211 CMR, § 64.04

Current through Register 1533, October 25, 2024
Section 64.04 - Definitions

Commissioner: the commissioner of insurance, or his or her designee.

Health Benefit Plan: any general, blanket or group policy of health, accident and sickness insurance issued by an insurer licensed under M.G.L. c. 175; a group hospital or medical service plan issued under M.G.L. c. 176A or M.G.L. c. 176B; a group health maintenance contract issued by an HMO under M.G.L. c. 176G; an insured group health benefit plan that includes a preferred provider arrangement under M.G.L. c. 176I; and any multiple employer welfare arrangement (MEWA) required to be licensed under M.G.L. c. 175; offered to an eligible small business. The term "health benefit plan" does not include accident only, credit, dental, vision, long-term care only or disability income insurance, coverage issued as a supplement to liability insurance, insurance arising out of a worker's compensation or similar law, automobile medical payment insurance, insurance under which beneficiaries are payable with or without regard to fault and which is statutorily required to be contained in a liability insurance policy or equivalent self-insurance, or any group blanket or general policy which provides supplemental coverage to Medicare or other governmental programs.

Qualified family medical insurance: qualified medical insurance offered to an eligible employee that covers the employee and two or more additional members of the employee's family.

Qualified individual medical insurance: qualified medical insurance offered to an individual eligible employee.

Qualified medical insurance: a health benefit plan that meets all requirements of M.G.L. c. 176J and 211 CMR 66.00.

Qualified two-person family medical insurance: qualified medical insurance offered to an employee that covers the employee and one additional family member.

211 CMR, § 64.04