Sections
Article 1 General Provisions 6-1401 – 6-1419

Terms Used In Arizona Laws > Title 6 > Chapter 14

  • Accountable health plan: means an entity that offers, issues or otherwise provides a health benefits plan and is approved by the director as an accountable health plan pursuant to section 20-2303. See Arizona Laws 20-2301
  • Act: means a bodily movement. See Arizona Laws 13-105
  • Adjudicate: means an insurer's decision to deny or pay a claim, in whole or in part, including the decision as to how much to pay. See Arizona Laws 20-3101
  • Adult: means a person who has attained eighteen years of age. See Arizona Laws 1-215
  • Adverse decision: means a utilization review determination by the utilization review agent that a requested service or claim for service is not a covered service or is not medically necessary under the plan if that determination results in a documented denial or nonpayment of the service or claim. See Arizona Laws 20-2501
  • Affidavit: A written statement of facts confirmed by the oath of the party making it, before a notary or officer having authority to administer oaths.
  • Affiliation period: means a period of two months, or three months for late enrollees, that under the terms of the health benefits plan offered by a health care services organization must expire before the health benefits plan becomes effective and in which the health care services organization is not required to provide health care services or benefits and cannot charge the participant or beneficiary a premium for any coverage during the period. See Arizona Laws 20-2301
  • Allegation: something that someone says happened.
  • 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.
  • Annual percentage rate: The cost of credit at a yearly rate. It is calculated in a standard way, taking the average compound interest rate over the term of the loan so borrowers can compare loans. Lenders are required by law to disclose a card account's APR. Source: FDIC
  • Annuity: A periodic (usually annual) payment of a fixed sum of money for either the life of the recipient or for a fixed number of years. A series of payments under a contract from an insurance company, a trust company, or an individual. Annuity payments are made at regular intervals over a period of more than one full year.
  • 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.
  • Applicant: means a provider organization that submits an application to the contractor to provide continuing education courses. See Arizona Laws 20-2901
  • Approved continuing education course: means any course that has been approved by at least five other states or that is approved by a contractor or automatically approved pursuant to section 20-2904. See Arizona Laws 20-2901
  • Approved provider: means an organization or individual that offers an approved continuing education course and that is authorized by the contractor to offer the course to a licensee for credit toward the licensee's continuing education requirements. See Arizona Laws 20-2901
  • Arbitration: means a dispute resolution process in which an impartial arbitrator determines the dollar amount a health care provider is entitled to receive for payment of a surprise out-of-network bill. See Arizona Laws 20-3111
  • Arbitrator: means an impartial person who is appointed to conduct an arbitration. See Arizona Laws 20-3111
  • Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
  • Assumed investment rate: means the rate of investment return that is required to be credited to a variable life insurance policy, after the deduction of charges for taxes, investment expenses and mortality and expense guarantees, to maintain the variable death benefit in an amount that is equal at all times to the amount of the death benefit, other than incidental insurance benefits, that would be payable under the plan of insurance if the death benefit did not vary according to the investment experience of the separate account. See Arizona Laws 20-2601
  • Attorney-in-fact: A person who, acting as an agent, is given written authorization by another person to transact business for him (her) out of court.
  • Auditing entity: means any person, company, group or plan working on behalf of or pursuant to a contract with an insurer or pharmacy benefits manager for the purposes of auditing pharmacy drug claims adjudicated by pharmacies. See Arizona Laws 20-3321
  • Bank: means a corporation that holds a banking permit issued pursuant to chapter 2 of this title. See Arizona Laws 6-101
  • Bankruptcy: Refers to statutes and judicial proceedings involving persons or businesses that cannot pay their debts and seek the assistance of the court in getting a fresh start. Under the protection of the bankruptcy court, debtors may discharge their debts, perhaps by paying a portion of each debt. Bankruptcy judges preside over these proceedings.
  • Base premium rate: means , for each rating period, the lowest premium rate that could have been charged under a rating system by the accountable health plan to small employers for health benefits plans involving the same or similar coverage, family size and composition, and geographic area. See Arizona Laws 20-2301
  • Basic health benefit plan: means a plan that is developed by a committee established by the legislature and that is adopted by the director. See Arizona Laws 20-2301
  • 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
  • Benefit base: means the amount to which the net investment return is applied. See Arizona Laws 20-2601
  • Benefits based on the health status of the insured: means a contract of insurance to pay a fixed benefit amount, without regard to the specific services received, to a policyholder who meets certain eligibility criteria based on health status including:

