2022 Indiana Code
Title 25. Professions and Occupations
Article 1. General Provisions
Chapter 9.1. Out of Network Provider Referrals
25-1-9.1-5. "Health Plan"

Sec. 5. (a) As used in this chapter, "health plan" means:

(1) a policy of accident and sickness insurance (as defined in IC 27-8-5-1);

(2) an individual contract or a group contract with a health maintenance organization under IC 27-13; or

(3) another plan or program that provides payment, reimbursement, or indemnification for the costs of health care items or services;

that conditions the payment of benefits, in whole or in part, on a covered individual's use of providers that have agreed to be part of a network.

(b) The term does not include the following:

(1) Worker's compensation or similar insurance.

(2) Benefits provided under a certificate of exemption issued by the worker's compensation board under IC 22-3-2-5.

(3) Medicaid (IC 12-15).

As added by P.L.147-2017, SEC.1.