Health Benefit Laws definition

Health Benefit Laws means laws relating to the licensure, certification, qualification or authority to transact business relating to the provision of, or payment for, or both the provision of and payment for, health benefits, health care or insurance coverage, including ERISA, COBRA, HIPAA, SCHIP, Medicare, Medicaid, CHAMPUS/TriCare, and laws relating to the regulation of workers compensation, utilization review, third party administrative services, case management and coordination of benefits.
Health Benefit Laws means all Applicable Law relating to the licensure, certification, qualification or authority to transact business relating to the provision of, payment for, arrangement of, or administration or utilization of health or medical benefits, insurance or provider claims, including ERISA, the Consolidated Omnibus Budget Reconciliation Act of 1985, as amended, the HIPAA, the Applicable Law governing the Medicare Advantage Program, the Insurance Code of the State of Florida, and other Applicable Law relating to the regulation of workers compensation, managed care organizations, insurance companies, third-party administrators, utilization review agents, certificates of need, utilization review coordination of benefits, hospital reimbursement, Medicare and Medicaid participation, fraud and abuse, patient referrals and provider incentives.
Health Benefit Laws means all federal, state and local statutes and regulations related to the licensure, certification, qualification or authority to transact business relating to the provision of and/or payment for health benefits, including without limitation health maintenance organization laws, insurance laws, reinsurance and insolvency laws, preferred provider organization laws, point-of-service laws, certificate of need laws, third party administrator laws, ERISA, COBRA, provider credentialling laws, utilization review laws, coordination of benefit requirements, hospital reimbursement laws, Medicaid participation laws, insurance holding company laws, fraud and abuse laws and patient referral laws.

Examples of Health Benefit Laws in a sentence

  • Health Benefit Laws, Health Compliance Laws and Information Privacy and Security Laws.

  • Except as disclosed in the Company Disclosure Memorandum or in the Filed Company SEC Reports, the Company and its Subsidiaries have been, and are, in compliance in all material respects with all Laws applicable to their respective businesses or operations, including all Medicare, Medicaid and CHAMPUS provisions and Health Benefit Laws, and each Material Contract (as hereinafter defined) complies in all material respects with all applicable Laws.

  • The Company and its operations are in compliance in all material respects with all applicable Laws and Orders, including the rules and regulations promulgated by the OIR, AHCA, CMS and other Governmental Authorities in other jurisdictions where the Company is conducting its Business, and all Health Benefit Laws.

  • All forms of the Provider Contracts which are currently in use by the Company conform in all material respects to the requirements of Laws governing Medicare Advantage organizations and all other applicable Health Benefit Laws.

  • All forms of Enrollment Forms, benefit forms, evidence of coverage forms, policy forms and other materials furnished to Members as currently in use by the Company in connection with the Health Benefit Plans have been submitted to and approved by CMS and, as applicable, the OIR, AHCA and other Governmental Authorities, and otherwise conform, in all material respects, to the requirements of Laws, including Law governing the Medicare Advantage Program and other applicable Health Benefit Laws.

  • All forms of the Broker Contracts which are currently in use by the Company and its Subsidiaries conform in all material respects to the requirements of the applicable Health Benefit Laws.

  • Except as set forth on Schedule 3.14(a) of the Disclosure Schedule, the business of each Target Entity has been conducted and is now being conducted in all material respects in substantial compliance with all Legal Requirements (including all Health Benefit Laws (as defined below) and all environmental laws applicable to the Target Entities, the use of their Assets, or the conduct of their businesses), Orders of Governmental Authorities having jurisdiction over it and all Licenses relating to its Business.


More Definitions of Health Benefit Laws

Health Benefit Laws means all federal, state and local statutes and regulations related to the licensure, certification, qualification or authority to transact business relating to the provision of and/or payment for health benefits, including without limitation health maintenance organization laws, insurance laws, reinsurance and insolvency laws, preferred provider organization laws, point-of-service laws, certificate of need laws, third party administrator laws, ERISA, the Consolidated Omnibus Budget Reconciliation Act of 1985, provider credentialling laws, utilization review laws, coordination of benefit requirements, hospital reimbursement laws, Medicaid participation laws, insurance holding company laws, fraud and abuse laws and patient referral laws.
Health Benefit Laws means all Laws of the State of Florida and all other jurisdictions wherein the Company is conducting its Business, and federal Laws of the United States of America, relating to the licensure, certification, qualification or authority to transact business relating to the provision of, payment for, arrangement of, or administration or utilization of health or medical benefits, insurance or provider claims, including ERISA, the Consolidated Omnibus Budget Reconciliation Act of 1985, as amended, the HIPAA, the Laws governing the Medicare Advantage Program, the Insurance Code of the State of Florida, and other Laws relating to the regulation of workers compensation, managed care organizations, insurance companies, third-party administrators, utilization review agents, certificates of need, utilization review coordination of benefits, hospital reimbursement, Medicare and Medicaid participation, fraud and abuse, patient referrals and provider incentives.

