Terms Used In Tennessee Code > Title 8 > Chapter 37 > Part 3 - State Accumulation Fund

• affiliate: means any entity that exercises control over or is controlled by the HMO, directly or indirectly through:
  (A) Equity ownership of voting securities. See Tennessee Code 56-32-102
• Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
• Amortization: Paying off a loan by regular installments.
• Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
• Appropriation: The provision of funds, through an annual appropriations act or a permanent law, for federal agencies to make payments out of the Treasury for specified purposes. The formal federal spending process consists of two sequential steps: authorization
• Arrest: Taking physical custody of a person by lawful authority.
• Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
• Attorney: means the person designated and authorized by subscribers as the attorney-in-fact having authority to obligate them on reciprocal insurance contracts. See Tennessee Code 56-16-102
• basic health care services: includes , but is not limited to, services made necessary as the result of Title XIX federal programs or waivers for which TennCare is primarily responsible for implementation or enforcement. See Tennessee Code 56-32-102
• Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. ^{Source: OCC}
• Beneficiary: means a person designated in the subscription certificate referred to in subdivision (10), as entitled to the dental services referred to in subdivision (10). See Tennessee Code 56-30-102
• board: means the board provided for in part 3 of this chapter. See Tennessee Code 8-34-101
• Chief officer: means the person with overall authority for a public or private hospital or treatment resource, or the person's designee. See Tennessee Code 33-1-101
• Child: means a person who is under eighteen (18) years of age. See Tennessee Code 33-1-101
• Code: includes the Tennessee Code and all amendments and revisions to the code and all additions and supplements to the code. See Tennessee Code 1-3-105
• Codicil: An addition, change, or supplement to a will executed with the same formalities required for the will itself.
• Coinsurance: means an enrollee's share of covered medical expenses when an enrollee and the HMO share in a specific ratio of the covered medical expenses. See Tennessee Code 56-32-102
• Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-30-102
• Commissioner: means the commissioner of mental health and substance abuse services. See Tennessee Code 33-1-101
• Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-31-102
• Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-32-102
• Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-1-102
• Common law: The legal system that originated in England and is now in use in the United States. It is based on judicial decisions rather than legislative action.
• Community mental health center: includes for profit corporations and private entities qualified as tax exempt organizations under Internal Revenue Code, §. See Tennessee Code 33-1-101
• Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
• Consent: means voluntary agreement to what is reasonably well understood regardless of how the agreement is expressed. See Tennessee Code 33-1-101
• Contract: A legal written agreement that becomes binding when signed.
• Conviction: A judgement of guilt against a criminal defendant.
• Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
• County mayor: means and includes "county executive" unless the context clearly indicates otherwise. See Tennessee Code 1-3-105
• Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
• Defendant: In a civil suit, the person complained against; in a criminal case, the person accused of the crime.
• Defense attorney: Represent defendants in criminal matters.
• Dental service: means professional services rendered by persons duly licensed under the laws of this state to practice dentistry and all services defined as constituting the practice of dentistry as set out in title 63, chapter 5. See Tennessee Code 56-30-102
• Department: means the department of mental health and substance abuse services. See Tennessee Code 33-1-101
• Department: means the department of commerce and insurance. See Tennessee Code 56-1-102
• Dependent: A person dependent for support upon another.
• Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
• Earnable compensation: includes , but is not limited to, any bonus or incentive payment. See Tennessee Code 8-34-101
• EMAC: means the national interstate mutual aid agreement adopted by all fifty (50) states, the District of Columbia, the United States Virgin Islands, Puerto Rico and ratified by the 104th United States Congress in 1996 (PL-104-321) that enables states to share resources during times of disaster created during the 104th Congress. See Tennessee Code 68-140-603
• Employer: means :
  (A) The state or any department, commission, institution, board or agency of the state government by which a member is paid, with respect to members in its employ. See Tennessee Code 8-34-101
• Enrollee: means an individual who is enrolled in an HMO. See Tennessee Code 56-32-102
• Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. ^{Source: U.S. Courts}
• Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
• Evidence of coverage: means any certificate, agreement or contract issued to an enrollee setting out the coverage to which the enrollee is entitled. See Tennessee Code 56-32-102
• Fiduciary: A trustee, executor, or administrator.
• Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006.
• Foreign: when used without limitation, includes all companies formed by authority of any other state or government. See Tennessee Code 56-1-102
• Fraud: Intentional deception resulting in injury to another.
