As used in this Article, the following definitions apply:
     (a) “Health care services” means health care services or products rendered or sold by a provider within the scope of the provider’s license or legal authorization. The term includes, but is not limited to, hospital, medical, surgical, dental, vision and pharmaceutical services or products.

Terms Used In Illinois Compiled Statutes 215 ILCS 5/370g

  • Contract: A legal written agreement that becomes binding when signed.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • individual: shall include every infant member of the species homo sapiens who is born alive at any stage of development. See Illinois Compiled Statutes 5 ILCS 70/1.36
  • Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
  • State: when applied to different parts of the United States, may be construed to include the District of Columbia and the several territories, and the words "United States" may be construed to include the said district and territories. See Illinois Compiled Statutes 5 ILCS 70/1.14

     (b) “Insurer” means an insurance company or a health service corporation authorized in this State to issue policies or subscriber contracts which reimburse for expenses of health care services.
     (c) “Insured” means an individual entitled to reimbursement for expenses of health care services under a policy or subscriber contract issued or administered by an insurer.
     (d) “Provider” means an individual or entity duly licensed or legally authorized to provide health care services.
     (e) “Noninstitutional provider” means any person licensed under the Medical Practice Act of 1987, as now or hereafter amended.
     (f) “Beneficiary” means an individual entitled to reimbursement for expenses of or the discount of provider fees for health care services under a program where the beneficiary has an incentive to utilize the services of a provider which has entered into an agreement or arrangement with an administrator.
     (g) “Administrator” means any person, partnership or corporation, other than an insurer or health maintenance organization holding a certificate of authority under the “Health Maintenance Organization Act”, as now or hereafter amended, that arranges, contracts with, or administers contracts with a provider whereby beneficiaries are provided an incentive to use the services of such provider.
     (h) “Emergency medical condition” means a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate medical attention to result in:
        (1) placing the health of the individual (or, with
respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy;
        (2) serious impairment to bodily functions; or
        (3) serious dysfunction of any bodily organ or part.