Definitions.

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As used in this chapter:

(1) “Department” means the Delaware Department of Health and Social Services.

(2) “Health insurer” includes all of the following:

a. An insurer providing insurance of human beings against bodily injury, disablement or death by accident or accidental means, or the expense thereof, or against disablement or expense resulting from sickness, and every insurance appertaining thereto.

b. A health service corporation.

c. A health maintenance organization.

d. A group health plan, as defined in § 607(1) of the federal Employee Retirement Income Security Act of 1974 (29 U.S.C. § 1167(1)).

e. Any entity offering a service benefit plan.

f. A self-funded entity or group providing health-care coverage.

g. A pharmacy benefit manager.

h. Any other parties that are, by statute, contract, or agreement, legally responsible for payment of a claim for a health-care item or service.

i. Any person or other entity which provides coverage in this State for medical, surgical, chiropractic, physical therapy, speech pathology, audiology, professional mental health, dental, hospital, or optometric expenses, whether such coverage is by direct payment, reimbursement, or otherwise.


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