For the purposes of this chapter, the term:
(1) “Health benefit plan” means an accident and health insurance policy or certificate, hospital and medical services corporation contract, health maintenance organization subscriber contract, plan provided by a multiple employer welfare arrangement, or plan provided by another benefit arrangement. The term “health benefit plan” shall not mean accident only, credit, or disability insurance; coverage of medicare services or federal employee health plans under contracts with the United States Government; medicare supplement or long-term care insurance; specified disease insurance; hospital confinement indemnity coverage; limited benefit health coverage; coverage issued as a supplement to liability insurance; insurance arising out of a workers’ compensation or similar law; automobile medical payment insurance; medical expense and loss of income benefits; or insurance under which benefits are payable with or without regard to fault and which is statutorily required to be contained in a liability insurance policy or equivalent self-insurance.
(2) “Health insurer” means a person that provides one or more health benefit plans or insurance in the District of Columbia, including an insurer, a hospital and medical services corporation, a fraternal benefit society, a health maintenance organization, a multiple employer welfare arrangement, or any other person providing a plan of health insurance subject to the authority of the Commissioner of the Department of Insurance, Securities, and Banking.
(3) “Insured” means a person covered by a health benefit plan.
(Oct. 21, 2000, D.C. Law 13-175, § 2, 47 DCR 6832; June 11, 2004, D.C. Law 15-166, § 4(q), 51 DCR 2817.)
Section ReferencesThis section is referenced in § 31-2803 and § 31-3161.
Effect of AmendmentsD.C. Law 15-166, in par. (2), substituted “Department of Insurance, Securities, and Banking” for “Department of Insurance and Securities Regulation”.
Emergency LegislationFor temporary (90 day) amendment of section, see § 4(q) of Consolidation of Financial Services Emergency Amendment Act of 2004 (D.C. Act 15-381, February 27, 2004, 51 DCR 2653).