[PART IX.]  UNIVERSAL IMMUNIZATION FUNDING PROGRAM

     [§325-131]  Definitions.  As used in this part:

     "Adult covered lives" means all adults under the age of sixty-five who have immunizations covered:

     (1)  By an individual or group health insurance policy, plan, contract, or agreement issued or delivered in the State;

     (2)  By a group health insurance policy evidenced by a certificate of insurance issued or delivered to an individual residing in the State;

     (3)  By an employee benefit plan of a self-insured entity or a government plan for any employer or government entity that has an office or other worksite located in the State or has two or more employees; or

     (4)  As a participant or beneficiary of a health cost sharing program.

     "Assessed entity" means an insurer that is not a medicare advantage health plan and is governed by article 10A of chapter 431, a nonprofit mutual benefit society governed by article 1 of chapter 432, a fraternal benefit society governed by article 2 of chapter 432, or a health maintenance organization governed by chapter 432D.

     "Assessment" means the association member liability with respect to immunization costs determined in accordance with this part.

     "Child covered lives" means all children aged eighteen years or younger who have immunizations covered:

     (1)  By an individual or group health insurance policy, plan, contract, or agreement issued or delivered in the State;

     (2)  By a group health insurance policy evidenced by a certificate of insurance issued or delivered to an individual residing in the State;

     (3)  By an employee benefit plan of a self-insured entity or a government plan for any employer or government entity that has an office or other worksite located in the State or has two or more employees; or

     (4)  As a participant or beneficiary of a health cost sharing program.

     "Department" means the department of health.

     "Director" means the director of health or the director's designee.

     "Estimated adult immunization cost" means the estimated cost to the State for the purchase and distribution of adult immunizations.

     "Estimated child immunization cost" means the estimated cost to the State for the purchase and distribution of child immunizations.

     "Health cost sharing program" means any cost sharing or similar program that seeks to share the costs of health care services and that in the preceding twelve months has either coordinated payment for or reimbursed over $10,000 of costs for health care services delivered in the State or communicated by mail or electronic media to residents of the State concerning its potential participation.

     "Immunization" means any preparation of killed microorganisms, living attenuated organisms, living fully virulent organisms, or part thereof, or any other treatment intended to trigger an immune response that is authorized by the United States Food and Drug Administration, recommended by the national Advisory Committee on Immunization Practices of the federal Centers for Disease Control and Prevention, or has been authorized for purchase by the director for the purposes of producing or increasing immunity to particular diseases.  "Immunization" includes any other substance designated as such by order of the director.

     "Program" means the universal immunization funding program established under this part.

     "Provider" means a person licensed by the State to administer immunizations or provide health care services or a partnership or corporation or other entity made up of those persons.

     "Vaccines for children program" means the federal entitlement program established under title 42 United States Code section 1396s, which provides immunizations at no charge for eligible children eighteen years of age or younger. [L 2025, c 175, pt of §2]