The 1991 version of the Russian Health Insurance Act (HIA) initiated the transition from a universal, government-provided health service to private insurance. The Act was comprised of 28 articles specifying the legal, economic, and organizational basis of medical insurance for the Russian Federation (Zakon 1991). Article 1 defined the forms of medical insurance. Articles 2 to 5 defined the insured, the insurers, and the conditions of the agreement between them as the insurance policy. Articles 6 to 9 specified the rights and responsibilities of the insured and the insurers. Articles 10 to 13 concerned the sources of financing and structure of insurance funds. Articles 14 to 19 summarized the structure, rights, and responsibilities of insurance companies. Articles 20 and 21 outlined the rights, responsibilities, and licensing of medical care provider organizations. Finally, articles 22 to 28 defined the programs, contracts, tariffs, taxes, and regulations between the panics of the medical care system and government agencies.