Definitions

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As used in this subchapter:

  1. (1) “Commissioner” means the Insurance Commissioner;

  2. (2) “Covered person” means a person covered by a health plan including an enrollee, subscriber, policyholder, beneficiary of a group plan, or individual covered by any other health plan;

  3. (3) “Dentist” means a person licensed under the Arkansas Dental Practice Act, § 17-82-101 et seq.;

  4. (4) “Healthcare service” means that service offered or provided by the healthcare providers within the scope of their practice and relating to the prevention, cure, or treatment of illness or disease;

  5. (5) “Health carrier” means any insurance company, health maintenance organization, or hospital and medical service corporation as defined in § 23-75-101, subject to the following laws:

    1. (A) The Arkansas Insurance Code;

    2. (B) Provisions pertaining to health maintenance organizations, § 23-76-101 et seq.; and

    3. (C) Any successor laws of the foregoing; and

  6. (6) “Health plan” means any policy, contract, or agreement offered by a health carrier to provide, reimburse, or pay for healthcare services except the following:

    1. (A) Workers' compensation coverage;

    2. (B) Self-funded or self-insured health plans, unless the plan is established or maintained for employees of a governmental entity; and

    3. (C) A policy, contract, or agreement that limits coverage for dental services in connection with the treatment of a covered accidental injury or the treatment of a nondental physiological condition.


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