health maintenance organization (HMO)
An organization that offers, provides, or arranges for coverage of designated
health services needed by plan members under a prepaid per capita or prepaid
aggregate fixed-sum basis. Services are provided through contracts and other
arrangements into which the HMO enters with healthcare providers. With limited
exceptions, persons enrolled in an HMO must receive healthcare benefits through
these contract providers or no insurance benefit is provided.
Links for IRMI Online Subscribers Only:
IWC XV.F;
PLI XVI.P