40 Pa. Stat. § 3801.301
The following words and phrases when used in this chapter shall have the meanings given to them in this section unless the context clearly indicates otherwise:
"Commissioner." The Insurance Commissioner of the Commonwealth.
"Company,""association" or "exchange." An entity defined in section 101 of the act of May 17, 1921 (P.L. 682, No. 284), known as The Insurance Company Law of 1921.
"Department." The Insurance Department of the Commonwealth.
"Filing." A form or rate required by section 3.
"Form." A policy, contract, certificate, evidence of coverage, application, rider or endorsement affording insurance coverage or benefit against loss from sickness or loss or damage from bodily injury or death of the insured by accident and each modification of any of the above.
"Fraternal benefits society." An entity organized and operating under the act of December 14, 1992 (P.L. 835, No. 134) , known as the Fraternal Benefit Societies Code.
"Group accident and health insurance." A form affording insurance coverage against death, injury, disablement, disease or sickness resulting from an accident and covering a large or small group. The term shall not include blanket accident insurance policies or franchise accident and sickness insurance policies as defined in sections 621.3 and 621.4 of the act of May 17, 1921 (P.L. 682, No. 284), known as The Insurance Company Law of 1921.
"Health care provider." A person, corporation, facility, institution or other entity licensed, certified or approved by the Commonwealth to provide health care or professional medical services. The term includes, but is not limited to, physicians, professional nurses, certified nurse-midwives, podiatrists, hospitals, nursing homes, ambulatory surgical centers or birth centers.
"Health maintenance organization" or "HMO." An entity organized and operating under the act of December 29, 1972 (P.L. 1701, No. 364), known as the Health Maintenance Organization Act.
"Hospital plan corporation." An entity organized and operating under 40 Pa.C.S. Ch. 61 (relating to hospital plan corporations).
"Insurer." A foreign or domestic company, association or exchange, hospital plan corporation, professional health services plan corporation, fraternal benefits society, health maintenance organization and risk-assuming preferred provider organization.
"Preferred provider organization." An entity organized and operating under section 630 of the act of May 17, 1921 (P.L. 682, No. 284), known as The Insurance Company Law of 1921.
"Professional health services plan corporation." An entity organized and operating under 40 Pa.C.S. Ch. 63 (relating to professional health services plan corporations).
"Provider contracts." An agreement made between an insurer and a health care provider regarding the provision of any payment for health care services. The term shall not include contracts or related documents which are subject to the exclusive approval of the Department of Health under 40 Pa.C.S. § 6324 (relating to rights of health service doctors) and section 630 of the act of May 17, 1921 (P.L. 682, No. 284), known as The Insurance Company Law of 1921.
"Rate." A manual of classification, rules and rates, each rating plan and each modification of any of the above.
"Small group." A group that purchases accident and health insurance in the small group market, as defined in section 2791(e)(5) of the Public Health Service Act (110 Stat. 1972, 42 U.S.C. § 300gg - 91(e)(5) ), provided, however, that for plan years beginning prior to January 1, 2016, or other date as established in Federal law, "50 employees" is substituted for "100 employees" in the definition of "small employer" in section 2791(e)(4) of the Public Health Service Act.
"Statement of policy." A document as defined in 45 Pa.C.S. § 501 (relating to definitions), provided that the document has been published in the Pennsylvania Bulletin.
40 P.S. § 3801.301