Closed panel plan means a plan that provides health benefits to covered persons primarily in the form of services through a panel of providers that have contracted with or are employed by the plan, and that excludes benefits for services provided by other providers, except in cases of emergency or referral by a panel member.
Closed panel plan means a health care plan that requires enrollees to use participating providers. "Open panel plan" means a health care plan that provides incentives for enrollees to use participating providers and that also allows enrollees to use providers that are not participating providers. (R.C. 1751.01(E) and (S)(1), not in the bill.) No health insuring corporation may offer an open panel plan, unless the health insuring corporation is also licensed as an insurer under the Insurance Law, the health insuring corporation, on June 4, 1997, holds a certificate of authority or license to operate under R.C. Chapter 1736. or 1740. (both chapters have been repealed), or an insurer licensed under the Insurance Law is responsible for the out-of-network risk as evidenced by both an evidence of coverage filing under R.C. 1751.11 (evidence of subscriber's coverage for health care plan under which health care benefits are provided) and a policy and certificate filing under R.C. 3923.02 (sickness and accident insurance policy or certificate). (R.C. 1751.01(S)(2), not in the bill.)
Examples of Closed panel plan in a sentence
Closed panel plan is a Plan that provides health care benefits to covered persons in the form of services through a panel of providers who are primarily employed by the Plan, and that excludes coverage for services provided by other providers, except in cases of emergency or referral by a panel member.
Closed panel plan is a plan that provides health care benefits to covered persons in the form of services through a panel of providers who are primarily employed by the plan, and that excludes coverage for services provided by other providers, except in cases of Emergency or referral by a panel member.
More Definitions of Closed panel plan
Closed panel plan means a health care plan that
Closed panel plan means a health care plan that requires enrollees to use participating providers. "Open panel plan" means a health care plan that provides incentives for enrollees to use participating providers and that also allows