Title XI, SEC. 11008. DEFINITIONS. 
            In this title: 

        (1) Applicable secretary. The term ``applicable Secretary'' means 

          (A) the Secretary with respect to health insurance plans and 
        insurers, or 

          (B) the Secretary of labor with respect to self-insured plans and 
        self-insured plan sponsors. 

        (2) Covered employee. The term ``covered employee'' means an employee 
      (or dependent of such an employee) covered under a group health benefits 
      plan. 

        (3) Covered individual. The ``covered individual'' means, with respect 
      to a health benefit plan, an individual insured, enrolled, eligible for 
      benefits, or otherwise covered under the plan. 

        (4) Group health benefits plan. The term ``group health benefits plan'' 
      means a group health insurance plan and a self-insured plan. 

        (5) Group health insurance plan. 

          (A) In general. The term ``group health insurance plan'' means a 
        health insurance plan offered primarily to employers for the purpose of 
        providing health insurance to the employees (and dependents) of the 
        employer. 

          (B) Inclusion of association plans and mewas. Such term includes 

            (i) any arrangement in which coverage for health benefits is 
          offered to employers through an association, trust, or other 
          arrangement, and 

            (ii) a multiple employer welfare arrangement (as defined in section 
          3(40) of the Employee Retirement Income Security Act of 1974), 
          whether funded through insurance or otherwise. 

        (6) Health benefits plan. The term ``health benefits plan'' means 
      health insurance plan and a self-insured health benefit plan. 

        (7) Health benefit plan sponsor. The term ``health benefit plan 
      sponsor'' means,  with respect to a health insurance plan or self-insured 
      plan, the insurer offering the plan or the self-insured sponsor for the 
      plan, respectively. 

        (8) Health insurance plan. 

          (A) In general. Except as provided in subparagraph (B), the term 
        ``health insurance plan'' means any contract of health insurance, 
        including any hospital or medical service policy or certificate, any 
        major medical policy or certificate, any hospital or medical service 
        plan contract, or health maintenance organization subscriber contract 
        offered by an insurer. 

          (B) Exception. Such term does not include any of the following 

            (i) coverage only for accident, dental, vision, disability income, 
          or long-term care insurance, or any combination thereof, 

            (ii) medicare supplemental health insurance, 

            (iii) coverage issued as a supplement to liability insurance, 

            (iv) worker's compensation or similar insurance, or 

      (v) automobile medical-payment insurance, 

      or any combination thereof. 

          (C) Stop loss insurance not covered. Such term does not include any 
        aggregate or specific stop-loss insurance or similar coverage 
        applicable to a self-insured plan. The Secretary may develop rules 
        determining the applicability of this subparagraph with respect to 
        minimum premium plans or other partially insured plans. 

        (9) Health insurer. The term ``health insurer'' means a licensed 
      insurance company, a prepaid hospital or medical service plan, a health 
      maintenance organization, or other entity providing a plan of health 
      insurance or health benefits with respect to which the State insurance 
      laws are not preempted under section 514 of the Employee Retirement 
      Income Security Act of 1974. 

        (10) Individual health insurance plan. 

          (A) In general. The term ``individual health insurance plan'' means 
        any health insurance plan directly purchased by an individual or 
        offered primarily to individuals (including families) for the purpose 
        of permitting individuals (without regard to an employer contribution) 
        to purchase health insurance coverage. 

          (B) Inclusion of association plans. Such term includes any 
        arrangement in which coverage for health benefits is offered to 
        individuals through an association, trust, list-billing arrangement, or 
        other arrangement in which the individual purchaser is primarily 
        responsible for the payment of any premium associated with the 
        contract. 

          (C) Treatment of certain association plans. In the case of a health 
        insurance plan sponsored by an association, trust, or other arrangement 
        that provides health insurance coverage both to employers and to 
        individuals, the plan shall be treated as 

            (i) a group health insurance plan with respect to such employers, 
          and 

            (ii) an individual health insurance plan with respect to such 
          individuals. 

        (11) Self-insured plan. The term ``self-insured plan'' means an 
      employee welfare benefit plan or other arrangement insofar as the plan or 
      arrangement provides benefits with respect to some or all of the items 
      and services included in the comprehensive benefit package (as in effect 
      as of January 1, 1995) that is funded in a manner other than through the 
      purchase of one or more health insurance plans. such term shall not 
      include a group health insurance plan (as defined in paragraph 
      (5)(B)(ii)). 

        (12) Self-insured sponsor. The term ``self-insured sponsor'' includes,  
      with respect to a self-insured plan, any entity which establishes or 
      maintains the plan. 

        (13) State commissioner of insurance. The term ``State commissioner of 
      insurance'' includes a State superintendent of insurance.