Related to Health Benefit Laws

  • Foreign Benefit Law means any applicable statute, law, ordinance, code, rule, regulation, order or decree of any foreign nation or any province, state, territory, protectorate or other political subdivision thereof regulating, relating to, or imposing liability or standards of conduct concerning, any Employee Benefit Plan.

  • Health benefit plan means a policy, contract, certificate or agreement offered or issued by a health carrier to provide, deliver, arrange for, pay for or reimburse any of the costs of health care services.

  • Basic health benefit plan means any plan offered to an individual, a small group,

  • Health benefits plan means a benefits plan which pays or

  • Pension Benefits Act means The Pension Benefits Act of Ontario and regulations thereunder as amended from time to time.

  • Group health benefit plan means any health care plan, subscription contract, evidence of

  • BENEFIT LIMIT means the total benefit allowed under this plan for a covered healthcare service. The benefit limit may apply to the amount we pay, the duration, or the number of visits for a covered healthcare service.

  • Non-U.S. Benefit Plan has the meaning set forth in Section 3.20(a).

  • Health Benefits means health maintenance organization, insured or self-funded medical, dental, vision, prescription drug and behavioral health benefits.

  • Pension Benefit Plan means at any time any employee pension benefit plan (including a Multiple Employer Plan, but not a Multiemployer Plan) which is covered by Title IV of ERISA or is subject to the minimum funding standards under Section 412 of the Code and either (i) is maintained by any member of the Controlled Group for employees of any member of the Controlled Group; or (ii) has at any time within the preceding five years been maintained by any entity which was at such time a member of the Controlled Group for employees of any entity which was at such time a member of the Controlled Group.

  • Annual Benefit Limit means the maximum amount of benefits paid by the Company to the Policy Holder in a Policy Year irrespective of whether any limits of any benefit items stated in the Benefit Schedule have been reached. The Annual Benefit Limit is counted afresh in a new Policy Year.

  • Retirement Plans means the retirement income, supplemental executive retirement, excess benefits and retiree medical, life and similar benefit plans providing retirement perquisites, benefits and service credit for benefits at least as great in the aggregate as are payable thereunder prior to a Change in Control;

  • Company Benefit Plans has the meaning set forth in Section 3.16(a).

  • Foreign Benefit Arrangement means any employee benefit arrangement mandated by non-U.S. law that is maintained or contributed to by any Credit Party or any of its Subsidiaries.

  • Lifetime Benefit Limit means the maximum amount of benefits paid by the Company to the Policy Holder cumulatively since the inception of these Terms and Benefits, irrespective whether any limits of any benefit items stated in the Benefit Schedule have been reached or whether the Annual Benefit Limit in a Policy Year has been reached.

  • Company Pension Plan means each: (a) Company Employee Plan that is an “employee pension benefit plan,” within the meaning of Section 3(2) of ERISA; or (b) other occupational pension plan, including any final salary or money purchase plan.

  • Company Benefit Plan has the meaning specified in Section 4.13(a).

  • Business Benefit Plan means each Benefit Plan that is contributed to, sponsored, maintained or entered into by Seller or a Retained Subsidiary, a Purchased Subsidiary or any Affiliate of any of them for the benefit of any Business Employee.

  • Foreign Benefit Plan means any Employee Benefit Plan established, maintained or contributed to outside of the United States of America or which covers any employee working or residing outside of the United States.

  • Buyer Benefit Plans has the meaning set forth in Section 6.10(f).

  • Qualified Benefit Plan has the meaning set forth in Section 3.20(c).

  • Parent Benefit Plans has the meaning set forth in Section 5.07(b).

  • Welfare Benefit Plan means each welfare benefit plan maintained or contributed to by the Company, including, but not limited to a plan that provides health (including medical and dental), life, accident or disability benefits or insurance, or similar coverage, in which Executive was participating at the time of the Change in Control.

  • Company Employee Plan means any plan, program, policy, practice, contract, agreement or other arrangement providing for compensation, severance, termination pay, deferred compensation, performance awards, stock or stock-related awards, fringe benefits or other employee benefits or remuneration of any kind, whether written or unwritten or otherwise, funded or unfunded, including without limitation, each "employee benefit plan," within the meaning of Section 3(3) of ERISA which is or has been maintained, contributed to, or required to be contributed to, by the Company or any Affiliate for the benefit of any Employee, or with respect to which the Company or any Affiliate has or may have any liability or obligation;

  • Canadian Defined Benefit Pension Plan means a Canadian Pension Plan that contains or has ever contained a “defined benefit provision” as such term is defined in Section 147.1(1) of the Income Tax Act (Canada).

  • Company Employee Plans has the meaning set forth in Section 3.12(a).