Definitions

01. Accident Only Coverage. “Accident Only Coverage” means a policy or certificate that provides coverage, singly or in combination, for death, dismemberment, disability or hospital and medical care caused by an accident, and does not provide coverage for non-accidents. (7-1-24) 02. Dental Coverage. “Dental Coverage” means a policy or certificate that primarily provides benefits for dental expenses. (7-1-24) 03. Disability Income Protection Coverage. “Disability Income Protection Coverage” means a policy or certificate that provides for periodic payments, weekly or monthly, for a specified period during the continuance of disability resulting from either sickness or injury or a combination of both. (7-1-24) 04. Hospital Confinement Indemnity Coverage. “Hospital Confinement Indemnity Coverage” means a policy or certificate of accident and sickness insurance that provides daily benefits for hospital confinement on an indemnity basis, meaning the benefit is a fixed dollar amount per day of confinement, regardless of the expenses incurred. (7-1-24) 05. Limited Benefit Health Coverage. “Limited Benefit Health Coverage” means a policy or certificate that provides benefits that are less than the minimum standards under Sections 035 through 039 of this chapter. (7-1-24) IDAHO ADMINISTRATIVE CODE IDAPA 18.04.08 Department of Insurance Individual / Group Supplementary Disability Insurance Rules Section 011 Page 4 06. Major Medical Expense Coverage. “Major Medical Expense Coverage” means a policy of accident and sickness insurance that provides hospital, medical and surgical expense coverage. (7-1-24) 07. Specified Accident Coverage. “Specified Accident Coverage” means a policy or certificate that provides coverage for a specifically identified kind of accident (or accidents) for each person insured under the coverage for accidental death or accidental death and dismemberment combined. (7-1-24) 08. Specified Disease Coverage. “Specified Disease Coverage” means a policy or certificate that pays benefits only after the diagnosis of a specifically named disease or diseases. (7-1-24) 09. Vision Coverage. “Vision Coverage” means a policy or certificate that primarily provides benefits for vision expenses. (7-1-24)