40-5905. Same; definitions.
371 words·~2 min read·
/ks/chapter-40/40-5905A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
40-5905. Same; definitions. For the purposes of this act:
(1)"Covered service" means any service or material for which:
(A)Reimbursement from the vision care insurance or health benefit plan is provided for by an insured's vision care insurance plan or health benefit plan contract subject to the application of the vision care insurance or health benefit plan's deductibles, copayments or coinsurance; or
(B)a reimbursement would be available subject to the application of any contractual limitations of deductibles or copayments required under the vision care discount plan coinsurance.
(2)"Covered services" does not include any services or materials covered or provided at a nominal or de minimus rate.
(b)"Contractual discount" means a percentage reduction from a vision care provider's usual and customary rate for providing covered services and materials required under a participating provider agreement.
(c)"Discount card" shall have the meaning ascribed to such term in K.S.A. 50-1,100 , and amendments thereto.
(d)"Health benefit plan" shall have the meaning ascribed to such term in K.S.A. 40-4602 , and amendments thereto.
(e)"Health insurer" shall have the meaning ascribed to such term in K.S.A. 40-4602 , and amendments thereto.
(f)"Material" includes, but is not limited to, lenses, devices containing lenses, prisms, lens treatments and coatings, contact lenses, orthoptics, vision training and any prosthetic device necessary to correct, relieve, or treat any defect or abnormal condition of the human eye or its adnexa.
(g)"Participating provider agreement" includes a health benefit plan, vision care insurance or a vision care discount plan.
(h)"Participating provider" shall have the meaning ascribed to such term in K.S.A. 40-4602 , and amendments thereto.
(i)"Vision care insurance" means an integrated health benefit plan or vision care insurance policy or contract which provides vision benefits pertaining to the provision of covered services or materials.
(j)"Vision care provider" means an optometrist licensed by the board of examiners in optometry or an ophthalmologist licensed by the state board of healing arts.
(k)"Vision care discount plan" means any entity which has been specifically authorized by the vision care providers to provide discounts to patients, but which plan is not insurance nor a discount card as defined in K.S.A. 50-1,100 , and amendments thereto.