Senate Bill 1378 Printer's Number 1814
PENNSYLVANIA, June 15 - section 9103 (relating to definitions).
"Contracting entity." A person or entity that enters into a
direct contract with a provider for the delivery of dental
services in the ordinary course of business, including a third-
party administrator or a dental carrier.
"Dental benefits plan." A benefits plan that pays or
provides dental expense benefits for covered dental services and
is delivered or issued for delivery in this Commonwealth by or
through a dental carrier or on a stand-alone basis.
"Dental carrier." A dental insurance company, dental service
corporation or dental plan organization authorized to provide a
dental benefits plan in this Commonwealth or a health benefits
plan in this Commonwealth that includes coverage for dental
services.
"Dental service." A service for the diagnosis, prevention,
treatment or cure of a dental condition, illness, injury or
disease. The term shall not include a service delivered by a
provider under a health benefits plan that is billed as a
medical service under the health benefits plan.
"Medical assistance." As defined under section 4802
(relating to definitions).
"Provider network contract." A contract between a
contracting entity and a provider specifying the rights and
responsibilities of the contracting entity and providing for the
delivery of and payment for dental services to covered persons.
"Third party." A person or entity that enters into a
contract with a contracting entity or with another third party
to gain access to the dental services or contractual discounts
of a provider network contract. The term shall not include an
employer or other group for which the contracting entity or
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