40 Pa. C.S. § 4001

Current through Pa Acts 2024-53, 2024-56 through 2024-111

Section 4001 - 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:

"Health insurance policy." An individual or group policy, subscriber contract, certificate or plan issued by an insurer that provides medical or health care coverage. The term does not include any of the following:

(1) An accident only policy.

(2) A credit only policy.

(3) A long-term care or disability income policy.

(4) A specified disease policy.

(5) A Medicare supplement policy.

(6) A TRICARE policy, including a Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) supplement policy.

(7) A fixed indemnity policy.

(8) A dental only policy.

(9) A vision only policy.

(10) A workers' compensation policy.

(11) An automobile medical payment policy.

(12) Another similar policy providing for limited benefits.

"Insurer." An entity licensed by the department with accident and health authority to issue a health insurance policy that is offered or 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 of that act.

(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) or 63 (relating to professional health services plan corporations).

"Maintenance medication." A medication prescribed for a chronic, long-term condition and taken on a regular, recurring basis.

"Medication synchronization." The coordination of prescription drug filling or refilling by a pharmacy or dispensing physician for a health insurance enrollee taking two or more maintenance medications for the purpose of improving medication adherence.

"Pharmacy." As defined in section 2 of the act of September 27, 1961 ( P.L. 1700, No.699), known as the Pharmacy Act.

40 Pa.C.S. § 4001

Added by P.L. TBD 2019 No. 46, § 1, eff. 7/1/2020.