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Arkansas Code Title 23. Public Utilities and Regulated Industries § 23-99-1801. Definitions

Current as of March 28, 2024 | Updated by Findlaw Staff

As used in this subchapter:

(1) “Enrollee” means an individual who is entitled to receive healthcare services under the terms of a health benefit plan;

(2) “Ground ambulance services” means services authorized and licensed by the Department of Health to provide care and transportation of patients upon the streets and highways of Arkansas;

(3) “Ground ambulance service provider” means an entity that provides ambulance transportation and emergency medical services to a patient;

(4)(A) “Health benefit plan” means a plan, policy, contract, certificate, agreement, or other evidence of coverage for healthcare services offered, issued, renewed, or extended in this state by a healthcare insurer.

(B) “Health benefit plan” includes nonfederal governmental plans as defined in 29 U.S.C. § 1002(32), as it existed on January 1, 2023.

(C) “Health benefit plan” does not include:

(i) A disability income plan;

(ii) A credit insurance plan;

(iii) Insurance coverage issued as a supplement to liability insurance;

(iv) A medical payment under automobile or homeowners insurance plans;

(v) A health benefit plan provided under Arkansas Constitution, Article 5, § 32, the Workers' Compensation Law, § 11-9-101 et seq., or the Public Employee Workers' Compensation Act, § 21-5-601 et seq.;

(vi) A plan that provides only indemnity for hospital confinement;

(vii) An accident-only plan;

(viii) A specified disease plan;

(ix) A long-term-care-only plan;

(x) A dental-only plan;

(xi) A vision-only plan;

(xii) Medicaid; or

(xiii) A state or local governmental employee plan; and

(5)(A) “Healthcare insurer” means an entity that is subject to state insurance regulation and provides coverage for health benefits in this state.

(B) “Healthcare insurer” includes:

(i) An insurance company;

(ii) A health maintenance organization;

(iii) A hospital and medical service corporation;

(iv) A risk-based provider organization; and

(v) A sponsor of a nonfederal self-funded governmental plan.

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Cite this article: FindLaw.com - Arkansas Code Title 23. Public Utilities and Regulated Industries § 23-99-1801. Definitions - last updated March 28, 2024 | https://codes.findlaw.com/ar/title-23-public-utilities-and-regulated-industries/ar-code-sect-23-99-1801/

FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.

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