As used in this subchapter:(1) 'Covered materials' means materials for which reimbursement from the insurer, vision care plan, or vision care discount plan is provided to a vision care provider by an individual's vision benefit plan or contract and that are reimbursable subject to a deductible, copayment, coinsurance, or other contractual limitations;(2) 'Covered services' means services for which reimbursement from the insurer, vision care plan, or vision care discount plan is provided to a vision care provider by an individual's vision benefit plan or contract and that are reimbursable subject to a deductible, copayment, coinsurance, or other contractual limitations;(3) 'Insurer' means an insurance company, a health maintenance organization, a hospital and medical service corporation, or a self-insured health plan for employees of a governmental entity;(4) 'Materials' means ophthalmic devices, including without limitation:(A) Lenses;(B) Devices containing lenses;(C) Artificial intraocular lenses;(D) Ophthalmic frames;(E) Lens-mounting apparatus;(F) Prisms;(G) Spectacle or contact lens treatments and coatings; and(H) Prosthetic devices to correct, relieve, or treat defects or traocular lenses;(D) Ophthalmic frames;(E) Lens-mounting apparatus;(F) Prisms;(G) Spectacle or contact lens treatments and coatings; and(H) Prosthetic devices to correct, relieve, or treat defects or abnormal conditions of the human eye or its adnexa;(5) 'Noncovered materials' means materials that are not covered by an insurer, a vision care plan, or a vision care discount plan;(6) 'Noncovered services' means services that are not covered by an insurer, a vision care plan, or a vision care discount plan;(7) 'Participating provider agreement' means an agreement between a vision care provider and an insurer that obligates a vision care provider to provide for compensation services and materials to an individual who is insured by the insurer;(8) 'Services' means benefits or services provided by a vision care provider;(9) 'Vision benefit plan or contract' means a plan, contract, or policy of insurance issued by an insurer that provides for vision care benefits or services;(10) 'Vision care discount plan' means a separate plan to provide benefits or services under a rider to a health benefit plan or as a stand-alone agreement that is authorized by a vision care provider to provide care discount plan' means a separate plan to provide benefits or services under a rider to a health benefit plan or as a stand-alone agreement that is authorized by a vision care provider to provide discounts to individuals under the Primary Eye Care Provider Act, § 23-99-301 et seq.;(11) 'Vision care plan' means an entity that provides health benefits and that creates, promotes, sells, provides, advertises, or administers an integrated or stand-alone vision benefit plan or contract; and(12) 'Vision care provider' means an individual licensed as an optometrist under § 17-90-301 et seq., or a licensed osteopathic or medical physician licensed under § 17-91-101 et seq. or § 17-95-401 et seq., if the physician has also completed a residency in ophthalmology.Added by Act 2015, No. 959,§ 1, eff. 7/22/2015.
Arkansas Legal Code