Section 760 IAC 1-83-11 - "Health payer" definedAuthority: IC 27-1-44.5-11
Affected: IC 5-10-8-6.7; IC 12-7-2-126.9; IC 27-1-34-1; IC 27-1-44.5-2; IC 27-8-5-1; IC 27-13-1-19
Sec. 11. "Health payer" includes the following:
(2) Medicaid or a managed care organization (as defined in IC 12-7-2-126.9) that has contracted with Medicaid to provide services to a Medicaid recipient.(3) An insurer that issues a policy of accident and sickness insurance (as defined in IC 27-8-5-1), except for the following types of coverage:(A) Accident only, credit, dental, vision, long term care, or disability income insurance.(B) Coverage issued as a supplement to liability insurance.(C) Automobile medical payment insurance.(D) A specified disease policy.(E) A policy that provides indemnity benefits not based on any expense incurred requirements, including a plan that provides coverage for:(i) hospital confinement, critical illness, or intensive care; or(ii) gaps for deductibles or copayments.(F) Worker's compensation or similar insurance.(G) A student health plan.(H) A supplemental plan that always pays in addition to other coverage.(4) A health maintenance organization (as defined in IC 27-13-1-19).(5) A pharmacy benefit manager (as defined in IC 27-1-24.5-12).(6) A third party administrator.(7) A multiple employer welfare arrangement (as defined in IC 27-1-34-1).(8) A state employee health plan (as defined in IC 5-10-8-6.7(a)).(9) Any other person identified by the commissioner for participation in the data base.Department of Insurance; 760 IAC 1-83-11; Filed 10/30/2024, 9:32 a.m.: 20241127-IR-760240151FRA