(1) "Act"means the Workers' Compensation Act in Article 1 of Chapter 97 of the GeneralStatutes, as amended.
(2) "Affiliate"has the same meaning as in G.S. 58‑19‑5(1).
(3) "Annual statementfiling" means the most recent annual filing made with the Commissionerunder G.S. 58‑2‑165.
(4) "Board"means the board of trustees or other governing body of a group.
(5) "Books andrecords" means all files, documents, and databases in a paper form,electronic medium, or both.
(6) "Control"means "control" as defined in G.S. 58‑19‑5(2).
(7) "GAAP financialstatement" means a financial statement as defined by generally acceptedaccounting principles.
(8) "Group"means two or more employers who agree to pool their workers' compensationliabilities under the Act and are licensed under this Part.
(9) "Hazardousfinancial condition" means that, based on its present or reasonablyanticipated financial condition, a person is insolvent or, although not financiallyimpaired or insolvent, is unlikely to be able:
a. To meet obligationsfor known claims and reasonably anticipated claims; or
b. To pay otherobligations in the normal course of business.
(10) "Member"means an employer that participates in a group.
(11) "Qualifiedactuary" means a member in good standing of the Casualty Actuarial Societyor a member in good standing of the American Academy of Actuaries, who has beenapproved as qualified for signing casualty loss reserve opinions by the CasualtyPractice Council of the American Academy of Actuaries, and is in compliancewith G.S. 58‑2‑171.
(12) "Rate"means the cost of insurance per exposure unit, whether expressed as a singlenumber or as a prospective loss cost with an adjustment to account for thetreatment of expenses, profit, and variations in loss experience, before anyapplication of individual risk variations based on loss or expenseconsiderations, and does not include minimum premiums.
(13) "Servicecompany" means an entity that has contracted with an employer or group forthe purpose of providing any services related to claims adjustment, losscontrol, or both.
(14) "Third‑partyadministrator" or "TPA" means a person engaged by a board toexecute the policies established by the board and to provide day‑to‑daymanagement of the group. "Third‑party administrator" or"TPA" does not mean:
a. An employer actingon behalf of its employees or the employees of one or more of its affiliates.
b. An insurer that islicensed under this Chapter or that is acting as an insurer with respect to apolicy lawfully issued and delivered by it and under the laws of a state inwhich the insurer is licensed to write insurance.
c. An agent or brokerwho is licensed by the Commissioner under Article 33 of this Chapter whoseactivities are limited exclusively to the sale of insurance.
d. An adjuster licensedby the Commissioner under Article 33 of this Chapter whose activities arelimited to adjustment of claims.
e. An individual who isan officer, a member, or an employee of a board.
(15) "Underwriting"means the process of selecting risks and classifying them according to theirdegrees of insurability so that the appropriate rates may be assigned. Theprocess also includes rejection of those risks that do not qualify. (1997‑362, s. 3; 2001‑223,s. 21.1.)
(1) "Act"means the Workers' Compensation Act in Article 1 of Chapter 97 of the GeneralStatutes, as amended.
(2) "Affiliate"has the same meaning as in G.S. 58‑19‑5(1).
(3) "Annual statementfiling" means the most recent annual filing made with the Commissionerunder G.S. 58‑2‑165.
(4) "Board"means the board of trustees or other governing body of a group.
(5) "Books andrecords" means all files, documents, and databases in a paper form,electronic medium, or both.
(6) "Control"means "control" as defined in G.S. 58‑19‑5(2).
(7) "GAAP financialstatement" means a financial statement as defined by generally acceptedaccounting principles.
(8) "Group"means two or more employers who agree to pool their workers' compensationliabilities under the Act and are licensed under this Part.
(9) "Hazardousfinancial condition" means that, based on its present or reasonablyanticipated financial condition, a person is insolvent or, although not financiallyimpaired or insolvent, is unlikely to be able:
a. To meet obligationsfor known claims and reasonably anticipated claims; or
b. To pay otherobligations in the normal course of business.
(10) "Member"means an employer that participates in a group.
(11) "Qualifiedactuary" means a member in good standing of the Casualty Actuarial Societyor a member in good standing of the American Academy of Actuaries, who has beenapproved as qualified for signing casualty loss reserve opinions by the CasualtyPractice Council of the American Academy of Actuaries, and is in compliancewith G.S. 58‑2‑171.
