Section 4702. Definitions

As used in this article: (a) "Community rating"
  means a rating methodology in which the premium equivalent rate for  all
  persons covered under a municipal cooperative health benefit plan is the
  same,  based  upon  the  experience  of the entire pool of risks covered
  under the plan, without regard to age, sex, health status or  occupation
  and  such  that  refunds,  rebates, credits or dividends based upon age,
  sex, health status or occupation are not permitted.
    (b) "Fully-insured" means that all  benefits  payable  pursuant  to  a
  municipal  cooperative  health  benefit  plan  are  guaranteed  under  a
  contract or policy of insurance delivered in this state and issued by an
  insurance  company  authorized  to  do  accident  and  health  insurance
  business  in this state, an article forty-three corporation, or a health
  maintenance organization.
    (c) "Governing board" means the group of persons,  designated  in  the
  municipal  cooperation  agreement establishing the municipal cooperative
  health benefit plan, to be responsible for administering the plan.
    (d) "Municipal cooperation agreement" means an appropriate cooperative
  agreement authorized by article five-G of the general municipal law.
    (e) "Municipal cooperative health benefit plan" or  "plan"  means  any
  plan  established  or  maintained  by two or more municipal corporations
  pursuant to  a  municipal  cooperation  agreement  for  the  purpose  of
  providing  medical,  surgical  or  hospital  services  to  employees  or
  retirees of such municipal corporations and to the  dependents  of  such
  employees or retirees.
    (f) "Municipal corporation" means within the state of New York, a city
  with  a population of less than one million or a county outside the city
  of New York, town, village, board of cooperative  educational  services,
  school  district,  a  public  library, as defined in section two hundred
  fifty-three of the education law, or district, as defined in section one
  hundred nineteen-n of the general municipal law.
    (g) "Plan document" means the group contract issued by  the  municipal
  cooperative  health benefit plan to participating municipal corporations
  describing the terms and conditions of coverage.
    (h) "Premium  equivalent"   or   "contribution"   means   the   amount
  contributed  by  participating  municipal corporations to cover expected
  claims and  expenses  thereon,  required  reserves,  surplus,  stop-loss
  insurance,  and  other  expenses  associated  with the operations of the
  municipal cooperative health benefit plan.
    (i) "Qualified actuary" means an actuary  who  is  a  member  in  good
  standing  of  the American Academy of Actuaries or Society of Actuaries,
  with experience in establishing rates for self-insured trusts  providing
  health benefits or other similar experience.
    (j) "Summary  plan  description"  means the certificate of coverage or
  booklet delivered  to  employees  or  retirees  enrolled  in  the  plan,
  summarizing the essential terms and conditions of coverage for employees
  or retirees and their dependents.