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Anticompetitive terms

Clauses or conditions in contracts that reduce competition, such as those that prevent an insurer from directing patients to other providers or restrict pricing.

Group health plan

An employee welfare benefit plan that provides medical care to employees or their families, typically offered by an employer or employee organization.

Health insurance issuer

A company that offers health insurance policies, like Blue Cross Blue Shield or Aetna.

Covered entity

In this bill, refers to a healthcare provider (like a hospital or doctor's office), a network of providers, or a company that helps provide access to a network of medical professionals.

Value-based network arrangement

A type of healthcare network designed to reward providers for delivering high-quality, cost-effective care, rather than simply paying for the volume of services.

Affiliate

A company or organization that is closely connected to another company, often through shared ownership or control.

Grandfathering

Allowing an old rule or agreement to continue to apply to some existing situations even after a new rule or law has taken effect, rather than requiring immediate compliance with the new rule.