the parties in the event that they fail to enter into a mutually
agreeable provider contract within the time frames established
by this act.
"Department." The Insurance Department of the Commonwealth.
"Health care services." A medical-surgical, hospital,
facility or ancillary service provided to an individual.
"Health insurance carrier." An entity licensed in this
Commonwealth to issue health insurance, subscriber contracts,
certifications or plans that provide medical or health care
coverage by a health care facility or licensed health care
provider that is offered or governed under this act or any of
the following:
(1) The act of December 29, 1972 (P.L.1701, No.364),
known as the Health Maintenance Organization Act.
(2) The act of May 18, 1976 (P.L.123, No.54), known as
the Individual Accident and Sickness Insurance Minimum
Standards Act.
(3) 40 Pa.C.S. Chs. 61 (relating to hospital plan
corporations) and 63 (relating to professional health
services plan corporations).
"Health insurance policy." A health insurance policy,
subscriber contract, certificate or policy that provides health
or sickness and accident coverage offered by a health insurance
carrier and that is subject to review by the department under
the provisions of the act of December 18, 1996 (P.L.1066,
No.159), known as the Accident and Health Filing Reform Act. The
term does not include any of the following:
(1) An accident-only policy.
(2) A credit-only policy.
(3) A long-term care or disability income policy.
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