38.2-1701 - Definitions.

§ 38.2-1701. Definitions.

As used in this chapter:

"Account" means any one of the two accounts created under § 38.2-1702.

"Association" means the Virginia Life, Accident and Sickness InsuranceGuaranty Association created under § 38.2-1702.

"Authorized assessment" or the term "authorized" when used in the contextof assessments means that a resolution by the board of directors has beenpassed whereby an assessment will be called immediately or in the future frommember insurers for a specified amount. An assessment is authorized when theresolution is passed.

"Benefit plan" means a specific employee, union, or association of naturalpersons benefit plan.

"Called assessment" or the term "called" when used in the context ofassessments means that a notice has been issued by the Association to memberinsurers requiring that an authorized assessment be paid within the timeframe set forth within the notice. An authorized assessment becomes a calledassessment when notice is mailed by the Association to member insurers.

"Contractual obligation" means an obligation under a policy or contract orcertificate under a group policy or contract, or portion thereof for whichcoverage is provided under § 38.2-1700.

"Covered policy" means a policy or contract or portion of a policy orcontract for which coverage is provided under § 38.2-1700.

"Extra-contractual claims" shall include, for example, claims relating tobad faith in the payment of claims, punitive or exemplary damages, orattorney fees and costs.

"Impaired insurer" means a member insurer considered by the Commission tobe potentially unable to fulfill its contractual obligations.

"Insolvent insurer" means a member insurer that is placed under an order ofliquidation by a court of competent jurisdiction with a finding of insolvency.

"Member insurer" means an insurer licensed to transact in this Commonwealthany class of insurance to which this chapter applies under § 38.2-1700,including an insurer whose license to transact the business of insurance inthe Commonwealth has been suspended, revoked, not renewed or voluntarilywithdrawn, but does not include cooperative nonprofit life benefit companies,health maintenance organizations, mutual assessment life, accident andsickness insurance companies, burial societies, fraternal benefit societies,dental and optometric services plans, and health services plans not subjectto this chapter pursuant to § 38.2-4213.

"Moody's Corporate Bond Yield Average" means the Monthly Average Corporatesas published by Moody's Investors Service, Inc., or any successor thereto.

"Owner" of a policy or contract or "policy owner" and "contract owner"means the person who is identified as the legal owner under the terms of thepolicy or contract or who is otherwise vested with legal title to the policyor contract through a valid assignment completed in accordance with the termsof the policy or contract and properly recorded as the owner on the books ofthe insurer. The terms "owner," "contract owner," and "policy owner" donot include persons with a mere beneficial interest in a policy or contract.

"Plan sponsor" means: (i) the employer, in the case of a benefit planestablished or maintained by a single employer; (ii) the employeeorganization in the case of a benefit plan established or maintained by anemployee organization; or (iii) in the case of a benefit plan established ormaintained by two or more employers or jointly by one or more employers andone or more employee organizations, the association, committee, joint boardof trustees, or other similar group of representatives of the parties whoestablish or maintain the benefit plan.

"Premiums" means amounts or considerations, by whatever name called,received on covered policies or contracts, less any returned premiums,considerations, and deposits and less dividends and experience credits."Premiums" does not include amounts or considerations received for policiesor contracts or for the portions of policies or contracts for which coverageis not provided under subsection C of § 38.2-1700 except that assessablepremium shall not be reduced on account of subdivision C 2 of § 38.2-1700relating to interest limitations and subsection D 2 of § 38.2-1700 relatingto limitations with respect to one individual, one participant, and onecontract owner. "Premiums" shall not include (i) premiums for coverage inexcess of $5 million on an unallocated annuity contract covered undersubdivision D 2 d of § 38.2-1700 or (ii) with respect to multiple nongrouppolicies of life insurance owned by one owner, whether the policy owner is anindividual, firm, corporation, or other person, and whether the personsinsured are officers, managers, employees or other persons, premiums forcoverage in excess of $5 million with respect to these policies or contracts,regardless of the number of policies or contracts held by the owner.

"Principal place of business" of a plan sponsor or a person other than anatural person means the single state in which the natural persons whoestablish policy for the direction, control, and coordination of theoperations of the entity as a whole primarily exercise that function,determined by the Association in its reasonable judgment by considering thefollowing factors: (i) the state in which the primary executive andadministrative headquarters of the entity is located; (ii) the state in whichthe principal office of the chief executive officer of the entity is located;(iii) the state in which the board of directors (or similar governing personor persons) of the entity conducts the majority of its meetings; (iv) thestate from which the management of the overall operations of the entity isdirected; and in the case of a benefit plan sponsored by affiliated companiescomprising a consolidated corporation, the state in which the holding companyor controlling affiliate has its principal place of business as determinedusing these factors. However, in the case of a plan sponsor, if more than 50percent of the participants in the benefit plan are employed in a singlestate, that state shall be deemed to be the principal place of business ofthe plan sponsor. The principal place of business of a plan sponsor describedin clause (iii) of the definition of plan sponsor in this section shall bedeemed to be the principal place of business of the association, committee,joint board of trustees, or other similar group of representatives of theparties who establish or maintain the benefit plan that, in lieu of aspecific or clear designation of a principal place of business, shall bedeemed to be the principal place of business of the employer or employeeorganization that has the largest investment in the benefit plan in question.

"Receivership court" means the court in the insolvent or impaired insurer'sstate having jurisdiction over the conservation, rehabilitation, orliquidation of the insurer.

"Resident" means a person to whom a contractual obligation is owed and whoresides in the Commonwealth on the date a member insurer becomes an impairedinsurer or a court order is entered that determines a member insurer to be aninsolvent insurer. A person may be a resident of only one state, which in thecase of a person other than a natural person shall be its principal place ofbusiness. Citizens of the United States that are either (i) residents offoreign countries, or (ii) residents of United States possessions,territories, or protectorates that do not have an association similar to theAssociation, shall be deemed residents of the state of domicile of theinsurer that issued the policies or contracts.

"Structured settlement annuity" means an annuity purchased in order to fundperiodic payments for a plaintiff or other claimant in payment for or withrespect to personal injury or sickness suffered by the plaintiff or otherclaimant.

"Supplemental contract" means a written agreement entered into for thedistribution of proceeds under a life, health, or annuity policy or contract.

"Unallocated annuity contract" means an annuity contract or group annuitycertificate that is not issued to and owned by an individual or a trustcreated by an individual for the benefit of one or more individuals, exceptto the extent of any annuity benefits guaranteed to an individual or such atrust by an insurer under the contract or certificate.

(1976, c. 330, § 38.1-482.19; 1980, c. 186; 1986, c. 562; 2010, c. 510.)