability in accordance with underwriting rules and standards of the insurer; or

  (iv)issue policies of the title insurer. See Montana Code 33-25-105

• Title insurer: means an insurer formed and authorized under the laws of this state to transact the business of title insurance in this state or a foreign or alien insurer so authorized. See Montana Code 33-25-105
• Title plant: means a set of privately maintained records in which entries have been made of documents imparting constructive notice, under the law, of matters affecting title to real property, an interest therein, or an encumbrance thereon, that have been filed or recorded in the jurisdiction for which the title plant is maintained and from which the ownership of real property within the jurisdiction can be ascertained and liens, encumbrances, defects, and clouds on title to the real property can be determined. See Montana Code 33-25-105
• Tort: A civil wrong or breach of a duty to another person, as outlined by law. A very common tort is negligent operation of a motor vehicle that results in property damage and personal injury in an automobile accident.
• Total investment of the insurer: includes :

  (a)direct investment by the insurer in an asset; and

  (b)the insurer's proportionate share of an investment in an asset by an investment subsidiary of the insurer, which must be calculated by multiplying the amount of the subsidiary's investment by the percentage of the insurer's ownership interest in the subsidiary. See Montana Code 33-12-102

• Transcript: A written, word-for-word record of what was said, either in a proceeding such as a trial or during some other conversation, as in a transcript of a hearing or oral deposition.
• Transfer: means a sale, assignment, pledge, hypothecation, or other alienation or encumbrance of a structured settlement payment right made by a payee for consideration. See Montana Code 33-20-1402
• Transfer agreement: means the agreement providing for a transfer of a structured settlement payment right. See Montana Code 33-20-1402
• Transfer expenses: means all expenses of a transfer that are:

  (i)required under the transfer agreement to be paid by the payee; or

  (ii)deducted from the gross advance amount, including without limitation any court filing fee, attorney fee, escrow fee, lien recordation fee, judgment and lien search fee, finder's fee, commission, and other payments to a broker or other intermediary. See Montana Code 33-20-1402

• Transferee: means a party acquiring or proposing to acquire a structured settlement payment right through a transfer. See Montana Code 33-20-1402
• Travel administrator: means a person who directly or indirectly underwrites, collects charges, collateral, or premiums from, or adjusts or settles claims on residents of this state in connection with travel insurance, except that a person may not be considered a travel administrator if that person's only actions that would otherwise cause it to be considered a travel administrator are among the following:

  (a)a person working for a travel administrator to the extent that the person's activities are subject to the supervision and control of the travel administrator;

  (b)an insurance producer selling insurance or engaged in administrative and facilitation of claims-related activities within the scope of the producer's license;

  (c)a travel retailer offering and disseminating travel insurance and registered under the license of a limited lines travel insurance producer in accordance with this part;

  (d)an individual adjusting or settling claims in the normal course of that individual's practice or employment as an attorney at law and who does not collect charges or premiums in connection with insurance coverage; or

  (e)a business entity that is affiliated with a licensed insurer while acting as a travel administrator for the direct and assumed insurance business of an affiliated insurer. See Montana Code 33-17-1401

• Travel assistance services: means noninsurance services for which the consumer is not indemnified based on a fortuitous event and that do not result in the transfer or shifting of risk that would constitute the business of insurance. See Montana Code 33-17-1401
• Travel insurance: means insurance coverage for personal risks incident to planned travel, including but not limited to:

  (i)interruption or cancellation of a trip or event;

  (ii)loss of baggage or personal effects;

  (iii)damages to accommodations or rental vehicles;

  (iv)sickness, accident, disability, or death occurring during travel;

  (v)emergency evacuation;

  (vi)repatriation of remains; or

  (vii)any other contractual obligations to indemnify or pay a specified amount to the traveler upon determinable contingencies related to travel as approved by the commissioner. See Montana Code 33-17-1401

• Travel protection plans: means plans that provide one or more of the following:

  (a)travel insurance;

  (b)travel assistance services; or

  (c)cancellation fee waivers. See Montana Code 33-17-1401

• Travel retailer: means a business entity that makes, arranges, or offers travel services and that may offer and disseminate travel insurance as a service to its customers on behalf of and under the direction of a limited lines travel insurance producer. See Montana Code 33-17-1401
• Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.
• Trust account: A general term that covers all types of accounts in a trust department, such as estates, guardianships, and agencies. ^{Source: OCC}
• Trustee: A person or institution holding and administering property in trust.
• Unallocated annuity contract: means an annuity contract or group annuity certificate that is not issued to and owned by an individual, except to the extent of annuity benefits guaranteed to an individual by the insurer under the contract or certificate. See Montana Code 33-10-202
• Unauthorized insurer: means an insurance institution that has not been granted a certificate of authority by the commissioner to transact the business of insurance in this state. See Montana Code 33-19-104
• under common control with: means the possession, direct or indirect, of the power to direct or cause the direction of the management and policies of a person, whether through the ownership of voting securities, by contract other than a commercial contract for goods or nonmanagement services, or otherwise, unless the power is the result of an official position with or corporate office held by the person. See Montana Code 33-19-104
• Underlying interest: means the assets, liabilities, other interests, or a combination of assets, liabilities, or other interests underlying a derivative instrument, such as any one or more securities, currencies, rates, indices, commodities, or derivative instruments. See Montana Code 33-12-102
• United States: includes the District of Columbia and the territories. See Montana Code 1-1-201
• Unrestricted surplus: means the amount by which total admitted assets exceed 125% of the insurer's required liabilities. See Montana Code 33-12-102
• Uphold: The decision of an appellate court not to reverse a lower court decision.
• Urgent care request: means a request for a health care service or course of treatment with respect to which the time periods for making a nonurgent care request determination could:

