CHAPTER 1. DEFINITIONS

IC 27-17
    ARTICLE 17. DISCOUNT MEDICAL CARD PROGRAM ORGANIZATIONS

IC 27-17-1
     Chapter 1. Definitions

IC 27-17-1-1
Application of definitions
    
Sec. 1. The definitions in this chapter apply throughout this article.
As added by P.L.73-2006, SEC.3.

IC 27-17-1-2
"Cardholder"
    
Sec. 2. "Cardholder" means a person that pays consideration for the right to participate in a discount medical card program.
As added by P.L.73-2006, SEC.3.

IC 27-17-1-3
"Commissioner"
    
Sec. 3. "Commissioner" refers to the insurance commissioner appointed under IC 27-1-1-2.
As added by P.L.73-2006, SEC.3.

IC 27-17-1-4
"Department"
    
Sec. 4. "Department" refers to the department of insurance created by IC 27-1-1-1.
As added by P.L.73-2006, SEC.3.

IC 27-17-1-5
"Discount medical card program"
    
Sec. 5. "Discount medical card program" means a program through which a discount medical card program organization provides, in exchange for consideration, a cardholder with access to medical services provided by a program provider under a provider agreement. The term does not include:
        (1) a policy or contract regulated under this title; or
        (2) self-funded coverage regulated under the federal Employee Retirement Income Security Act of 1974 (29 U.S.C. 1001 et seq.).
As added by P.L.73-2006, SEC.3.

IC 27-17-1-6
"Discount medical card program organization"
    
Sec. 6. (a) "Discount medical card program organization" means a person that:
        (1) negotiates and enters into provider agreements;
        (2) in exchange for consideration, provides cardholders with a

right of access to the discounted prices available under the provider agreements entered into under subdivision (1); and
        (3) determines the charge to cardholders for the discount prices.
    (b) The term does not include the following:
        (1) An insurance company, or an affiliate (as defined in IC 27-1-12-2) of an insurance company, that is regulated under this title.
        (2) A health maintenance organization, or an affiliate (as defined in IC 27-1-12-2) of a health maintenance organization, that is regulated under this title.
        (3) A limited service health maintenance organization, or an affiliate (as defined in IC 27-1-12-2) of a limited service health maintenance organization, that is regulated under this title.
As added by P.L.73-2006, SEC.3.

IC 27-17-1-7
"Marketer"
    
Sec. 7. "Marketer" means a person that markets, promotes, sells, or distributes a discount medical card program. The term includes a person that markets or distributes a discount medical card program under the person's own name, but does not operate a discount medical card program.
As added by P.L.73-2006, SEC.3.

IC 27-17-1-8
"Medical service"
    
Sec. 8. (a) "Medical service" means care, service, or treatment related to:
        (1) an illness or a dysfunction of; or
        (2) injury to;
the human body.
    (b) The term includes physician care, inpatient care, hospital services, surgical services, emergency services, ambulance services, dental care services, vision care services, mental health services, substance abuse services, chiropractic services, podiatric care services, laboratory services, radiology services, and medical equipment and supplies.
    (c) The term does not include pharmaceutical supplies or prescriptions.
As added by P.L.73-2006, SEC.3.

IC 27-17-1-9
"Person"
    
Sec. 9. "Person" means an individual or a business entity.
As added by P.L.73-2006, SEC.3.

IC 27-17-1-10
"Program provider"
    
Sec. 10. "Program provider" means a provider that has, individually or through a provider network, entered into a provider

agreement with a discount medical card program organization.
As added by P.L.73-2006, SEC.3.

IC 27-17-1-11
"Provider"
    
Sec. 11. "Provider" means a person that is licensed under Indiana law to provide medical services.
As added by P.L.73-2006, SEC.3.

IC 27-17-1-12
"Provider agreement"
    
Sec. 12. "Provider agreement" means a written agreement between a discount medical card program organization and a:
        (1) provider; or
        (2) provider network;
for the provider or providers that belong to the provider network to render medical services to cardholders at discounted rates.
As added by P.L.73-2006, SEC.3.

IC 27-17-1-13
"Provider network"
    
Sec. 13. "Provider network" means a group of two (2) or more providers that is represented by a person for purposes of negotiations with third parties.
As added by P.L.73-2006, SEC.3.

IC 27-17-1-14
"Service area"
    
Sec. 14. "Service area" means a geographic area within a radius of sixty (60) miles from the home or place of business of a cardholder.
As added by P.L.73-2006, SEC.3.