P.R. Laws tit. 26, § 9272
For purposes of this chapter:
(a) Evidence of coverage.— Means a certificate, policy, agreement, or contract setting forth the coverage to which a subscriber is entitled.
(b) Limited health service organization.— Means any corporation, partnership or other entity that undertakes to provide or arrange for the provision of one (1) or more limited health services to subscribers in return for a prepayment which is deemed to be earned whether the individual uses the limited health services provided under the plan. Limited health service organization does not include:
(1) An entity that meets the requirements of § 9277 of this title, or
(2) a provider or entity when providing or arranging for the provision of limited health services pursuant to a contract with a limited health service organization or with an entity that complies with the provisions of clause (1) of this subsection.
(c) Provider.— Means a physician, dentist, hospital, healthcare facility, or other person or institution duly authorized in Puerto Rico to deliver or furnish limited health services.
(d) Limited health services.— Means dental care services, vision care services, mental health services, substance abuse services, pharmaceutical services, podiatric care services, and such other services as may be determined by the Commissioner to be limited health services. Limited health service shall not include hospital, medical, surgical or emergency services except as these services are provided incident to the limited health services set forth in the preceding sentence.
(e) Subscriber.— Means any person, including his/her dependents, who is entitled to received limited health services pursuant to a contract with an entity authorized to provide or arrange for such services.
History —Aug. 29, 2011, No. 194, added as § 16.020 on Aug. 23, 2012, No. 203, § 2, eff. 90 days after Aug. 23, 2012.