Arkansas § 23-99-1301 Definitions

Arkansas Statutes

§ 23-99-1301 — Definitions

Arkansas § 23-99-1301

Title23

This text of Arkansas § 23-99-1301 (Definitions) is published on Counsel Stack Legal Research, covering Arkansas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Ark. Code Ann. § 23-99-1301 (2026).

Text

As used in this subchapter:

(1)"Contracting entity" means a healthcare insurer or any subcontractor, affiliate, or other entity that contracts directly or indirectly with a healthcare provider for the delivery of healthcare services to enrollees;

(2)"Enrollee" means a person who is entitled to receive healthcare services under the terms of a health benefit plan;

(3)(A) "Health benefit plan" means a plan, policy, contract, certificate, agreement, or other evidence of coverage for healthcare services offered or issued by a healthcare insurer in this state.

(B)"Health benefit plan" does not include:

(i)A disability income plan;

(ii)A credit insurance plan;

(iii)Insurance coverage issued as a supplement to liability insurance;

(iv)Medical payments under an automobile or homeowners insu

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As used in this subchapter: (1) "Contracting entity" means a healthcare insurer or any subcontractor, affiliate, or other entity that contracts directly or indirectly with a healthcare provider for the delivery of healthcare services to enrollees; (2) "Enrollee" means a person who is entitled to receive healthcare services under the terms of a health benefit plan; (3) (A) "Health benefit plan" means a plan, policy, contract, certificate, agreement, or other evidence of coverage for healthcare services offered or issued by a healthcare insurer in this state. (B) "Health benefit plan" does not include: (i) A disability income plan; (ii) A credit insurance plan; (iii) Insurance coverage issued as a supplement to liability insurance; (iv) Medical payments under an automobile or homeowners insurance plan; (v) A health benefit plan provided under Arkansas Constitution, Article 5, § 32, the Workers' Compensation Law, § 11-9-101 et seq., or the Public Employee Workers' Compensation Act, § 21-5-601 et seq.; (vi) A plan that provides only indemnity for hospital confinement; (vii) An accident-only plan; (viii) A specified disease plan; (ix) A long-term care insurance plan; or (x) A vision-only plan; (4) "Healthcare contract" means a contract entered into, materially amended, or renewed between a contracting entity and a healthcare provider for the delivery of healthcare services to enrollees; (5) (A) "Healthcare insurer" means an entity that is subject to state insurance regulation and provides health insurance in this state. (B) "Healthcare insurer" includes: (i) An insurance company; (ii) A health maintenance organization; (iii) A hospital and medical service corporation; (iv) A risk-based provider organization; and (v) A sponsor of a nonfederal self-funded governmental plan; (6) "Healthcare provider" means a person or entity that is licensed, certified, or otherwise authorized by the laws of this state to provide healthcare services; (7) "Healthcare services" means services or goods provided for the purpose of preventing, diagnosing, treating, alleviating, relieving, curing, or healing human illness, disease, condition, disability, or injury; (8) "Out-of-network provider" means a healthcare provider that provides healthcare services to an enrollee but is not a participating provider; (9) "Participating provider" means a healthcare provider that has a healthcare contract with a contracting entity to provide healthcare services to enrollees with the expectation of receiving payment either directly from the contracting entity or from a healthcare insurer affiliated with the contracting entity; and (10) "Payor" means a contracting entity or healthcare insurer responsible for payment for healthcare services provided to an enrollee under the terms of a healthcare contract or a health benefit plan.