Kentucky Statutes 304.38-030 – Definitions for subtitle
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As used in this subtitle, unless the context otherwise requires:
(1) “Commissioner” means the commissioner of the Department of Insurance;
(2) “Enrollee” means a person who has been enrolled in a health maintenance organization;
(3) “Evidence of coverage” means any certificate, agreement, contract, or other document issued to an enrollee stating the health care services to which the enrollee is entitled. All coverages described in an evidence of coverage issued by a health maintenance organization are deemed to be “health benefit plans” to the extent defined in KRS § 304.17A-005 unless exempted by the commissioner;
(4) “Health care services” means any services included in the furnishing to any individual of medical, optometric, or dental care, or hospitalization or incident to the furnishing of such care or hospitalization, as well as the furnishing to any person of any and all other services and goods for the purpose of preventing, alleviating, curing, or healing human illness, physical disability, or injury;
(5) “Health maintenance organization” means any person who undertakes to provide, directly or through arrangements with others, health care services to individuals enrolled with such an organization on a per capita or a predetermined, fixed prepayment basis. A health maintenance organization is authorized to provide all health care services;
(6) “Person” includes but is not limited to any individual, partnership, association, trust, or corporation; and
(7) “Provider” means a person or group of persons licensed to practice medicine, osteopathy, dentistry, podiatry, optometry, or another health profession in a state or licensed to act as a hospital or another health care facility.
Effective: July 15, 2010
History: Amended 2010 Ky. Acts ch. 24, sec. 1498, effective July 15, 2010. — Amended 2002 Ky. Acts ch. 105, sec. 22, effective July 15, 2002. — Amended 2000
Ky. Acts ch. 427, sec. 1, effective July 14, 2000. — Created 1974 Ky. Acts ch. 357, subtit. 38, sec. 3, effective June 21, 1974.
(1) “Commissioner” means the commissioner of the Department of Insurance;
Terms Used In Kentucky Statutes 304.38-030
- Commissioner: means the commissioner of the Department of Insurance. See Kentucky Statutes 304.38-030
- Contract: A legal written agreement that becomes binding when signed.
- Enrollee: means a person who has been enrolled in a health maintenance organization. See Kentucky Statutes 304.38-030
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
- Health maintenance organization: means any person who undertakes to provide, directly or through arrangements with others, health care services to individuals enrolled with such an organization on a per capita or a predetermined, fixed prepayment basis. See Kentucky Statutes 304.38-030
- Person: includes but is not limited to any individual, partnership, association, trust, or corporation. See Kentucky Statutes 304.38-030
- State: when applied to a part of the United States, includes territories, outlying possessions, and the District of Columbia. See Kentucky Statutes 446.010
(2) “Enrollee” means a person who has been enrolled in a health maintenance organization;
(3) “Evidence of coverage” means any certificate, agreement, contract, or other document issued to an enrollee stating the health care services to which the enrollee is entitled. All coverages described in an evidence of coverage issued by a health maintenance organization are deemed to be “health benefit plans” to the extent defined in KRS § 304.17A-005 unless exempted by the commissioner;
(4) “Health care services” means any services included in the furnishing to any individual of medical, optometric, or dental care, or hospitalization or incident to the furnishing of such care or hospitalization, as well as the furnishing to any person of any and all other services and goods for the purpose of preventing, alleviating, curing, or healing human illness, physical disability, or injury;
(5) “Health maintenance organization” means any person who undertakes to provide, directly or through arrangements with others, health care services to individuals enrolled with such an organization on a per capita or a predetermined, fixed prepayment basis. A health maintenance organization is authorized to provide all health care services;
(6) “Person” includes but is not limited to any individual, partnership, association, trust, or corporation; and
(7) “Provider” means a person or group of persons licensed to practice medicine, osteopathy, dentistry, podiatry, optometry, or another health profession in a state or licensed to act as a hospital or another health care facility.
Effective: July 15, 2010
History: Amended 2010 Ky. Acts ch. 24, sec. 1498, effective July 15, 2010. — Amended 2002 Ky. Acts ch. 105, sec. 22, effective July 15, 2002. — Amended 2000
Ky. Acts ch. 427, sec. 1, effective July 14, 2000. — Created 1974 Ky. Acts ch. 357, subtit. 38, sec. 3, effective June 21, 1974.