§ 304-38a-010

304.38A -010 Definitions for subtitle. As used in this subtitle, unless the context requires otherwise: (1) 'Enrollee' means an individual who is enrolled in a limited health services benefit plan; (2) 'Evidence of coverage' means any certificate, agreement, contract, or other document issued t o an enrollee stating the limited health services to which the enrollee is entitled. All coverages described in an evidence of coverage issued by a limited health service organization are deemed to be 'limited health services benefit plans' to the extent d efined in KRS 304.17C -010 unless exempted by the commissioner; (3) 'Limited health service' means dental care services, vision care services, mental health services, substance abuse services, chiropractic services, pharmaceutical services, podiatric care s ervices, and such other services as may be determined by the commissioner to be limited health services. Limited health service shall not include hospital, medical, surgical, or emergency services except as these services are provided incidental to the lim ited health services set forth in this subsection; (4) 'Limited health service contract' means any contract entered into by a

ency services except as these services are provided incidental to the lim ited health services set forth in this subsection; (4) 'Limited health service contract' means any contract entered into by a limited health service organization with a policyholder to provide limited health services; (5) 'Limited health service organizati on' means a corporation, partnership, limited liability company, or other entity that undertakes to provide or arrange limited health service or services to enrollees. A limited health service organization does not include a provider or an entity when prov iding or arranging for the provision of limited health services under a contract with a limited health service organization, health maintenance organization, or a health insurer; and (6) 'Provider' means the same as defined in KRS 304.17A -005(23). Effectiv e: July 15, 2010 History: Amended 2010 Ky. Acts ch. 24, sec. 1515, effective July 15, 2010. -- Amended 2006 Ky. Acts ch. 253, sec. 7, effective July 12, 2006. -- Amended 2005 Ky. Acts ch. 144, sec. 13, effective June 20, 2005. -- Created 2002 Ky. Acts ch. 105, sec. 10, effective July 15, 2002.