Title 33, Chapter 21, Section 1
( 33-21-1)
As used in this chapter, the term: (1) "Basic health care services" means health care services which
an enrolled population might reasonably require in order to be
maintained in good health, including as a minimum but not
restricted to preventive care, emergency care, inpatient hospital
and physician care, and outpatient medical services. (2) "Enrollee" means an individual who has elected to contract for
or participate in a health benefits plan for that individual or
for that individual and that individual's eligible dependents. (3) "Evidence of coverage" means any certificate, agreement, or
contract issued to an enrollee setting out the coverage to which
he is entitled. (4) "Health benefits plan" means any arrangement whereby any
person undertakes to provide, arrange for, pay for, or reimburse
any part of the cost of any health care services, at least part of
which consists of arranging for or the provision of health care
services, as distinguished from an arrangement which provides only
for indemnification against the cost of such services on a prepaid
basis through insurance or otherwise. (5) "Health care services" means any services included in the
furnishing to any individual of medical or dental care or
hospitalization or incident to the furnishing of such care or
hospitalization, as well as the furnishing to any person of any
and all other services for the purpose of preventing, alleviating,
curing, or healing human illness or injury. (6) "Health maintenance organization" means any person who
undertakes to provide or arrange for one or more health benefits
plans. (7) "Insurer" means every insurer authorized under this title to
issue contracts of accident and sickness insurance. Hospital
service nonprofit corporations, nonprofit medical service
corporations, health care corporations, and health maintenance
organizations are included within such term. (7.1) "Patient" means a person who seeks or receives health care
services from a health maintenance organization. (8) "Person" means any natural or artificial person including but
not limited to individuals, partnerships, associations, trusts, or
corporations. (9) "Provider" means any physician, hospital, or other person who
is licensed or otherwise authorized in this state to furnish
health care services. |