{"data":{"id":"us-ky/krs-304.38-030","jurisdiction":"us-ky","citation":"KRS 304.38-030","heading":"Definitions for subtitle.","body":"As used in this subtitle, unless the context otherwise requires:\n(1) \"Commissioner\" means the commissioner of the Department of Insurance;\n(2) \"Enrollee\" means a person who has been enrolled in a health maintenance\norganization;\n(3) \"Evidence of coverage\" means any certificate, agreement, contract, or other\ndocument issued to an enrollee stating the health care services to which the enrollee\nis entitled. All coverages described in an evidence of coverage issued by a health\nmaintenance organization are deeme d to be \"health benefit plans\" to the extent\ndefined in KRS 304.17A-005 unless exempted by the commissioner;\n(4) \"Health care services\" means any services included in the furnishing to any\nindividual of medical, optometric, or dental care, or hospitalizati on or incident to\nthe furnishing of such care or hospitalization, as well as the furnishing to any person\nof any and all other services and goods for the purpose of preventing, alleviating,\ncuring, or healing human illness, physical disability, or injury;\n(5) \"Health maintenance organization\" means any person who undertakes to provide,\ndirectly or through arrangements with others, health care services to individuals\nenrolled with such an organization on a per capita or a predetermined, fixed\nprepayment basis. A health maintenance organization is authorized to provide all\nhealth care services;\n(6) \"Person\" includes but is not limited to any individual, partnership, association, trust,\nor corporation; and\n(7) \"Provider\" means a person or group of persons licen sed to practice medicine,\nosteopathy, dentistry, podiatry, optometry, or another health profession in a state or\nlicensed to act as a hospital or another health care facility.","path":[],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=29964","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:57:56Z","sha256":"c22022e29a27cbc03b5573c13c7b8518695daa5009313a01f39d6dd17081a1ba","source_id":"us-ky","stale":false,"prev":"us-ky/krs-304.38-020","next":"us-ky/krs-304.38-035"},"notice":"GroundRules: Original legal text. Not legal advice."}