§ 1191b. Definitions
(a)
Group health plan
For purposes of this part—
(1)
In general
The term “group health plan” means an employee welfare benefit plan to the extent that the plan provides medical care (as defined in paragraph (2) and including items and services paid for as medical care) to employees or their dependents (as defined under the terms of the plan) directly or through insurance, reimbursement, or otherwise.
(2)
Medical care
The term “medical care” means amounts paid for—
(A)
the diagnosis, cure, mitigation, treatment, or prevention of disease, or amounts paid for the purpose of affecting any structure or function of the body,
(b)
Definitions relating to health insurance
For purposes of this part—
(1)
Health insurance coverage
The term “health insurance coverage” means benefits consisting of medical care (provided directly, through insurance or reimbursement, or otherwise and including items and services paid for as medical care) under any hospital or medical service policy or certificate, hospital or medical service plan contract, or health maintenance organization contract offered by a health insurance issuer.
(2)
Health insurance issuer
The term “health insurance issuer” means an insurance company, insurance service, or insurance organization (including a health maintenance organization, as defined in paragraph (3)) which is licensed to engage in the business of insurance in a State and which is subject to State law which regulates insurance (within the meaning of section
1144
(b)(2) of this title). Such term does not include a group health plan.
(c)
Excepted benefits
For purposes of this part, the term “excepted benefits” means benefits under one or more (or any combination thereof) of the following:
(2)
Benefits not subject to requirements if offered separately
(d)
Other definitions
For purposes of this part—
(1)
COBRA continuation provision
The term “COBRA continuation provision” means any of the following:
(3)
Network plan
The term “network plan” means health insurance coverage offered by a health insurance issuer under which the financing and delivery of medical care (including items and services paid for as medical care) are provided, in whole or in part, through a defined set of providers under contract with the issuer.
(5)
Family member
The term “family member” means, with respect to an individual—
(6)
Genetic information
(A)
In general
The term “genetic information” means, with respect to any individual, information about—
(B)
Inclusion of genetic services and participation in genetic research
Such term includes, with respect to any individual, any request for, or receipt of, genetic services, or participation in clinical research which includes genetic services, by such individual or any family member of such individual.
(7)
Genetic test
(A)
In general
The term “genetic test” means an analysis of human DNA, RNA, chromosomes, proteins, or metabolites, that detects genotypes, mutations, or chromosomal changes.
(9)
Underwriting purposes
The term “underwriting purposes” means, with respect to any group health plan, or health insurance coverage offered in connection with a group health plan—