For the purposes of this part:

1. (a) “Actuarial certification” means a written statement signed by a member of the American Academy of Actuaries;
2. (b) “Actuarial memorandum” means the document describing the basis on which rates were determined and that includes other supporting documentation as required;
3. (c) “Anticipated loss ratio” means the calculation of the medical loss ratio over a period that is at least as great as the anticipated policy lifetime that does not exceed 20 years;
4. (d) “Case characteristics” means demographic or other relevant characteristics considered by the individual carrier in the determination of premium rates for an individual;
5. (e) “Durational medical loss ratio” means the medical loss ratio calculated for a specified duration not to exceed 12 months;
6. (f) “Earned premium” means premium revenue pursuant to 45 CFR Part 158.130;
7. (g) “Earned premium adjustments” means federal and state taxes and licensing and regulatory fees pursuant to 45 CFR Part 158.161 (a) and 158.162 (a)(1) and (b)(1);
8. (h) “Health coverage” means “health coverage” as defined in RSA 420-G:2, IX;
9. (i) “Incurred claims” means reimbursements for clinical services provided to enrollees, pursuant to 45 CFR Part 158.140;
10. (j) “Medical loss ratio” means “medical loss ratio” as defined in 45 CFR Part 158.221(a);
11. (k) “Member” means “covered person” as defined in Ins 4101.04(c);
12. (l) “Premium” means the total amount due from a policyholder to an individual carrier for the provision of health coverage;
13. (m) “Premium rate” means an amount per covered person used to calculate premium;
14. (n) “Quality improvement expenses” means amounts expended for activities that improve health care quality pursuant to 45 CFR 158.150 and 45 CFR 158.151; and
15. (o) “Tier” means a category of enrollment to which enrolled individuals can elect coverage, and includes, at a minimum, “single person”, “couple”, and “family” tiers;

Source. #9690, eff 4-9-10; ss by #9938, eff 6-10-11; ss by #10212, eff 11-1-12; ss by #12799, eff 6-10-19