Definitions

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. (Mass. Register #1394 6/28/19) 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.