2023 New York Laws › ISC - Insurance › Article 77 - The Life and Health Insurance Company Guaranty Corporation of New York Act › 7705 - Definitions.

§ 7705. Definitions. As used in this article:
(a) "Account"  means  any  of  the  two accounts created under section
seven thousand seven hundred six of this article.
(b) "Contractual  obligations"  means  any  obligation  under  covered
policies,   but  shall  not  include  any  obligation  with  respect  to
policyholder dividends unpaid or unapplied, retrospective  rate  credits
or similar benefits or provisions.
(c) "Corporation" means The Life and Health Insurance Company Guaranty
Corporation  of  New  York  created  under  section seven thousand seven
hundred six of this article unless the context otherwise requires.
(d) "Covered policy" means any of the kinds of insurance specified  in
paragraph  one,  two  or three of subsection (a) of section one thousand
one hundred thirteen of this chapter, any supplemental contract, or  any
funding  agreement  referred  to  in  section three thousand two hundred
twenty-two of this chapter, or any portion or part thereof,  within  the
scope  of  this article under section seven thousand seven hundred three
of this article, except that any certificate  issued  to  an  individual
under  any group or blanket policy or contract shall be considered to be
a separate covered policy for purposes of section seven  thousand  seven
hundred eight of this article.
(e) "Health  insurance"  means  the kinds of insurance specified under
items (i) and (ii)  of  paragraph  three  and  paragraph  thirty-one  of
subsection  (a)  of  section  one  thousand one hundred thirteen of this
chapter, and section one thousand one hundred seventeen of this chapter;
medical expense indemnity, dental expense indemnity,  hospital  service,
or  health  service  under  article  forty-three  of  this  chapter; and
comprehensive health services under article  forty-four  of  the  public
health  law.  "Health  insurance"  shall  not include hospital, medical,
surgical, prescription drug, or other health care benefits pursuant  to:
(1)  part  C  of  title  XVIII  of  the social security act (42 U.S.C. §
1395w-21 et seq.) or part D of title XVIII of the  social  security  act
(42  U.S.C. § 1395w-101 et seq.), commonly known as Medicare parts C and
D, or any regulations promulgated thereunder; (2) titles XIX and XXI  of
the  social  security  act (42 U.S.C. § 1396 et seq.), commonly known as
the Medicaid and child health insurance  programs,  or  any  regulations
promulgated thereunder; (3) the basic health program under section three
hundred sixty-nine-gg of the social services law; (4) chapter 55 of part
II  of  subtitle A of title X (10 U.S.C §§ 1071-1110(b)), commonly known
as TRICARE, or any regulations promulgated thereunder; or (5) subpart  G
of  part  III  of title V (5 U.S.C. §§ 8101-9009), commonly known as the
Federal Employees Program, or any regulations promulgated thereunder.
(f) "Impaired  insurer"  means  a  member  insurer  which  after   the
effective  date of this article is found to be impaired for the purposes
of section one thousand three hundred ten or one thousand three  hundred
eleven  of  this  chapter  and  is consequently placed under an order of
liquidation, rehabilitation or conservation under  article  seventy-four
of this chapter.
(g) "Insolvent  insurer"  means  a  member  insurer  which  after  the
effective date of this article becomes insolvent  for  the  purposes  of
section  one  thousand  three hundred nine of this chapter and is placed
under a final order of liquidation, rehabilitation or conservation by  a
court of competent jurisdiction.
(h)  (1) "Member insurer" means:
(A)  any life insurance company licensed to transact in this state any
kind of insurance to which this  article  applies  under  section  seven
thousand  seven  hundred  three of this article; provided, however, that
the term "member insurer" also means any life insurance company formerly
licensed to transact in this state any kind of insurance to  which  this

article applies under section seven thousand seven hundred three of this
article; and
(B)  an  insurer  licensed  or formerly licensed to write accident and
health  insurance  or  salary  protection  insurance  in   this   state,
corporation  organized  pursuant to article forty-three of this chapter,
reciprocal insurer organized  pursuant  to  article  sixty-one  of  this
chapter, cooperative property/casualty insurance company operating under
or   subject   to   article   sixty-six   of   this  chapter,  nonprofit
property/casualty  insurance  company  organized  pursuant  to   article
sixty-seven   of  this  chapter,  and  health  maintenance  organization
certified pursuant to article forty-four of the public health law.
(2) "Member insurer" shall not include a municipal cooperative  health
benefit  plan  established  pursuant  to  article  forty-seven  of  this
chapter, an employee welfare fund registered under article forty-four of
this chapter,  a  fraternal  benefit  society  organized  under  article
forty-five  of  this  chapter, an institution of higher education with a
certificate  of  authority  under  section  one  thousand  one   hundred
twenty-four  of  this chapter, or a continuing care retirement community
with a certificate of authority under article forty-six  or  forty-six-A
of the public health law.
(i) "Premiums"  means  direct gross insurance premiums and annuity and
funding agreement considerations  received  on  covered  policies,  less
return  premiums  and  considerations  thereon  and  dividends  paid  or
credited to policyholders or contract holders on such  direct  business,
subject  to  such  modifications  as the superintendent may establish by
regulation  or  order  as  necessary   to   facilitate   the   equitable
administration  of  this  article.  Premiums do not include premiums and
considerations on contracts between insurers  and  reinsurers.  For  the
purposes  of  determining  the  assessment  for  an  insurer  under this
article, the term "premiums", with respect to a group  annuity  contract
(or  portion  of  any  such  contract)  that  does not guarantee annuity
benefits to any specific individual identified in the contract and  with
respect  to  any  funding  agreement  issued  to fund benefits under any
employee benefit plan, means the lesser of one million  dollars  or  the
premium  attributable  to  that portion of such group contract that does
not guarantee benefits to any specific individuals  or  such  agreements
that fund benefits under any employee benefit plan.
(j) "Person"  means  any  individual  or  legal  entity,  including  a
corporation, partnership, association, limited liability company, trust,
or voluntary organization.
(k) "Resident" means a person to whom a contractual obligation is owed
and who either: (1) resides in this state on the  date  of  entry  of  a
court  order  of  liquidation or rehabilitation with respect to a member
insurer that is an impaired or insolvent insurer; or (2) resided in this
state at the time a member insurer  issued  a  covered  policy  to  such
person.
(l)  "Supplemental contract" means an agreement or any other mechanism
for the distribution of proceeds under a life insurance  policy,  health
insurance policy, annuity contract, or funding agreement.
(m)  "Long-term  care  insurance" means an insurance policy, rider, or
certificate  advertised,  marketed,  offered,  or  designed  to  provide
coverage,  subject  to  eligibility  requirements,  for  not  less  than
twenty-four consecutive months for each covered  person  on  an  expense
incurred,  indemnity,  prepaid  or other basis and provides at least the
benefits set forth in part fifty-two of title  eleven  of  the  official
compilation of codes, rules and regulations of this state.