Code of Massachusetts Regulations › 956 CMR - COMMONWEALTH HEALTH INSURANCE CONNECTOR AUTHORITY › Title 956 CMR 8.00 - Student Health Insurance Program › Section 8.02 - Definitions

Current through Register 1525, July 5, 2024
The following terms as used in
				956 CMR 8.00 have the
				following meanings, except where the context clearly indicates
				otherwise:
Carrier
. An insurer licensed or
				otherwise authorized to transact accident and health insurance under M.G.L. c.
				175; a nonprofit hospital service corporation organized under M.G.L. c. 176A; a
				nonprofit medical service corporation organized under M.G.L. c. 176B; or a
				health maintenance organization organized under M.G.L. c. 176G. An entity
				exempt from licensure under
				211 CMR 43.02(2)
				 that operates a Student Health Insurance
				Program shall not be considered a Carrier or subject to a Carrier's enabling
				statute or the provisions of M.G.L. c. 176N or M.G.L. c. 176O for the purposes
				of complying with the requirements for that Student Health Insurance
				Program.
Commonwealth Health Insurance Connector Authority
				or Connector
. The entity established pursuant to M.G.L. c. 176Q,
				§ 2.
Division of Insurance
. The
				Massachusetts Division of Insurance established pursuant to M.G.L. c. 26,
				§ 1.
Emergency Services
. Services
				consistent with the Division of Insurance statutory references including those
				specified in M.G.L. c. 175, § 47U; M.G.L. c. 176A, § 8U; M.G.L. c.
				176B, § 4U; and M.G.L. c. 176G, § 5.
Essential Health Benefits Benchmark
				Plan
. T e health benefit plan required by Affordable Care Act
				§ 1302 and chosen by the Commonwealth through the Division of Insurance,
				pursuant to
				45 CFR §
									156.100.
Evidence of Coverage
. Any certificate,
				contract or agreement of health insurance including riders, amendments,
				endorsements and any other supplementary inserts or a summary plan description
				as defined in Division of Insurance regulations
				211 CMR 52.00:
Managed Care Consumer Protections and Accreditation of
				Carriers
.
Full-time Student
. A student who meets
				the minimum academic requirements for full-time students as defined by the
				School in which the student is enrolled.
Health Benefit Plan
. Any health plan
				offered through a health insurance program or other program through which an
				individual may obtain medical health benefits and services.
Independent Institution of Higher
				Education
. Any institution, other than institutions within the
				public system of higher education as set forth in M.G.L. c. 15A, § 5 and
				other than Quincy College, that offers courses leading to an academic degree
				and is accredited by the Massachusetts Board of Higher Education under the
				provisions of M.G.L. c. 69, §§ 30, 30A and 31A and
				610 CMR 2.00:
Independent Institutions of Higher Education Standards
.
MassHealth
. The Medical Assistance
				program administered by the Executive Office of Health and Human Services
				pursuant to M.G.L. c. 6A, §16 and M.G.L. c. 118E and in accordance with
				Title XIX of the Federal Social Security Act and all applicable Federal
				demonstrations and waivers.
Office of Patient Protection
. The
				office within the Health Policy Commission established by M.G.L. c. 111, §
				217 responsible for the administration and enforcement of M.G.L. c. 176O,
				§§ 13 through 16.
Part-time Student
. A student who
				participates in at least 75% of the academic requirements for full-time
				students.
Public Institution of Higher
				Education
. An Institution of Higher Education as defined in M.G.L.
				c. 15A, § 5 and Quincy College.
School
. A Public or Independent
				Institution of Higher Education located in Massachusetts.
School Year
. The 365-day period
				commencing on the first day of the fall semester at each School.
Short-term Course
. A course that meets
				no more than 15 days a semester or 30 days a year.
Student
. A Full-time or Part-time
				Student enrolled in a degree-granting program at a School who is not enrolled
				exclusively in online courses and whose enrollment does not consist entirely of
				Short-term Courses.
Student Health Insurance Program
. A
				student health insurance program offered by a School in accordance with the
				requirements of M.G.L. c. 15A, § 18 and
				956 CMR 8.00, including both
				fully insured and self-insured programs.