{"data":{"id":"us-ky/krs-304.17b-001","jurisdiction":"us-ky","citation":"KRS 304.17B-001","heading":"Definitions for subtitle.","body":"As used in this subtitle, unless the context requires otherwise:\n(1) \"Administrator\" is defined in KRS 304.9-051(1);\n(2) \"Agent\" is defined in KRS 304.9-020;\n(3) \"Assessment process\" means the process of assessing and allocating guaranteed\nacceptance progr am losses or Kentucky Access funding as provided for in KRS\n304.17B-021;\n(4) \"Authority\" means the Kentucky Health Care Improvement Authority;\n(5) \"Case management\" means a process for identifying an enrollee with specific health\ncare needs and interacting  with the enrollee and their respective health care\nproviders in order to facilitate the development and implementation of a plan that\nefficiently uses health care resources to achieve optimum health outcome;\n(6) \"Commissioner\" is defined in KRS 304.1-050(1);\n(7) \"Department\" is defined in KRS 304.1-050(2);\n(8) \"Earned premium\" means the portion of premium paid by an insured that has been\nallocated to the insurer's loss experience, expenses, and profit year to date;\n(9) \"Enrollee\" means a person who is enro lled in a health benefit plan offered under\nKentucky Access;\n(10) \"Eligible individual\" is defined in KRS 304.17A-005(11);\n(11) \"Guaranteed acceptance program\" or \"GAP\" means the Kentucky Guaranteed\nAcceptance Program established and operated under KRS 304 .17A-400 to\n304.17A-480;\n(12) \"Guaranteed acceptance program participating insurer\" means an insurer that\noffered health benefit plans through December 31, 2000, in the individual market to\nguaranteed acceptance program qualified individuals;\n(13) \"Health benefit plan\" is defined in KRS 304.17A-005(22);\n(14) \"High-cost condition\" means acquired immune deficiency syndrome (AIDS), angina\npectoris, ascites, chemical dependency, cirrhosis of the liver, coronary insufficiency,\ncoronary occlusion, cystic fibrosis, Friedreich's ataxia, hemophilia, Hodgkin's\ndisease, Huntington's chorea, juvenile diabetes, leukemia, metastatic cancer, motor\nor sensory aphasia, multiple sclerosis, muscular dystrophy, myasthenia gravis,\nmyotonia, open -heart surgery, Parkinson's disease, polycystic kidney, psychotic\ndisorders, quadriplegi a, stroke, syringomyelia, Wilson's disease, chronic renal\nfailure, malignant neoplasm of the trachea, malignant neoplasm of the bronchus,\nmalignant neoplasm of the lung, malignant neoplasm of the colon, short gestation\nperiod for a newborn child, and low birth weight of a newborn child;\n(15) \"Incurred losses\" means for Kentucky Access the excess of claims paid over\npremiums received;\n(16) \"Insurer\" is defined in KRS 304.17A-005(29);\n(17) \"Kentucky Access\" means the program established in accordance with KRS\n304.17B-001 to 304.17B-031;\n(18) \"Kentucky Access Fund\" means the fund established in KRS 304.17B-021;\n(19) \"Kentucky Health Care Improvement Authority\" means the board established to\nadminister the program initiatives listed in KRS 304.17B-003(5);\n(20) \"Kentucky Health Care Improvement Fund\" means the fund established for receipt\nof the Kentucky tobacco master settlement moneys for program initiatives listed in\nKRS 304.17B-003(5);\n(21) \"MARS\" means the Management Administrative Reporting System administered by\nthe Commonwealth;\n(22) \"Medicaid\" means coverage in accordance with Title XIX of the Social Security\nAct, 42 U.S.C. secs. 1396 et seq., as amended;\n(23) \"Medicare\" means coverage under both Parts A and B of Title XVIII of the Social\nSecurity Act, 42 U.S.C. secs. 1395 et seq., as amended;\n(24) \"Office\" means the Office of Health Data and Analytics in the Cabinet for Health\nand Family Services;\n(25) \"Pre-existing condition exclusion\" is defined in KRS 304.17A-220(6);\n(26) \"Standard health benefit plan\" means a health benefit plan that meets the\nrequirements of KRS 304.17A-250;\n(27) \"Stop-loss carrier\" means any person providing stop-loss health insurance coverage;\n(28) \"Supporting insurer\" means all insurers, stop -loss carriers, and self -insured\nemployer-controlled or bona fide associations; and\n(29) \"Utilization management\" is defined in KRS 304.17A-500(12).","path":[],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=48811","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:48Z","sha256":"107968fa8a5b6cb2054b49c6060d8ab770434d72b529c29d2f3d0a7282cff33c","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.17a-846","next":"us-ky/krs-304.17b-003"},"notice":"GroundRules: Original legal text. Not legal advice."}