• Grace period: The number of days you'll have to pay your bill for purchases in full without triggering a finance charge. ^{Source: Federal Reserve}
• Grand jury: agreement providing that a lender will delay exercising its rights (in the case of a mortgage,
• Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
• Health care services: means any services included in the furnishing to any individual of medical or dental care, or hospitalization, or incidental to the furnishing of the care or hospitalization, as well as the furnishing to any person of any and all other services for the purpose of preventing, alleviating, curing, or healing human illness, injury or physical disability. See Tennessee Code 56-32-102
• Hospital: means a public or private hospital or facility or part of a hospital or facility equipped to provide inpatient care and treatment for persons with mental illness or serious emotional disturbance. See Tennessee Code 33-1-101
• Indemnification: In general, a collateral contract or assurance under which one person agrees to secure another person against either anticipated financial losses or potential adverse legal consequences. ^{Source: FDIC}
• Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
• Lease: A contract transferring the use of property or occupancy of land, space, structures, or equipment in consideration of a payment (e.g., rent). ^{Source: OCC}
• Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
• Licensed physician: means a graduate of an accredited medical school authorized to confer upon graduates the degree of doctor of medicine (M. See Tennessee Code 33-1-101
• Litigation: A case, controversy, or lawsuit. Participants (plaintiffs and defendants) in lawsuits are called litigants.
• Member: means any person included in the membership of the retirement system, as provided in chapter 35, part 1 of this title. See Tennessee Code 8-34-101
• Mental illness: means a psychiatric disorder, alcohol dependence, or drug dependence, but does not include intellectual disability or other developmental disabilities as defined in title 52. See Tennessee Code 33-1-101
• Month: means a calendar month. See Tennessee Code 1-3-105
• Mortgage: The written agreement pledging property to a creditor as collateral for a loan.
• Net worth: means the excess of total admitted assets over total admitted liabilities, but the liabilities shall not include fully subordinated debt approved by the commissioner. See Tennessee Code 56-32-112
• Nonprofit dental service corporation: means any corporation organized pursuant to this chapter for the purpose of establishing, maintaining and operating a nonprofit dental service plan, and that employs the service benefit concept in the majority of the programs it administers. See Tennessee Code 56-30-102
• Nonprofit dental service plan: means a plan whereby specified dental service is provided by a nonprofit dental service corporation to subscribers to the plan. See Tennessee Code 56-30-102
• Nonprofit vision service corporation: means any corporation organized pursuant to this chapter for the purpose of establishing, maintaining and operating a nonprofit vision service plan. See Tennessee Code 56-31-102
• Nonprofit vision service plan: means a plan whereby specified vision service is provided by a nonprofit vision service corporation to subscribers to the plan. See Tennessee Code 56-31-102
• Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
• Oversight: Committee review of the activities of a Federal agency or program.
• Participating dentist: means a dentist licensed to practice dentistry in this state under title 63, chapter 5, who contracts in writing with a dental service plan corporation to perform the dental services specified in the subscription certificates issued by the corporation, and at the rates of compensation determined by the board of directors of the corporation, and who agrees to abide by the bylaws, rules and regulations of the corporation applicable to participating dentists. See Tennessee Code 56-30-102
• Participating optometrist: means an optometrist duly licensed to practice optometry in this state who contracts in writing with a vision service plan corporation to perform the vision services specified in the subscription certificates issued by the corporation, and at rates of compensation determined by the board of directors of the corporation, and who agrees to abide by the bylaws, rules and regulations of the corporation applicable to participating optometrists. See Tennessee Code 56-31-102
• Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
• Person: includes a natural person, a corporation, an association, a common law trust or corporation. See Tennessee Code 56-30-102
• Person: includes a natural person, a corporation, an association, a common-law trust or corporation. See Tennessee Code 56-31-102
• Person: includes a corporation, firm, company or association. See Tennessee Code 1-3-105
• person: includes an individual, insurer, company, association, organization, Lloyds, society, reciprocal insurer or interinsurance exchange, partnership, syndicate, business trust, corporation, agent, general agent, broker, solicitor, service representative, adjuster, and every legal entity. See Tennessee Code 56-32-102
• Physician-hospital organization: means an organization formed to allow hospitals and physicians to jointly obtain provider contracts with HMOs and other payers of health care benefits. See Tennessee Code 56-32-102
• Power of attorney: A written instrument which authorizes one person to act as another's agent or attorney. The power of attorney may be for a definite, specific act, or it may be general in nature. The terms of the written power of attorney may specify when it will expire. If not, the power of attorney usually expires when the person granting it dies. ^{Source: OCC}
• premiums: as used in this chapter includes, but is not limited to, any and all payments made by the state to any entity providing health care services pursuant to any federal waiver received by the state that waives any or all of Title XIX of the federal Social Security Act, compiled in 42 U. See Tennessee Code 56-32-112
• Probable cause: A reasonable ground for belief that the offender violated a specific law.
• Probation: A sentencing alternative to imprisonment in which the court releases convicted defendants under supervision as long as certain conditions are observed.
• Property: includes both personal and real property. See Tennessee Code 1-3-105
• Prosecute: To charge someone with a crime. A prosecutor tries a criminal case on behalf of the government.
