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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).
Effective: July 15, 2010
History: Amended 2010 Ky. Acts ch. 24, sec. 1515, effective July 15, 2010. -Amended 2006 Ky. Acts ch. 253, sec. 7, effective July 12, 2006. -- Amended 2005
Ky. Acts ch. 144, sec. 13, effective June 20, 2005. -- Created 2002 Ky. Acts ch. 105,
sec. 10, effective July 15, 2002.
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