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003.22.120-3. Definitions

AR ADC 003.22.120-3Arkansas Administrative CodeEffective: January 1, 2022

West's Arkansas Administrative Code
Title 003. Department of Commerce
Division 22. Insurance Department
Rule 120. Coverage for Early Refills of Prescription Eye Drops
Effective: January 1, 2022
Ark. Admin. Code 003.22.120-3
003.22.120-3. Definitions
Currentness
The following words and terms, when used in this Rule, shall have the following meanings, unless the context clearly indicates otherwise.
(1) “Covered person” means a person who is and continues to remain eligible for coverage under a health benefit plan and is covered under the health benefit plan.
(2)(a) “Health benefit plan” means:
(1) An individual, blanket, or group plan, policy, or contract for healthcare services issued or delivered by a healthcare insurer; and
(2) Any health benefit program receiving state or federal appropriations from the State of Arkansas, including the Arkansas Medicaid Program and the Arkansas Works Program, or any successor program.
(b) “Health benefit plan” includes:
(1) Indemnity and managed care plans; and
(2) Nonfederal governmental plans as defined in 29 U.S.C. § 1002(32), as it existed on January 1, 2021.
(c) “Health benefit plan” does not include:
(1) A disability income plan;
(2) A credit insurance plan;
(3) Insurance coverage issued as a supplement to liability insurance;
(4) A medical payment under automobile or homeowners insurance plans;
(5) A health benefit plan provided under Arkansas Constitution, Article 5, § 32, the Workers' Compensation Law, § 11-9-101 et seq., or the Public Employee Workers' Compensation Act, § 21-5-601 et seq.;
(6) A plan that provides only indemnity for hospital confinement;
(7) An accident-only plan;
(8) A specified disease plan;
(9) A long-term-care-only plan;
(10) A dental-only plan; or
(11) A vision-only plan.
(3) “Healthcare insurer” means an entity subject to the insurance laws of this state or the jurisdiction of the Insurance Commissioner that contracts or offers to contract to provide health insurance coverage, including without limitation an insurance company, a health maintenance organization, a hospital medical service corporation, a self- insured governmental or church plan in this state, or the Arkansas Medicaid Program.
(4) “Healthcare professional” means a person who is licensed, certified, or otherwise authorized by the laws of this state to administer health care in the ordinary course of the practice of his or her profession.
(5) “Prescription eye drops” means a prescription topical eye medication that is delivered through eye drops and is used to treat a chronic condition of the eye.

Credits

Adopted Jan. 1, 2022.
Current with amendments received through February 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 003.22.120-3, AR ADC 003.22.120-3
End of Document