(12) "Rate"means the cost of insurance per exposure unit, whether expressed as a singlenumber or as a prospective loss cost with an adjustment to account for thetreatment of expenses, profit, and variations in loss experience, before anyapplication of individual risk variations based on loss or expenseconsiderations, and does not include minimum premiums.
(13) "Servicecompany" means an entity that has contracted with an employer or group forthe purpose of providing any services related to claims adjustment, losscontrol, or both.
(14) "Third‑partyadministrator" or "TPA" means a person engaged by a board toexecute the policies established by the board and to provide day‑to‑daymanagement of the group. "Third‑party administrator" or"TPA" does not mean:
a. An employer actingon behalf of its employees or the employees of one or more of its affiliates.
b. An insurer that islicensed under this Chapter or that is acting as an insurer with respect to apolicy lawfully issued and delivered by it and under the laws of a state inwhich the insurer is licensed to write insurance.
c. An agent or brokerwho is licensed by the Commissioner under Article 33 of this Chapter whoseactivities are limited exclusively to the sale of insurance.
d. An adjuster licensedby the Commissioner under Article 33 of this Chapter whose activities arelimited to adjustment of claims.
e. An individual who isan officer, a member, or an employee of a board.
(15) "Underwriting"means the process of selecting risks and classifying them according to theirdegrees of insurability so that the appropriate rates may be assigned. Theprocess also includes rejection of those risks that do not qualify. (1997‑362, s. 3; 2001‑223,s. 21.1.)
(1) "Act"means the Workers' Compensation Act in Article 1 of Chapter 97 of the GeneralStatutes, as amended.
(2) "Affiliate"has the same meaning as in G.S. 58‑19‑5(1).
(3) "Annual statementfiling" means the most recent annual filing made with the Commissionerunder G.S. 58‑2‑165.
(4) "Board"means the board of trustees or other governing body of a group.
(5) "Books andrecords" means all files, documents, and databases in a paper form,electronic medium, or both.
(6) "Control"means "control" as defined in G.S. 58‑19‑5(2).
(7) "GAAP financialstatement" means a financial statement as defined by generally acceptedaccounting principles.
(8) "Group"means two or more employers who agree to pool their workers' compensationliabilities under the Act and are licensed under this Part.
(9) "Hazardousfinancial condition" means that, based on its present or reasonablyanticipated financial condition, a person is insolvent or, although not financiallyimpaired or insolvent, is unlikely to be able:
a. To meet obligationsfor known claims and reasonably anticipated claims; or
b. To pay otherobligations in the normal course of business.
(10) "Member"means an employer that participates in a group.
(11) "Qualifiedactuary" means a member in good standing of the Casualty Actuarial Societyor a member in good standing of the American Academy of Actuaries, who has beenapproved as qualified for signing casualty loss reserve opinions by the CasualtyPractice Council of the American Academy of Actuaries, and is in compliancewith G.S. 58‑2‑171.
(12) "Rate"means the cost of insurance per exposure unit, whether expressed as a singlenumber or as a prospective loss cost with an adjustment to account for thetreatment of expenses, profit, and variations in loss experience, before anyapplication of individual risk variations based on loss or expenseconsiderations, and does not include minimum premiums.
(13) "Servicecompany" means an entity that has contracted with an employer or group forthe purpose of providing any services related to claims adjustment, losscontrol, or both.
(14) "Third‑partyadministrator" or "TPA" means a person engaged by a board toexecute the policies established by the board and to provide day‑to‑daymanagement of the group. "Third‑party administrator" or"TPA" does not mean:
a. An employer actingon behalf of its employees or the employees of one or more of its affiliates.
b. An insurer that islicensed under this Chapter or that is acting as an insurer with respect to apolicy lawfully issued and delivered by it and under the laws of a state inwhich the insurer is licensed to write insurance.
c. An agent or brokerwho is licensed by the Commissioner under Article 33 of this Chapter whoseactivities are limited exclusively to the sale of insurance.
d. An adjuster licensedby the Commissioner under Article 33 of this Chapter whose activities arelimited to adjustment of claims.
e. An individual who isan officer, a member, or an employee of a board.
(15) "Underwriting"means the process of selecting risks and classifying them according to theirdegrees of insurability so that the appropriate rates may be assigned. Theprocess also includes rejection of those risks that do not qualify. (1997‑362, s. 3; 2001‑223,s. 21.1.)
