PREFERRED PROVIDER AGREEMENTS
In this chapter:
I. "Commissioner" means the insurance commissioner.
II. "Covered person" means an individual entitled to reimbursement for expenses of health care services under a policy issued or administered by a health care insurer.
II-a. "Date of enrollment" means the first day of coverage under the plan, or, if there is a waiting period, the first day of the waiting period, which is typically the first day of work.
III. "Health benefit plan" means the contract between the covered person or policyholder and the health care insurer which defines the services covered.
IV. "Health care insurer" means an insurance company, including nonprofit (tax exempt) health service corporations as defined in RSA 420-A, authorized in this state to issue policies that provide reimbursement for expenses of health care services.
V. "Health care services" means services or products rendered by a preferred provider which may include physician, hospitalization, laboratory, and x-ray services, and medical equipment and supplies, and which further may include, but are not limited to: medical, surgical, and dental care; psychological, obstetrical, osteopathic, optometric, optic, podiatric, chiropractic, nursing, physical therapy, and pharmaceutical services; health education; preventive medical, rehabilitative, and home health services; inpatient and outpatient hospital services, extended care, nursing home care, convalescent institutional care, laboratory and ambulance services, appliances, drugs, medicines, and supplies; and any other care, service, or treatment of disease, correction of defects, or the maintenance of the physical and mental well-being of the insured.
VI. "Preferred provider" means a licensed provider or group of providers who have contracted with or been designated by the health care insurer to provide health care services to covered persons under a health benefit plan.
VII. "Provider" means any physician, hospital or other institution, organization, or other person who furnishes health care services.
Source. 1987, 112:1. 2007, 289:17, eff. Jan. 1, 2008.