Definitions

Section 5101 Section 3801.30  Definitions Act means the Small Employer Health Insurance Rating Act [215 ILCS 93]. Actuarial Certification means a written statement that the small employer carrier meets the applicable provisions of the Act and this Part by a member of the American Academy of Actuaries or other pre-approved individual acceptable to the Director. Director means the Director of the Illinois Department of Insurance. Health Benefit Plan or Plan means any hospital or medical expense-incurred policy, hospital or medical service plan contract, or health maintenance organization subscriber contract.  Health benefit plan shall not include individual, accident-only, credit, dental, vision, Medicare supplement, hospital indemnity, long term care, specific disease, stop loss or disability income insurance, coverage issued as a supplement to liability insurance, workers' compensation or similar insurance, or automobile medical payment insurance. Review of Appropriate Records means a review conducted in accordance with the Actuarial Standards Board document entitled Actuarial Standards of Practice No. 23 which addresses the Data Quality issue and gives guidance on what level of review would be required in a review of appropriate records. Small 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 2 but not more than 50 employees on business days during the preceding calendar year and who employs at least 2 employees on the first day of the plan year. Small Employer Carrier means a carrier that offers health benefit plans covering employees of one or more small employers in this State.