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Code · Pennsylvania · Title 40 — INSURANCE · Chapter 50

§ 5002. Definitions.

343 words·~2 min read·/pa/title-40/chapter-50/5002

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§ 5002. Definitions.
The following words and phrases when used in this chapter shall have the meanings given to them in this section unless the context clearly indicates otherwise:
"Covered person." An individual who is entitled to receive health care services under a health benefit plan.
"Deliver by electronic means." Any of the following:
(1)The delivery to an email address at which a covered person has consented to receive a notice or document from an insurer.
(2)A post on an electronic network or website accessible via the Internet, mobile device or application, tablet or any other electronic device, administered by an insurer, including a separate notice of the post by delivery to an email address at which a covered person has consented to receive a notice or document or by any other delivery method that has been consented by the covered person, which contains the Internet address at which the notice or document is posted. For purposes of this definition, delivery shall be effective upon the post or actual delivery of the separate notice of the post as specified under this paragraph.
"ERISA." Employee Retirement Income Security Act of 1974 (Public Law 93-406, 88 Stat. 829).
"Health benefit plan." A policy, contract, certificate or agreement entered into, offered by or issued by an insurer to provide, deliver or arrange for, pay for or reimburse any of the costs of health care services, including a vision or dental benefit plan.
"Insurer." An entity licensed by the department with authority to issue a health benefit plan that is governed under any of the following:
(1)The act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, including section 630 and Article XXIV.
(2)The act of December 29, 1972 (P.L.1701, No.364), known as the Health Maintenance Organization Act.
(3)Chapter 61 (relating to hospital plan corporations).
(4)Chapter 63 (relating to professional health services plan corporations).
"Plan sponsor." A person or entity that establishes, adopts or maintains a health benefit plan on behalf of a covered person.
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