32 V.S.A. § 10401 — Definitions

As used in this chapter:
(1) “Health insurance” means any group or individual health care benefit policy, contract,
or other health benefit plan offered, issued, renewed, or administered by any health
insurer, including any health care benefit plan offered, issued, renewed, or administered
by any health insurance company, any nonprofit hospital and medical service corporation,
any dental service corporation, or any managed care organization as defined in 18 V.S.A. § 9402. The term includes comprehensive major medical policies, contracts, or plans; short-term,
limited-duration health insurance policies and contracts as defined in 8 V.S.A. § 4053; student health insurance policies; and Medicare supplement insurance policies, contracts,
or plans, but does not include Medicaid or any other State health care assistance
program in which claims are financed in whole or in part through a federal program
unless authorized by federal law and approved by the General Assembly. The term does
not include policies issued for specified disease, accident, injury, hospital indemnity,
long-term care, disability income, or other limited benefit health insurance policies,
except that any policy providing coverage for dental services shall be included.
(2) “Health insurer” means any person who offers, issues, renews, or administers a health
insurance policy, contract, or other health benefit plan in this State and includes
third party administrators or pharmacy benefit managers who provide administrative
services only for a health benefit plan offering coverage in this State. The term
does not include a third party administrator or pharmacy benefit manager to the extent
that a health insurer has paid the fee that would otherwise be imposed in connection
with health care claims administered by the third party administrator or pharmacy
benefit manager. (