Individual health benefits plan definition

Individual health benefits plan means: a. a health benefits plan
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Individual health benefits plan means: a. a health benefits plan for eligible persons and their dependents; and b. a certificate issued to an eligible person which evidences coverage under a policy or contract issued to a trust or association, regardless of the situs of delivery of the policy or contract, if the eligible person pays the premium and is not being covered under the policy or contract pursuant to continuation of benefits provisions applicable under federal or State law.
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Individual health benefits plan means a benefits plan for individuals and their dependents that pays or provides for hospital and medical expense benefits for covered services;
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Examples of Individual health benefits plan in a sentence

  • C.17B:27A-7.23 Individual health benefits plan to cover digital tomosynthesis of the breast.

  • C.17B:27A-7.28 Individual health benefits plan to provide certain coverage for prescription drugs.

  • C.17B:27A-7.20 Individual health benefits plan, coverage for synchronization of prescribed medications.

  • C.17B:27A-7.17 Individual health benefits plan to provide coverage for oral anticancer medication.

  • C.17B:27A-7.5 Individual health benefits plan to provide coverage for biologically-based mental illness.

  • RESPONSE: "Individual health benefits plan" is defined at N.J.S.A. 17B:27A-2 and "group health contract" is defined in the HMO rules at N.J.A.C. 11:24-1.2. The Department does not believe that it is necessary to repeat such definitions in these amendments.

  • C.17B:27A-7.19 Individual health benefits plan to provide coverage for prescription eye drops.


More Definitions of Individual health benefits plan

Individual health benefits plan means: a. a health benefits plan for eligible persons and their dependents; and b. a certificate issued to an eligible person which evidences coverage under a policy or contract issued to a trust or association,
Sample 1
Individual health benefits plan means: (a) a health benefits plan for eligible persons and their dependents ; and (b) a certificate issued to an eligible person which evidences coverage under a policy or contract issued to a trust or association, regardless of the situs of delivery of the policy or contract, if the eligible person pays the premium and is not being covered under the policy of contract pursuant to continuation of benefits provisions applicable under Federal or State law. The term "individual health benefits plan" shall include a policy, contract, or certificate evidencing coverage by a policy or contract issued to a trust or association, issued to an eligible person described in, but not limited to, the following examples: a student, except coverage issued to an institution of higher education for coverage of students and their dependents in New Jersey if such policy has been filed by the Commissioner as a discretionary group pursuant to N.J.S.A. 17B:27-49, an unemployed individual or part-time employee, except as may be provided pursuant to N.J.S.A. 17B:27A-17 et seq. and N.J.A.C. 11:21-7.3; a self-employed person; an employer, when he or she (and dependents) is the sole employee seeking coverage by a health benefits plan, except as may be provided pursuant to N.J.S.A. 17B:27A-17 et seq. and N.J.A.C. 11:21-7.6; any person who is the sole employee seeking coverage by a health benefits plan, except as may be provided pursuant to N.J.S.A. 17B:27A-17 et seq. and N.J.A.C. 11:21-7.6;; and an employee who is one of several employees of the same employer who are covered by certificates, contracts or policies issued by the same carrier, trust or association, if the employer does not contribute to, and remit payment for, the coverage of such employees.
Sample 1
Individual health benefits plan means: (a) a health benefits plan for eligible persons and their depend- ents; and (b) a certificate issued to an eligible person which evidences coverage under a policy or contract issued to a trust or association, regardless of the situs of delivery of the policy or contract, if the eligible person pays the premium and is not being covered under the policy of contract pursuant to continuation of benefits provisions applicable under Federal or State law. The term "individual health benefits plan" shall include a policy, contract, or certificate evidencing coverage by a policy or contract issued to a trust or as- sociation, issued to an eligible person described in, but not limited to, the following examples: a student, except coverage issued to an institution of higher education for coverage of students and their dependents in New Jersey if such policy has been filed by the Commissioner as a discretionary group pursuant to
Sample 1

Related to Individual health benefits plan

  • Health benefits plan means a benefits plan which pays or

  • 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.

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

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

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

  • Retirement Plan means a plan which provides retirement benefits to you and which is not funded wholly by your contributions. The term shall not include a profit-sharing plan, informal salary continuation plan, registered retirement savings plan, stock ownership plan, 401(K) or a non-qualified plan of deferred compensation.

  • 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.

  • Medical Benefits Schedule means the Medicare Schedule of Benefits produced by the Department of Health to which all fees and benefits relate for inpatient hospital services.

  • Pharmacy benefit manager means a person, business, or

  • Pharmacy benefits manager means a person that performs pharmacy benefits management.

  • Pharmacy benefits management means the administration or management of prescription drug