SUBPART K.  LIMITATIONS ON

ASSIGNMENT OF OBLIGATIONS

§1221.  Definitions

For purposes of this Subpart, the following definitions shall apply:

(1)  "Carve-out agreement" means a written agreement between a health insurance issuer and another entity to provide health care services other than medical, surgical, or physician services, including but not limited to an agreement to provide prescription drugs, mental health or substance abuse treatment services, or  services of clinicians other than physicians licensed to practice medicine, other than as incidental to the provision of the foregoing carve-out services.

(2)  "Health insurance coverage" means benefits consisting of medical care provided or arranged for directly, through insurance or reimbursement, or otherwise, and includes health care services paid for under  any plan, policy, or certificate of insurance.

(3)  "Health insurance issuer" means an insurance company, including a health maintenance organization as defined and licensed  pursuant to Subpart I of Part I of Chapter 2 of this Title, unless preempted as an employee benefit plan under the Employee Retirement Income Security Act of 1974.

Acts 2004, No. 417, §1; Redesignated from R.S. 22:421 by Acts 2008, No. 415, §1, eff. Jan. 1, 2009.