KRS 304.17C-130: Definitions for KRS 304.17C-130 to 304.17C-138.

As used in KRS 304.17C-130 to 304.17C-138:

(1) "Covered person" means an individual who is covered by a dental benefit plan;

(2) "Dental benefit plan" means a limited health service benefit plan that provides

coverage for dental services;

(3) "Dental carrier" means a health insurer that provides coverage for dental services;

(4) "Dental services":

(a) Means services for the diagnosis, prevention, treatment, or cure of a dental

condition, illness, injury, or disease; and

(b) Does not include services deliver ed by a provider that are billed as medical

expenses under a health insurance plan;

(5) "Dentist" means any dentist licensed or otherwise authorized in this state to furnish

dental services;

(6) "Health insurer" means any insurance company, health maintena nce organization,

self-insurer or multiple employer welfare arrangement not exempt from state

regulation by ERISA, provider -sponsored integrated health delivery network, self -

insured employer -organized association, nonprofit hospital, medical -surgical,

dental, and health service corporation, or limited health service organization

authorized to transact health insurance business in Kentucky; and

(7) "Provider":

(a) Means an individual or entity, acting within the scope of the individual or

entity's licensure or certification, that provides dental services or supplies

defined by the dental benefit plan; and

(b) Does not include a physician organization or physician hospital organization

that leases or rents its network to a third party.