Iowa Administrative Code › Agency 191 - Insurance Division › Life and Health Insurance › Chapter 37 - Medicare Supplement Insurance › Rule 191-37.52 - Definitions

Current through Register Vol. 47, No. 3, July 24, 2024
In addition to the definitions in Iowa Code section
				  507B2. and rule
				  191-152. (5-107B),
				  the following definitions shall apply to 191-Chapter 37, Division II. When
				  there is a definition for a term in this rule and also in Iowa Code section
				  507B2. or rule
				  191-152. (507B), the
				  definition in this rule shall take precedence.
"Advertisement"
includes:
1. The definition of "advertisement" in rule
				191-152.
				(507B).
2. Advertising material
				included with a policy when the policy is delivered and material used in the
				solicitation of renewals and reinstatements.
3. The definition of "advertisement" does not
				include:
* Items excluded in the definition of "advertisement" in rule
				  191-15.2(507B).
* Correspondence between a prospective group or blanket
				  policyholder and an insurer in the course of negotiating a group or blanket
				  contract.
* Court-approved material ordered by a court to be
				  disseminated to policyholders.
"Certificate"
means any certificate issued
				  under a group Medicare supplement policy, which certificate has been delivered
				  or issued for delivery in this state.
"Institutional advertisement"
means an
				  advertisement having as its sole purpose the promotion of the reader's,
				  viewer's or listener's interest in the concept of Medicare supplement
				  insurance, or the promotion of the insurer as a seller of Medicare supplement
				  insurance.
"Lead-generating device"
means any
				  communication directed to the public that, regardless of form, content or
				  stated purpose, is intended to result in the compilation or qualification of a
				  list containing names and other personal information to be used to solicit
				  residents of this state for the purchase of Medicare supplement
				  insurance.
"Limitation"
means any provision other than
				  an exception or a reduction that restricts coverage under the policy.
"Medicare"
means "The Health Insurance for
				  the Aged Act, Title XVIII of The Social Security Amendments of 1965 as Then
				  Constituted or Later Amended," or Title I, Part I, of Public Law 89-97, as
				  enacted by the Eighty-Ninth Congress of the United States of America, and also
				  known as the "Health Insurance for the Aged Act, as then constituted and any
				  later amendments or substitutes thereof," or words of similar import.
"Medicare supplement insurance"
means a
				  group or individual policy of accident and sickness insurance or a subscriber
				  contract of hospital and medical service associations or health maintenance
				  organizations that is advertised, marketed or designed primarily as a
				  supplement to reimbursements under Medicare for the hospital, medical or
				  surgical expenses of persons eligible for Medicare by reason of age.
"Person"
means a natural person,
				  association, organization, partnership, trust, group, discretionary group,
				  corporation or any other entity.
"Reduction"
means any provision that reduces
				  the amoimt of the benefit; a risk of loss is assumed but payment upon the
				  occurrence of the loss is limited to some amount or period less than would be
				  otherwise payable had the reduction not been used.