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., v) 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.Added by Act 2023, No. 597,§ 1, eff. 8/1/2023.
Arkansas Legal Code