Is the plan an individual or group plan or combination thereof that provides or pays for the cost of medical care?
• If yes, is the plan a group health plan if yes, does the plan have both of the following characteristics (a) it has fewer than 50 participants and (b) it is self-administered if yes, Stop, the plan is NOT a health plan, if no, the plan is a health plan. • Is the plan a health insurance issuer if yes, the plan is a health plan • Is the plan an issuer of a Medicare supplemental policy if yes, the plan is a health plan • Is the plan an HMO if yes, the plan is a health plan • Is the plan a multi-employer welfare benefit plan – if yes, the plan is a health plan • Is the plan an issuer of long-term care policies if yes, does the plan provide only nursing home fixed indemnity policies if yes, the plan is NOT a health plan if no, the plan is a health plan • Does the plan provide only excepted benefits if yes, the plan is NOT a health plan if no, the plan is a health plan After applying this test and the answer you derive at is that the plan is a health plan then you should know that this con
