[§432:1-406]  Definitions.  As used inthis article:

"Health care expenditures" meansclaims incurred.

"Managed hospital payment basis"means agreements wherein the financial risk is primarily related to the degreeof utilization rather than to the cost of services.

"Member" means an individual who iscovered by a mutual benefit society.

"Net worth" means the excess of totaladmitted assets over total liabilities, but the liabilities shall not includefully subordinated debt.

"Operating expenses" means claimsadjustment, administrative, soliciting, and reinsurance allowances.

"Society" means mutual benefitsociety.

"Uncovered expenditures" means thecosts to the mutual benefit society for health care services that are theobligation of the mutual benefit society, for which a member may be liable inthe event of the mutual benefit society's insolvency, and for which noalternative arrangements have been made that are acceptable to thecommissioner.  Uncovered expenditures do not include expenditures for serviceswhen a provider has agreed not to bill the member even though the provider isnot paid by the mutual benefit society, or for services that are guaranteed,insured, or assumed by a person or organization other than a mutual benefitsociety. [L 1997, c 367, pt of §1]