KRS 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 limited 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).