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Alaska Administrative Code (Last Updated: January 12, 2017) |
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Title 2. Administration. |
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Chapter 2.39. Group Health and Life Insurance. |
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Article 2.39.5. Appeals From Denials of Medical Claims Under the Medical Coverage Provided by the Teachers' Retirement System. |
Section 2.39.690. Definitions.
Latest version.
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In this chapter, (1) "board" means the Alaska Teachers' Retirement; (2) "claim" means a claim for benefits under the major medical insurance coverage provided under AS 14.25.168; (3) "claims payer" means the third-party administrator of benefit claims and payments under a contract entered into by the plan administrator under AS 39.30.090 - 39.30.095; (4) "day" means a calendar day; (5) "enrollee" means a person receiving medical coverage under any provision of AS 14.25, or the legal guardian of such a person; (6) "independent review organization" means an impartial health organization selected by the plan administrator to provide medical reviews of cases at the request of the plan administrator; (7) "plan administrator" means the administrator appointed by the commissioner of administration under AS 14.25.015; (8) "qualified hearing officer" means a person experienced in rendering decisions as a neutral decision-maker, and may include an employee of the state or a state agency other than the division of retirement and benefits in the Department of Administration.
Authorities
14.25.035;14.25.168