2010 Georgia Code
TITLE 33 - INSURANCE
CHAPTER 18 - NONPROFIT MEDICAL SERVICE CORPORATIONS
§ 33-18-2 - Definitions

O.C.G.A. 33-18-2 (2010)
33-18-2. Definitions


As used in this chapter, the term:

(1) "Additional services and supplies" means private duty nursing care and licensed practical nursing care; physiotherapy; local ambulance service; drugs and medications outside of the hospital; therapeutic services and equipment, including oxygen, the rental of oxygen equipment, hospital beds, and iron lungs; orthopedic services and appliances, including wheelchairs, trusses, braces, and crutches; and prosthetic devices, including artificial limbs and eyes. Nonprofit medical service corporations are authorized to purchase, rent, contract for, or otherwise compensate for such additional services and supplies; and reimbursement may be made either directly to those furnishing such additional services and supplies or to the subscriber or member. Such additional services and supplies shall not include hospital services.

(2) "Beneficiary" or "covered dependent" means a person designated in the subscription contract or application therefor as entitled to the medical services referred to in paragraph (5) of this Code section, with respect to whom appropriate dues are specified in writing between the medical service corporation and the member holding such certificate.

(3) "Medical service corporation" means a corporation organized without capital stock and not for profit and incorporated in accordance with Code Section 33-18-4 specifically for the purpose of establishing, maintaining, and operating a nonprofit medical service plan.

(4) "Medical service plan" means a plan or arrangement under which medical services are or may be rendered to a subscriber, a covered dependent, or other beneficiary by a licensed physician and surgeon, dentist, or podiatrist and under which additional services and supplies are or may be rendered to a subscriber, a covered dependent, or other beneficiary by another person or persons at the expense of a medical service corporation, as defined in paragraph (3) of this Code section, in consideration of periodical payments made by the subscriber or another in his behalf prior to the occurrence of the condition calling for the rendition of medical or surgical, dental, or podiatric services or additional services and supplies.

(5) "Medical services" means the general and usual services and care rendered and administered by doctors of medicine, dental surgery, and podiatry. It shall not include hospital service.

(6) "Participating physician" means a doctor of medicine licensed to practice medicine and surgery in this state under Chapter 34 of Title 43 or a dental surgeon licensed to practice dental surgery in this state under Chapter 11 of Title 43, or a podiatrist licensed to practice podiatry in this state under Chapter 35 of Title 43, who agrees in writing with a medical service corporation to perform the medical services specified in the subscription certificates issued by the medical service corporation and at such rates of compensation as shall be determined by the board of directors of the medical service corporation and who agrees to abide by the bylaws, rules, and regulations of the medical service corporation applicable to participating physicians.

(7) "Person" means a natural person, a copartnership, an association, a common-law trust, or a corporation.

(8) "Subscriber" or "member" means a person to whom a subscription certificate is issued by a medical service corporation, which certificate sets forth the kinds and extent of the medical services for which the medical service corporation is liable to make payment.