§ 58-12-26 — Insurer defined.

For the purposes of §§ 58-12-22 to 58-12-28 , inclusive, the term, insurer, means: (1) Any commercial insurance company, employer-employee benefit plan, health maintenance organization, professional association, service benefit plan, public self-funded employer or pool, union, or fraternal group selling or otherwise offering individual or group health insurance coverage including self-insured and self-funded plans; (2) Any profit or nonprofit prepaid plan offering either medical services of full or partial payment for services included in the department's medicaid plan; (3) Any other entity offering health benefits for which a medicaid recipient may be eligible in addition to public medical assistance; (4) Any managed care organization, third-party administrator, pharmacy benefits manager, or other entity which processes claims, administers services, or otherwise manages health benefits on behalf of any of the aforementioned insurers; or (5) Any other party that is by statute, contract, or agreement, legally responsible for payment of a claim for a health care item or service including workers' compensation, automobile insurance, and liability insurance plans.

Legislative History

SL 2005, ch 263, § 5; SL 2007, ch 286, § 3; SL 2021, ch 210, § 6.