Health benefits claim means a claim by a covered person for
Health benefits claim means a claim by a covered person for payment of benefits under a health benefits plan.
Health benefits plan means a benefits plan which pays or
Health Benefits means health maintenance organization, insured or self-funded medical, dental, vision, prescription drug and behavioral health benefits.
Pharmacy benefits management means the administration or management of prescription drug
Pharmacy benefits manager means a person that performs pharmacy benefits management.
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.
Pharmacy benefit manager means a person, business or other
Retiree means any person who has begun accruing a retirement
Disability benefits means any cash payments which are payable to a covered individual for all or part of a period of disability pursuant to P.L.1948, c.110 (C.43:21-25 et al.).
Medical Benefits means medical, optical, or dental benefits, including, but not limited to, hospital and physician services, prescription drugs, and related benefits.
Essential Health Benefits means, under section 1302(b) of the Patient Protection and Affordable Care Act, those health benefits to include at least the following general categories and the items and services covered within the categories: ambulatory patient services; Emergency Services; hospitalization; maternity and newborn care; mental health and substance abuse disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.
Covered benefits or “benefits” means those health care services to which a covered person is entitled under the terms of a health benefit plan.
Salaried Employee means an employee who is not covered by the Fair Labor Standards Act who regularly receives each pay period a predetermined amount constituting all or part of compensation. This base salary cannot be reduced because of variations in the quality or quantity of work performed.
Basic health benefit plan means any plan offered to an individual, a small group,