Source: http://dccode.elaws.us/code?no=31-3171.01
Timestamp: 2019-12-13 01:02:21
Document Index: 295501516

Matched Legal Cases: ['§ 31', '§ 31', '§ 31', '§ 31', '§ 18001', '§ 1305', '§ 201', '§ 3', '§ 1', '§ 201', '§ 31', '§ 31', '§ 31', '§ 301', '§ 2']

§ 31-3171.01. Definitions.
(1) "American Health Benefit Exchange" means an entity established pursuant to § 31-3171.04 , and section 1311(b) of the Federal Act.
(2) "Authority" means the District of Columbia Health Benefit Exchange Authority established by § 31-3171.02.
(3) "Commissioner" means the Commissioner of the Department of Insurance, Securities and Banking, as established by § 31-102.
(4) "Federal Act" means the Patient Protection and Affordable Care Act, approved March 23, 2010 (124 Stat. 119; 42 U.S.C. § 18001, note), as amended by the Health Care and Education Reconciliation Act of 2010 approved March 30, 2010 (124 Stat. 1029; 42 U.S.C. § 1305, note), and any amendments, regulations, or guidance issued pursuant to the Federal Act.
(5)(A) "Health benefit plan" means a policy, contract, certificate, or agreement offered or issued by a health carrier to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services.
(viii) Other similar insurance coverage, specified in federal regulations issued pursuant to the Health Insurance Portability and Accountability Act of 1996, approved August 21, 1996 (110 Stat. 1936; 42 U.S.C. § 201, note) ("HIPAA"), under which benefits for health care services are secondary or incidental to other insurance benefits.
(D) The term "health benefit plan" does not include the following benefits if the benefits are provided under a separate policy, certificate of insurance, or contract of insurance, and there is no coordination between the provision of the benefits and any exclusion of benefits under any group health plan maintained by the same plan sponsor, and the benefits are paid with respect to an event without regard to whether benefits are provided with respect to such an event under any group health plan maintained by the same plan sponsor:
(6) "Health carrier" means an entity subject to the insurance laws and regulations of the District that contracts, or offers to contract, to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services, including:
(7) "Health professional" shall have the same meaning as provided in § 3- 1201.01(8).
(8) "Internal Revenue Code of 1986" means the Internal Revenue Code of 1986, approved August 16, 1954 (100 Stat. 2095; 26 U.S.C. § 1 et seq.).
(9) "PHSA" means the Public Health Service Act, approved July 1, 1944 (58 Stat. 682; 42 U.S.C. § 201 et seq.).
(10) "Qualified dental plan" means a limited-scope dental plan that has been certified in accordance with § 31-3171.09.
(11) "Qualified employer" means a small employer that elects to make its full-time employees eligible for one or more qualified health plans offered through the Small Business Health Options Program Exchange ("SHOP Exchange"), and, at the option of the employer, some or all of its part-time employees; provided, that the employer:
(12) "Qualified health plan" means a health benefit plan that has a certification validating that the plan meets the criteria for certification described in section 1311(c) of the Federal Act and § 31-3171.09.
(13) "Qualified individual" means an individual, including a minor, who:
(14) "Secretary" means the Secretary of the United States Department of Health and Human Services.
(15) "SHOP Exchange" means a Small Business Health Options Program Exchange established pursuant to § 31-3171.04, and section 1311(b) of the Federal Act.
(16)(A) "Small employer" means a single employer that employed an average of not more than 50 employees during the preceding calendar year.
(17) "Social Security Act" means the Social Security Act, approved August 14, 1935 (49 Stat. 620; 42 U.S.C. § 301 et seq.), as amended.
(Mar. 2, 2012, D.C. Law 19-94, § 2, 59 DCR 213.)
Law 19-94, the "Health Benefit Exchange Authority Establishment Act of 2011", was introduced in Council and assigned Bill No. 19-2, which was referred to the Committee on Health, Public Services and Consumer Affairs. The Bill was adopted on first and second readings on December 2, 2012, and December 20, 2012, respectively. Signed by the Mayor on January 17, 2012, it was assigned Act No. 19-269 and transmitted to both Houses of Congress for its review. D.C. Law 19-94 became effective on March 2, 2012.