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For purposes of part 159, the following definitions apply unless otherwise provided:
Health Insurance Coverage:
We adopt the Public Health Service Act (PHSA) definition of “health insurance coverage” found at section 2791(b)(1) of the Public Health Service Act (PHSA).
Health Insurance Issuer:
We adopt the PHSA definition of “health insurance issuer” found at section 2791(b)(2) of the PHSA.
Health Insurance Product:
Means a package of benefits that an issuer offers that is reported to State regulators in an insurance filing.
Individual Health Insurance Coverage:
We adopt the PHSA definition of “individual health insurance coverage” found at section 2791(b)(5) of the PHSA.
Individual Market:
We adopt the Affordable Care Act definition of “individual market” found at section 1304(a)(2) of the Affordable Care Act and 2791(e)(1)(A) of the PHSA.
Portal Plan:
Means the discrete pairing of a package of benefits and a particular cost sharing option (not including premium rates or premium quotes).
Section 1101 High Risk Pools:
We define section 1101 high risk pools as any entity described in regulations implementing section 1101 of the Affordable Care Act.
Small Employer:
We adopt the Affordable Care Act definition of “small employer” found at section 1304(b)(2) and (3).
Small Group Coverage:
Means health insurance coverage offered to employees of small employers in the small group market.
Small Group Market:
We adopt the Affordable Care Act definition of “small group market” found at section 1304(a)(3).
State Health Benefits High Risk Pools:
Means nonprofit organizations created by State law to offer comprehensive health insurance to individuals who otherwise would be unable to secure such coverage because of their health status.
[75 FR 24482 May 5, 2010]