Ky. Rev. Stat. § 304.38A-010

Current through 2024 Ky. Acts ch. 225

Section 304.38A-010 - Definitions for subtitle

As used in this subtitle, unless the context requires otherwise:

(1) "Enrollee" means an individual who is enrolled in a limited health services benefit plan;

(2) "Evidence of coverage" means any certificate, agreement, contract, or other document issued to an enrollee stating the limited health services to which the enrollee is entitled. All coverages described in an evidence of coverage issued by a limited health service organization are deemed to be "limited health services benefit plans" to the extent defined in KRS 304.17C-010 unless exempted by the commissioner;

(3) "Limited health service" means dental care services, vision care services, mental health services, substance abuse services, chiropractic services, pharmaceutical services, podiatric care services, and such other services as may be determined by the commissioner to be limited health services. Limited health service shall not include hospital, medical, surgical, or emergency services except as these services are provided incidental to the limited health services set forth in this subsection;

(4) "Limited health service contract" means any contract entered into by a limited health service organization with a policyholder to provide limited health services;

(5) "Limited health service organization" means a corporation, partnership, limited liability company, or other entity that undertakes to provide or arrange limited health service or services to enrollees. A limited health service organization does not include a provider or an entity when providing or arranging for the provision of limited health services under a contract with a limited health service organization, health maintenance organization, or a health insurer; and

(6) "Provider" means the same as defined in KRS 304.17A-005(23).

KRS 304.38A-010

Effective:7/15/2010
Amended 2010, Ky. Acts ch. 24, sec. 1515, effective7/15/2010. --Amended 2006, Ky. Acts ch. 253, sec. 7, effective 7/12/2006. -- Amended 2005, Ky. Acts ch. 144, sec. 13, effective 6/20/2005. -- Created 2002, Ky. Acts ch. 105, sec. 10, effective 7/15/2002.