Ins 3.39(2)(d)1.1. A group policy issued to one or more employers or labor organizations, to the trustees of a fund established by one or more employers or labor organizations, or a combination of both, for employees or former employees or both, or for members or former members or both of the labor organizations; Ins 3.39(2)(d)3.3. Individual or group hospital, surgical, medical, major medical, or comprehensive medical expense coverage which continues after an insured becomes eligible for Medicare; or Ins 3.39(2)(e)(e) This section does not apply to either of the following: Ins 3.39(2)(e)1.1. A policy providing solely accident, dental, vision, disability income, or credit disability income coverage. Ins 3.39(2)(f)(f) This section may be enforced under ss. 601.41, 601.64, 601.65, Stats., or ch. 645, Stats., or any other enforcement provision of chs. 600 to 646, Stats., or Wisconsin Administrative Code Insurance chapters. Ins 3.39(3)(3) Definitions. In this section and for use in policies or certificates: Ins 3.39(3)(a)(a) “Accident,” “Accidental Injury,” or “Accidental Means” shall be defined to employ “result” language and shall not include words that establish an accidental means test or use words such as “external, violent, visible wounds” or similar words of description or characterization. Ins 3.39(3)(a)1.1. The definition shall not be more restrictive than the following: “Injury or injuries for which benefits are provided” means accidental bodily injury sustained by the insured person that is the direct result of an accident, independent of disease or bodily infirmity or any other cause, and occurs while insurance coverage is in force.” Ins 3.39(3)(a)2.2. The definition may provide that injuries shall not include injuries for which benefits are provided or available under any workers’ compensation, employer’s liability or similar law or motor vehicle no-fault plan, unless prohibited by law. Ins 3.39(3)(c)1.1. In the case of an individual Medicare supplement, Medicare select, or Medicare cost policy, the person who seeks to contract for insurance benefits. Ins 3.39(3)(c)2.2. In the case of a group Medicare supplement policy, the proposed certificateholder. Ins 3.39(3)(ce)(ce) “Balance bill” means seeking: to bill, charge, or collect a deposit, remuneration or compensation from; to file or threaten to file with a credit reporting agency; or to have any recourse against an insured or any person acting on the insured’s behalf for health care costs for which the insured is not liable. The prohibition on recovery does not affect the liability of an insured for any deductibles, coinsurance or copayments, or for premiums owed under the policy or certificate. Ins 3.39(3)(cs)(cs) “Bankruptcy” means when a Medicare Advantage 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. Ins 3.39(3)(d)(d) “Benefit period,” or “Medicare benefit period” shall not be defined more restrictively than as defined in the Medicare program. Ins 3.39(3)(e)(e) “CMS” means the Centers for Medicare & Medicaid Services within the U.S. department of health and human services. Ins 3.39(3)(f)(f) “Certificate” means a certificate delivered or issued for delivery in this state under a Medicare supplement policy or under a Medicare select policy that is issued on a group basis, i.e. employer retiree group. Ins 3.39(3)(g)(g) “Certificate form” means the form on which the certificate is delivered or issued for delivery by the issuer to a group that receives insurance coverage through a group Medicare supplement policy, or a group Medicare select policy. Ins 3.39(3)(gg)(gg) “Certificateholder” means an individual member of a group that is receives a certificate that identifies the individual as a participant in the group Medicare supplement policy or the group Medicare select policy issued in this state. Ins 3.39(3)(gr)(gr) “Complaint” means any dissatisfaction expressed by an individual concerning a Medicare select issuer or its network providers. Ins 3.39(3)(h)(h) “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. Ins 3.39(3)(i)1.1. “Creditable coverage” means with respect to an individual, coverage of the individual provided under any of the following: Ins 3.39(3)(i)1.c.c. Part A or Part B of Title XVIII of the social security act (Medicare); Ins 3.39(3)(i)1.d.d. Title XIX of the social security act (Medicaid), other than coverage consisting solely of benefits under section 1928;