The following definitions apply in this Article:

(1)        Dental service plan. – A contract for the provision of, or the payment of fees for, dental care or dental services, including any other professional services authorized or permitted to be provided by a duly licensed dentist.

(2)        Full-service corporation. – Any corporation organized under the provisions of this Article that offers a medical service plan or a health care service plan.

(3)        Health care service plan. – Any contract for the provision of, or the payment of fees for, hospital care, laboratory facilities, X-ray facilities, drugs, health care appliances, anesthesia, nursing care, operating and obstetrical equipment, or health care accommodations, including any other services permitted to be provided by a hospital under the laws of this State and approved by the North Carolina Hospital Association or the American Medical Association.

(4)        Hospital service corporation. – Any nonprofit corporation that operates one or any combination of the following:

a.         Dental service plan.

b.         Health care service plan.

c.         Medical service plan.

d.         Vision service plan.

(5)        Medical service plan. – Any contract for the furnishing of, or the payment of fees for, any of the following:

a.         Medical, obstetrical, surgical, or any other professional services authorized or permitted to be provided by a duly licensed physician or other provider listed in N.C. Gen. Stat. § 58-50-30.

b.         Professional medical services authorized or permitted to be provided by a health care provider licensed under Chapter 90 of the N.C. Gen. Stat..

(6)        Preferred provider. – A health care provider who has agreed to accept, from a corporation organized for the purposes authorized by this Article, special reimbursement terms in exchange for providing services to beneficiaries of a plan administered pursuant to this Article.

(7)        Single-service corporation. – Any corporation organized under the provisions of this Article that offers any of the following:

a.         Only a dental service plan.

b.         Only a vision service plan.

c.         Both a dental service plan and a vision service plan, but no other plans.

(8)        Vision service plan. – Any contract for the provision of, or the payment of fees for, vision care or vision services, including any other professional services permitted to be provided by a duly licensed optometrist or ophthalmologist. ?(2021-169, s. 1.)

Terms Used In North Carolina General Statutes 58-65-1.1

  • 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.
  • following: when used by way of reference to any section of a statute, shall be construed to mean the section next preceding or next following that in which such reference is made; unless when some other section is expressly designated in such reference. See North Carolina General Statutes 12-3
  • state: when applied to the different parts of the United States, shall be construed to extend to and include the District of Columbia and the several territories, so called; and the words "United States" shall be construed to include the said district and territories and all dependencies. See North Carolina General Statutes 12-3