adverse benefit determinationincludes an adverse benefit determination as defined in paragraph (a)(2)(i) of this section.
brand prescription drugincludes a drug with Emergency Use Authorization issued pursuant to section 564 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb-3), and that is generally marketed under a proprietary, trademark-protected name.
classificationmeans a classification as described in paragraph (c)(2)(ii) of this section.
controlled groupmeans any group treated as a single employer under section 52(a), 52(b), 414(m), or 414(o) of the Internal Revenue Code of 1986, as amended.
essential health benefitsmeans essential health benefits under section 1302(b) of the Patient Protection and Affordable Care Act and applicable regulations.
full-time employeemeans a “full-time employee” as defined in 26 CFR 54.4980H-1(a)(21) who is not in a limited non-assessment period for certain employees (as defined in 26 CFR 54.4980H-1(a)(26)).
paymenthas the meaning given such term in 45 CFR 164.501 of the privacy regulations issued under the Health Insurance Portability and Accountability Act.