Preferred provider plan definition

Preferred provider plan means a health care plan offered by an organization established under ch. 185, 193, 611, 613, or 614 or issued a certificate of authority under ch. 618 that makes available to its enrollees, without referral and for consideration other than predetermined periodic fixed payments, coverage of either comprehensive health care services or a limited range of health care services, regardless of whether the health care services are performed by participating or nonparticipating providers.
Preferred provider plan means a managed care plan that meets the definition in s. 609.01 (4), Stats. A preferred provider plan does not include any of the following:
Preferred provider plan means a health care plan offered by an organization established under ch. 185, 611, 613 or 614 or issued a certificate of authority under ch. 618 that makes available to its enrollees, for consideration other than predetermined peri- odic fixed payments, either comprehensive health care services or a limited range of health care services performed by providers par- ticipating in the plan.

Examples of Preferred provider plan in a sentence

  • Ins 9.26 Preferred provider plan subject to defined network plan regulations.


More Definitions of Preferred provider plan

Preferred provider plan means a benefit plan through which the Company provides for the payment of a level of coverage that is different from the basic level of coverage provided under this Policy if the Covered Person uses a Preferred Provider.
Preferred provider plan has the meaning given in s. 609.01 (4). History: 1991 a. 250; 1993 a. 27; 1995 a. 27; 1997 a. 35; 1999 a. 9; 2005 a. 22; 2011 a. 32.
Preferred provider plan means a health care plan offered by an organization established under ch. 185, 611, 613 or 614 or issued a certificate of authority under ch. 618 that makes available to its enrolled participants, for consideration other than predeter- mined periodic fixed payments, either comprehensive health care services or a limited range of health care services performed by providers selected by the organization.
Preferred provider plan means an undertaking to enter into agreements with providers relating to terms and conditions of reimbursements for the health care services of insureds, members, or enrollees relating to the amounts to be charged to insureds, members, or enrollees for health care services.

Related to Preferred provider plan

  • Maintenance Programme shall have the meaning set forth in Clause 14.3; “Maintenance Period” shall have the meaning set forth in Clause 14.1; “Maintenance Requirements” shall have the meaning set forth in Clause 14.2;

  • Participating provider means an Administrator Hospital or Professional Provider which has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to participants in the Participating Provider Option program or an Administrator facility which has been designated by the Claim Administrator as a Participating Provider.