health plan
Defined in 7 places across 3 titles of the United States Code.
For purposes of this section, the term "health plan" means a plan or program that provides health benefits, whether directly, through insurance, or otherwise, and includes—
Source
- 1996–present42 U.S.C. § 1320AThe Public Health and Welfare · Fraud and abuse control program · for purposes of this section
For purposes of this section, the term “health plan” means a plan or program that provides health benefits, whether directly, through insurance, or otherwise, and includes—
(1) a policy of health insurance;
(2) a contract of a service benefit organization; and
(3) a membership agreement with a health maintenance organization or other prepaid health plan.
Source
- 2013–202242 U.S.C. § 1320AThe Public Health and Welfare · Fraud and abuse control program · for purposes of this section
The term “health plan” has the meaning given such term by section 1320a–7c(c) of this title.
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- 1996–present42 U.S.C. § 1320AThe Public Health and Welfare · Health care fraud and abuse data collection program · for purposes of this section
The term “health plan” has the meaning given such term in section 1320d(5) of this title.
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- 2009–present42 U.S.C. § 300jjThe Public Health and Welfare · Definitions · in this subchapter
The term “health plan” has the meaning given such term in section 160.103 of title 45, Code of Federal Regulations.
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- 2009–present42 U.S.C. § 17921The Public Health and Welfare · Definitions · in this subchapter
The term “health plan” means an individual or group plan that provides, or pays the cost of, medical care (as such term is defined in section 300gg–91 of this title). Such term includes the following, and any combination thereof:
(A) A group health plan (as defined in section 300gg–91(a) of this title), but only if the plan—
(i) has 50 or more participants (as defined in section 1002(7) of title 29); or
(ii) is administered by an entity other than the employer who established and maintains the plan.
(B) A health insurance issuer (as defined in section 300gg–91(b) of this title).
(C) A health maintenance organization (as defined in section 300gg–91(b) of this title).
(D) Part A or part B of the Medicare program under subchapter XVIII of this chapter.
(E) The medicaid program under subchapter XIX of this chapter.
(F) A Medicare supplemental policy (as defined in section 1395ss(g)(1) of this title).
(G) A long-term care policy, including a nursing home fixed indemnity policy (unless the Secretary determines that such a policy does not provide sufficiently comprehensive coverage of a benefit so that the policy should be treated as a health plan).
(H) An employee welfare benefit plan or any other arrangement which is established or maintained for the purpose of offering or providing health benefits to the employees of 2 or more employers.
(I) The health care program for active military personnel under title 10.
(J) The veterans health care program under chapter 17 of title 38.
(K) The Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), as defined in section 1072(4) of title 10.
(L) The Indian health service program under the Indian Health Care Improvement Act (25 U.S.C. 1601 et seq.).
(M) The Federal Employees Health Benefit Plan under chapter 89 of title 5.
Source
- 1996–200142 U.S.C. § 1320DThe Public Health and Welfare · Definitions · for purposes of this part
The term “health plan” means an individual or group plan that provides, or pays the cost of, medical care (as such term is defined in section 300gg–91 of this title). Such term includes the following, and any combination thereof:
(A) A group health plan (as defined in section 300gg–91(a) of this title), but only if the plan—
(i) has 50 or more participants (as defined in section 1002(7) of title 29); or
(ii) is administered by an entity other than the employer who established and maintains the plan.
(B) A health insurance issuer (as defined in section 300gg–91(b) of this title).
(C) A health maintenance organization (as defined in section 300gg–91(b) of this title).
(D) Parts 1 A, B, C, or D of the Medicare program under subchapter XVIII.
(E) The medicaid program under subchapter XIX.
(F) A Medicare supplemental policy (as defined in section 1395ss(g)(1) of this title).
(G) A long-term care policy, including a nursing home fixed indemnity policy (unless the Secretary determines that such a policy does not provide sufficiently comprehensive coverage of a benefit so that the policy should be treated as a health plan).
(H) An employee welfare benefit plan or any other arrangement which is established or maintained for the purpose of offering or providing health benefits to the employees of 2 or more employers.
(I) The health care program for active military personnel under title 10.
(J) The veterans health care program under chapter 17 of title 38.
(K) The Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), as defined in section 1072(4) of title 10.