• Provider: means any physician, hospital or other person that is licensed or otherwise authorized in this state to furnish health care services. See Tennessee Code 56-32-102
• Qualified mental health professional: means a person who is licensed in the state, if required for the profession, and who is a psychiatrist. See Tennessee Code 33-1-101
• Reciprocal: means the aggregation of subscribers under a common name. See Tennessee Code 56-16-102
• Record: means information that is inscribed on a tangible medium or that is stored in an electronic or other medium and is retrievable in a perceivable form. See Tennessee Code 1-3-105
• Remainder: An interest in property that takes effect in the future at a specified time or after the occurrence of some event, such as the death of a life tenant.
• Representative: when applied to those who represent a decedent, includes executors and administrators, unless the context implies heirs and distributees. See Tennessee Code 1-3-105
• Retirement: means withdrawal from membership with a retirement allowance granted under chapters 34-37 of this title. See Tennessee Code 8-34-101
• Retirement system: means the Tennessee consolidated retirement system as defined in §. See Tennessee Code 8-34-101
• Serious emotional disturbance: means a condition in a child who currently or at any time during the past year has had a diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet psychiatric diagnostic criteria that results in functional impairment that substantially interferes with or limits the child's role or functioning in family, school, or community activities and includes any mental disorder, regardless of whether it is of biological etiology. See Tennessee Code 33-1-101
• Service: means service as a general employee, a teacher, a state police officer, a wildlife officer, a firefighter, a police officer, a state judge, a county judge, an attorney general, a commissioner or a county official which is paid for by an employer, and also includes service for which a former member of the general assembly is entitled to under former §. See Tennessee Code 8-34-101
• Service benefit concept: means a type of dental benefit contract between a beneficiary and a third party payer, whereby the beneficiary is guaranteed no out-of-pocket expenses for covered services beyond any agreed on cost sharing stipulated in the contract. See Tennessee Code 56-30-102
• Service of process: The service of writs or summonses to the appropriate party.
• Service recipient: means a person who is receiving service, has applied for service, or for whom someone has applied for or proposed service because the person has mental illness or serious emotional disturbance. See Tennessee Code 33-1-101
• Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
• signed: includes a mark, the name being written near the mark and witnessed, or any other symbol or methodology executed or adopted by a party with intention to authenticate a writing or record, regardless of being witnessed. See Tennessee Code 1-3-105
• State: means the state of Tennessee. See Tennessee Code 8-34-101
• State: when applied to the different parts of the United States, includes the District of Columbia and the several territories of the United States. See Tennessee Code 1-3-105
• Statute: A law passed by a legislature.
• Subscriber: means a person to whom a subscription certificate is issued by a dental care service plan corporation that sets forth the beneficiaries and the kind and extent of dental service for which the corporation is liable to make payment. See Tennessee Code 56-30-102
• Subscriber: means a person to whom a subscription certificate is issued by a vision care service plan corporation, which sets forth the beneficiaries and the kind and extent of vision service for which the corporation is liable to make payment. See Tennessee Code 56-31-102
• Subscriber: means a person obligated under a reciprocal insurance agreement. See Tennessee Code 56-16-102
• Subscription: includes a mark, the name being written near the mark and witnessed. See Tennessee Code 1-3-105
• Superseded system: means , where applicable, the Tennessee state retirement system, the Tennessee teachers' retirement system, the Tennessee judges' retirement system, the retirement system for county paid judges of Tennessee, the attorneys general retirement system of Tennessee, the public service commissioners' retirement system, and the Tennessee retirement system for county officials, any one (1) of them, or any combination thereof. See Tennessee Code 8-34-101
• Support: means any activity or resource that enables a service recipient to participate in a service for mental illness or serious emotional disturbance or in community life. See Tennessee Code 33-1-101
• Testify: Answer questions in court.
• Testimony: Evidence presented orally by witnesses during trials or before grand juries.
• Transcript: A written, word-for-word record of what was said, either in a proceeding such as a trial or during some other conversation, as in a transcript of a hearing or oral deposition.
• Treatment resource: means any public or private facility, service, or program providing treatment or rehabilitation services for mental illness or serious emotional disturbance, including, but not limited to, detoxification centers, hospitals, community mental health centers, clinics or programs, halfway houses, and rehabilitation centers. See Tennessee Code 33-1-101
• Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.
• Trustee: A person or institution holding and administering property in trust.
• United States: includes the District of Columbia and the several territories of the United States. See Tennessee Code 1-3-105
• Venue: The geographical location in which a case is tried.
• Verdict: The decision of a petit jury or a judge.
• Vision service: means the usual and general professional services rendered by persons duly licensed under the laws of this state to practice optometry. See Tennessee Code 56-31-102
• working capital: means current assets, including admitted stocks and admitted bonds, minus current liabilities. See Tennessee Code 56-32-112
• Writ: A formal written command, issued from the court, requiring the performance of a specific act.
• Writ of certiorari: An order issued by the Supreme Court directing the lower court to transmit records for a case for which it will hear on appeal.
• written: includes printing, typewriting, engraving, lithography, and any other mode of representing words and letters. See Tennessee Code 1-3-105
• Year: means a calendar year, unless otherwise expressed. See Tennessee Code 1-3-105