SEC. 9805. DEFINITIONS.
Title[ Title IV\Subtitle A\401 Contents
``(a) Group Health Plan.--For purposes of this chapter, the term
`group health plan' has the meaning given to such term by section
5000(b)(1).
``(b) Definitions Relating to Health Insurance.--For purposes of
this chapter--
``(1) Health insurance coverage.--
``(A) In general.--Except as provided in
subparagraph (B), the term `health insurance coverage'
means benefits consisting of medical care (provided
directly, through insurance or reimbursement, or
otherwise) 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.
``(B) No application to certain excepted benefits.--
In applying subparagraph (A), excepted benefits
described in subsection (c)(1) shall not be treated as
benefits consisting of medical care.
``(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 514(b)(2) of the Employee Retirement Income
Security Act of 1974, as in effect on the date of the enactment
of this section). Such term does not include a group health
plan.
``(3) Health maintenance organization.--The term `health
maintenance organization' means--
``(A) a federally qualified health maintenance
organization (as defined in section 1301(a) of the
Public Health Service Act (42 U.S.C. 300e(a))),
``(B) an organization recognized under State law as
a health maintenance organization, or
``(C) a similar organization regulated under State
law for solvency in the same manner and to the same
extent as such a health maintenance organization.
``(c) Excepted Benefits.--For purposes of this chapter, the term 'excepted benefits' means benefits under one or more (or any combination thereof) of the following:
``(1) Benefits not subject to requirements.--
``(A) Coverage only for accident, or disability income insurance, or any combination thereof.
``(B) Coverage issued as a supplement to liability insurance.
``(C) Liability insurance, including general liability insurance and automobile liability insurance.
``(D) Workers' compensation or similar insurance.
``(E) Automobile medical payment insurance.
``(F) Credit-only insurance.
``(G) Coverage for on-site medical clinics.
``(H) Other similar insurance coverage, specified in regulations, under which benefits for medical care are secondary or incidental to other insurance benefits.
``(2) Benefits not subject to requirements if offered
separately.--
``(A) Limited scope dental or vision benefits.
``(B) Benefits for long-term care, nursing home
care, home health care, community-based care, or any
combination thereof.
``(C) Such other similar, limited benefits as are
specified in regulations.
``(3) Benefits not subject to requirements if offered as
independent, noncoordinated benefits.--
``(A) Coverage only for a specified disease or illness.
``(B) Hospital indemnity or other fixed indemnity insurance.
``(4) Benefits not subject to requirements if offered as
separate insurance policy.--Medicare supplemental health
insurance (as defined under section 1882(g)(1) of the Social
Security Act), coverage supplemental to the coverage provided
under chapter 55 of title 10, United States Code, and similar
supplemental coverage provided to coverage under a group health
plan.
``(d) Other Definitions.--For purposes of this chapter--
``(1) COBRA continuation provision.--The term `COBRA
continuation provision' means any of the following:
``(A) Section 4980B, other than subsection (f)(1)
thereof insofar as it relates to pediatric vaccines.
``(B) Part 6 of subtitle B of title I of the
Employee Retirement Income Security Act of 1974 (29
U.S.C. 1161 et seq.), other than section 609 of such
Act.
``(C) Title XXII of the Public Health Service Act.
``(2) Governmental plan.--The term `governmental plan' has
the meaning given such term by section 414(d).
``(3) Medical care.--The term `medical care' has the meaning
given such term by section 213(d) determined without regard to--
``(A) paragraph (1)(C) thereof, and
``(B) so much of paragraph (1)(D) thereof as relates
to qualified long-term care insurance.
``(4) Network plan.--The term `network plan' means health
insurance coverage of a health insurance issuer under which the
financing and delivery of medical care are provided, in whole or
in part, through a defined set of providers under contract with
the issuer.
``(5) Placed for adoption defined.--The term `placement', or
being `placed', for adoption, in connection with any placement
for adoption of a child with any person, means the assumption
and retention by such person of a legal obligation for total or
partial support of such child in anticipation of adoption of
such child. The child's placement with such person terminates
upon the termination of such legal obligation.
``
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