(L) The Indian health service program under the Indian Health Care Improvement Act (25 U.S.C. 1601 et seq.).
(M) The Federal Employees Health Benefit Plan under chapter 89 of title 5.
Source
- 2016–present42 U.S.C. § 1320DThe Public Health and Welfare · Definitions · for purposes of this part
The term “health plan” means an individual or group plan that provides, or pays the cost of, medical care (as such term is defined in section 300gg–91 of this title). Such term includes the following, and any combination thereof:
(A) A group health plan (as defined in section 300gg–91(a) of this title), but only if the plan—
(i) has 50 or more participants (as defined in section 1002(7) of title 29); or
(ii) is administered by an entity other than the employer who established and maintains the plan.
(B) A health insurance issuer (as defined in section 300gg–91(b) of this title).
(C) A health maintenance organization (as defined in section 300gg–91(b) of this title).
(D) Parts 1 A, B, C, or D of the Medicare program under subchapter XVIII of this chapter.
(E) The medicaid program under subchapter XIX of this chapter.
(F) A Medicare supplemental policy (as defined in section 1395ss(g)(1) of this title).
(G) A long-term care policy, including a nursing home fixed indemnity policy (unless the Secretary determines that such a policy does not provide sufficiently comprehensive coverage of a benefit so that the policy should be treated as a health plan).
(H) An employee welfare benefit plan or any other arrangement which is established or maintained for the purpose of offering or providing health benefits to the employees of 2 or more employers.
(I) The health care program for active military personnel under title 10.
(J) The veterans health care program under chapter 17 of title 38.
(K) The Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), as defined in section 1072(4) of title 10.
(L) The Indian health service program under the Indian Health Care Improvement Act (25 U.S.C. 1601 et seq.).
(M) The Federal Employees Health Benefit Plan under chapter 89 of title 5.
Source
- 2009–201642 U.S.C. § 1320DThe Public Health and Welfare · Definitions · for purposes of this part
The term “health plan” means an individual or group plan that provides, or pays the cost of, medical care (as such term is defined in section 300gg–91 of this title). Such term includes the following, and any combination thereof:
(A) A group health plan (as defined in section 300gg–91(a) of this title), but only if the plan—
(i) has 50 or more participants (as defined in section 1002(7) of title 29); or
(ii) is administered by an entity other than the employer who established and maintains the plan.
(B) A health insurance issuer (as defined in section 300gg–91(b) of this title).
(C) A health maintenance organization (as defined in section 300gg–91(b) of this title).
(D) Parts 1 A, B, or C of the Medicare program under subchapter XVIII of this chapter.
(E) The medicaid program under subchapter XIX of this chapter.
(F) A Medicare supplemental policy (as defined in section 1395ss(g)(1) of this title).
(G) A long-term care policy, including a nursing home fixed indemnity policy (unless the Secretary determines that such a policy does not provide sufficiently comprehensive coverage of a benefit so that the policy should be treated as a health plan).
(H) An employee welfare benefit plan or any other arrangement which is established or maintained for the purpose of offering or providing health benefits to the employees of 2 or more employers.
(I) The health care program for active military personnel under title 10.
(J) The veterans health care program under chapter 17 of title 38.
(K) The Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), as defined in section 1072(4) of title 10.
(L) The Indian health service program under the Indian Health Care Improvement Act (25 U.S.C. 1601 et seq.).
(M) The Federal Employees Health Benefit Plan under chapter 89 of title 5.
Source
- 2001–200942 U.S.C. § 1320DThe Public Health and Welfare · Definitions · for purposes of this part
The term “health plan” means an insurance policy or contract, medical or hospital service agreement, membership or subscription contract, or other arrangement under which health services for individuals are provided or the expenses of such services are paid.
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- 1994–present38 U.S.C. § 4303Veterans Benefits · Definitions · for the purposes of this chapter
The term “health plan” means health insurance coverage and a group health plan.
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- 2010–present42 U.S.C. § 18021The Public Health and Welfare · Qualified health plan defined · in this title
The terms "health care clearinghouse", "health care provider", and "health plan" have the meanings given such terms in section 160.103 of title 45, Code of Federal Regulations (as in effect on the day before December 18, 2015).
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- 2015–present6 U.S.C. § 1533Domestic Security · Improving cybersecurity in the health care industry · in this section