  (i)seriously jeopardize the life or health of the covered person or the ability of the covered person to regain maximum function; or

  (ii)subject the covered person, in the opinion of a health care provider with knowledge of the covered person's medical condition, to severe pain that cannot be adequately managed without the health care service or treatment that is the subject of the request. See Montana Code 33-32-102

• Usage: means a reasonable and lawful public custom concerning transactions of the same nature as those which are to be affected thereby, existing at the place where the obligation is to be performed, and either known to the parties or so well established, general, and uniform that the parties must be presumed to have acted with reference thereto. See Montana Code 1-1-206
• Usual: means according to usage. See Montana Code 1-1-206
• Utilization review: means a set of formal techniques designed to monitor the use of or to evaluate the clinical necessity, appropriateness, efficacy, or efficiency of health care services, procedures, or settings. See Montana Code 33-32-102
• Utilization review: has the meaning provided in 33-32-102. See Montana Code 33-33-103
• Utilization review organization: means an entity that conducts utilization review for one or more of the following:

  (a)an employer with employees who are covered under a health benefit plan or health insurance policy;

  (b)a health insurance issuer providing review for its own health plans or for the health plans of another health insurance issuer;

  (c)a preferred provider organization or health maintenance organization; and

  (d)any other individual or entity that provides, offers to provide, or administers hospital, outpatient, medical, or other health benefits to a person treated by a health care provider under a policy, plan, or contract. See Montana Code 33-32-102

• Utilization review organization: means an entity that provides utilization review services. See Montana Code 33-33-103
• Variable Rate: Having a "variable" rate means that the APR changes from time to time based on fluctuations in an external rate, normally the Prime Rate. This external rate is known as the "index." If the index changes, the variable rate normally changes. Also see Fixed Rate.
• Vendor: means a person in the business of engaging in portable electronics transactions directly or indirectly. See Montana Code 33-24-202
• Verdict: The decision of a petit jury or a judge.
• Viatical settlement broker: means an individual who, for a fee, commission, or other consideration:

  (i)offers or advertises the availability of viatical settlement contracts;

  (ii)introduces holders of life insurance policies or certificates insuring the lives of individuals with a terminal illness or condition to viatical settlement providers; or

  (iii)offers or attempts to negotiate viatical settlement contracts between the policyholders or certificate holders and one or more viatical settlement providers. See Montana Code 33-20-1302

• Viatical settlement contract: means a written agreement establishing the terms under which compensation or anything of value will be paid, when the compensation or value is less than the expected death benefit of the insurance policy or certificate, in return for the viator's assignment, transfer, sale, devise, or bequest of the death benefit or ownership of any portion of the insurance policy or certificate of insurance. See Montana Code 33-20-1302
• Viatical settlement provider: means a person who solicits, enters into, or negotiates viatical settlement contracts or offers to enter into or negotiate viatical settlement contracts. See Montana Code 33-20-1302
• Viatical settlement purchase agreement: means a contract or agreement entered into by a viatical settlement purchaser with a viatical settlement provider to purchase a life insurance policy or an interest in a life insurance policy for the purpose of deriving an economic benefit. See Montana Code 33-20-1302
• Viatical settlement purchaser: means a person who, for the purpose of deriving an economic benefit:

  (i)gives consideration for a life insurance policy or an interest in the death benefits of a life insurance policy; or

  (ii)owns, acquires, or is entitled to a beneficial interest in a trust that owns a viatical settlement contract or that is the beneficiary of a life insurance policy that has been or will be the subject of a viatical settlement contract. See Montana Code 33-20-1302

• Viator: means the owner of a life insurance policy or the certificate holder under a group policy who enters or seeks to enter into a viatical settlement contract. See Montana Code 33-20-1302
• 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
• Warrant: means an instrument that gives the holder the right to purchase an underlying financial instrument at a given price and time or at a series of prices and times outlined in the warrant agreement. See Montana Code 33-12-102
• Willfully: when applied to the intent with which an act is done or omitted, means a purpose or willingness to commit the act or make the omission referred to. See Montana Code 1-1-204
• Writ of certiorari: An order issued by the Supreme Court directing the lower court to transmit records for a case for which it will hear on appeal.
• Writing: includes printing. See Montana Code 1-1-203