Georgia Code
Chapter 43 - Medicare Supplement Insurance
§ 33-43-1. Definitions

As used in this chapter, the term:
(1.1) “Bankruptcy” means when a Medicare+Choice organization that is not an issuer has filed, or has had filed against it, a petition for declaration of bankruptcy and has ceased doing business in the state.
(3.1) “Continuous period of creditable coverage” means the period during which an individual was covered by creditable coverage if during the period of the coverage the individual had no breaks in coverage greater than 63 days.
(3.2) (A) “Creditable coverage” means, with respect to an individual, coverage of the individual provided under any of the following:
(3.3) “Employee welfare benefit plan” means a plan, fund, or program of employee benefits as defined in 29 U.S.C. Section 1002 (Employee Retirement Income Security Act).
(3.4) “Insolvency” means when an issuer, licensed to transact the business of insurance in this state, has had a final order of liquidation entered against it with a finding of insolvency by a court of competent jurisdiction in the issuer’s state of domicile.
(6.1) “Medicare+Choice plan” means a plan of coverage for health benefits under medicare Part C as defined in P.L. 105-33, and includes:
(B) Creditable coverage shall not include one or more, or any combination of, the following:
(i) Coverage only for accident or disability income insurance, or any combination thereof;
(ii) Coverage issued as a supplement to liability insurance;
(iii) Liability insurance, including general liability insurance and automobile liability insurance;
(iv) Workers’ compensation or similar insurance;
(v) Automobile medical payment insurance;
(vi) Credit only insurance;
(vii) Coverage for on-site medical clinics; or
(viii) Other similar insurance coverage, specified in the Code of Federal Regulations as of July 1, 2000, under which benefits for medical care are secondary or incidental to other insurance benefits.
(C) Creditable coverage shall not include the following benefits if they are provided under a separate policy, certificate, or contract of insurance or are otherwise not an integral part of the plan:
(i) Limited scope dental or vision benefits;
(ii) Benefits for long-term care, nursing home care, home health care, community based care, or any combination thereof; or
(iii) Such other similar, limited benefits as are specified in the Code of Federal Regulations as of July 1, 2000.
(D) Creditable coverage shall not include the following benefits if offered as independent, noncoordinated benefits:
(i) Coverage only for a specified disease or illness; or
(ii) Hospital indemnity or other fixed indemnity insurance.
(E) Creditable coverage shall not include the following if offered as a separate policy, certificate, or contract of insurance:
(i) Medicare supplemental health insurance as defined under Section 1882(g)(1) of the Social Security Act;
(ii) Coverage supplemental to the coverage provided under Chapter 55 of Title 10 of the United States Code; or
(iii) Similar supplemental coverage provided to coverage under a group health plan.
History. Code 1981, § 33-43-1 , enacted by Ga. L. 1992, p. 1395, § 1; Ga. L. 1993, p. 91, § 33; Ga. L. 1996, p. 705, § 17; Ga. L. 2000, p. 1246, § 6.
Code Commission notes.
Pursuant to Code Section 28-9-5, in 2000, “July 1, 2000” was substituted for “the effective date of this Act” in divisions (3.2)(B)(viii) and (3.2)(C)(iii).

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