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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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