CHAPTER 1. DEFINITIONS

IC 27-17
    ARTICLE 17. DISCOUNT MEDICAL CARDPROGRAM 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 thisarticle.
As added by P.L.73-2006, SEC.3.

IC 27-17-1-2
"Cardholder"
    Sec. 2. "Cardholder" means a person that pays consideration forthe 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 commissionerappointed 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 createdby 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 programthrough which a discount medical card program organizationprovides, in exchange for consideration, a cardholder with access tomedical services provided by a program provider under a provideragreement. The term does not include:
        (1) a policy or contract regulated under this title; or
        (2) self-funded coverage regulated under the federal EmployeeRetirement Income Security Act of 1974 (29 U.S.C. 1001 etseq.).
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" meansa 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 theprovider 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 inIC 27-1-12-2) of an insurance company, that is regulated underthis title.
        (2) A health maintenance organization, or an affiliate (asdefined 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 anaffiliate (as defined in IC 27-1-12-2) of a limited service healthmaintenance 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 aperson that markets or distributes a discount medical card programunder the person's own name, but does not operate a discountmedical 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 treatmentrelated to:
        (1) an illness or a dysfunction of; or
        (2) injury to;
the human body.
    (b) The term includes physician care, inpatient care, hospitalservices, surgical services, emergency services, ambulance services,dental care services, vision care services, mental health services,substance abuse services, chiropractic services, podiatric careservices, laboratory services, radiology services, and medicalequipment and supplies.
    (c) The term does not include pharmaceutical supplies orprescriptions.
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 Indianalaw 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 betweena discount medical card program organization and a:
        (1) provider; or
        (2) provider network;
for the provider or providers that belong to the provider network torender 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 moreproviders that is represented by a person for purposes of negotiationswith 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 radiusof sixty (60) miles from the home or place of business of acardholder.
As added by P.L.73-2006, SEC.3.