Definitions for KRS 304.17C-130 to 304.17C-138

As used in KRS 304.17C-130 to 304.17C-138: (1) "Covered person" means an individual who is covered by a dental benefit plan; (2) "Dental benefit plan" means a limited health service benefit plan that provides coverage for dental services; (3) "Dental carrier" means a health insurer that provides coverage for dental services; (4) "Dental services": (a) Means services for the diagnosis, prevention, treatment, or cure of a dental condition, illness, injury, or disease; and (b) Does not include services delivered by a provider that are billed as medical expenses under a health insurance plan; (5) "Dentist" means any dentist licensed or otherwise authorized in this state to furnish dental services; (6) "Health insurer" means any insurance company, health maintenance organization, self-insurer or multiple employer welfare arrangement not exempt from state regulation by ERISA, provider-sponsored integrated health delivery network, self- insured employer-organized association, nonprofit hospital, medical-surgical, dental, and health service corporation, or limited health service organization authorized to transact health insurance business in Kentucky; and (7) "Provider": (a) Means an individual or entity, acting within the scope of the individual or entity's licensure or certification, that provides dental services or supplies defined by the dental benefit plan; and (b) Does not include a physician organization or physician hospital organization that leases or rents its network to a third party.