    (a) A disability income insurance policy that pays a fixed daily, weekly or monthly benefit amount to an insured who is deemed a person with a disability as defined by the policy terms. See Arizona Laws 20-2501

  • Billing company: means any affiliated or unaffiliated company that is hired by a health care provider or health care facility to coordinate the payment of bills with health insurers and to generate or bill and collect payment from enrollees on the health care provider's or health care facility's behalf. See Arizona Laws 20-3111
  • Bona fide association: means , for a health benefits plan issued by an accountable health plan, an association that meets the requirements of section 20-2324. See Arizona Laws 20-2301
  • Branch: means any banking office other than the principal banking office. See Arizona Laws 6-101
  • Branch office: means any place of business maintained by a licensee in addition to the principal place of business of a licensee. See Arizona Laws 6-1401
  • Branch office: means any fixed place of business, other than the primary office, where records are kept, mail is received, statements are rendered, money is collected, requests for service or bids are received, information pertaining to the business of pest management is given or pesticides are stored or disposed of. See Arizona Laws 3-3601
  • Branch supervisor: means a certified applicator working at or from a branch office who is responsible for ensuring the training, equipping and supervision of all applicators of the branch office. See Arizona Laws 3-3601
  • Business license: means a license that is issued pursuant to this chapter or rules adopted pursuant to this chapter to a person and that entitles that person and the person's employees to engage in the business of pest management. See Arizona Laws 3-3601
  • Business of pest management: means engaging in, offering to engage in, advertising for, soliciting or performing pest management, including any of the following:

    (a) Identifying infestations or making inspections for the purpose of identifying or attempting to identify infestations. See Arizona Laws 3-3601

  • Certified qualified applicator: means a certified applicator who is eligible to act as a qualifying party. See Arizona Laws 3-3601
  • Claim: means a request for payment for a service already provided. See Arizona Laws 20-2501
  • Clean claim: means a written or electronic claim for health care services or benefits that may be processed without obtaining additional information, including coordination of benefits information, from the health care provider, the enrollee or a third party, except in cases of fraud. See Arizona Laws 20-3101
  • Clerical errors: means a minor recordkeeping or transcribing error, including typographical errors, scrivner's errors or computer errors, in a required electronic or hard copy document, record or prescription order if both of the following criteria are met:

    (a) The error did not result in actual financial harm to an entity. See Arizona Laws 20-3321

  • COBRA continuation provision: means :

    (a) Section 4980B, except subsection (f)(1) as it relates to pediatric vaccines, of the internal revenue code of 1986. See Arizona Laws 20-2301

  • commission: means the department of insurance. See Arizona Laws 20-101
  • 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.
  • Company: means an insurer licensed pursuant to this title to transact life insurance or annuities in this state. See Arizona Laws 20-2631
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • Completed operations liability: means liability arising out of the installation, maintenance or repair of any product at a site which is not owned or controlled by either:

    (a) A person who performs that work. See Arizona Laws 20-2401

  • Conduct: means an act or omission and its accompanying culpable mental state. See Arizona Laws 13-105
  • Continuance: Putting off of a hearing ot trial until a later time.
  • Continuing education review committee: means the committee appointed by the director pursuant to section 20-2905 to establish minimum standards that apply to approved providers and approved continuing education courses and minimum performance standards that apply to contractors. See Arizona Laws 20-2901
  • Continuously licensed: means that a licensee's license has not terminated for any reason. See Arizona Laws 20-2901
  • Contract: A legal written agreement that becomes binding when signed.
  • Contracted provider: means a health care provider that has entered into a contract with a health insurer to provide health care services to the health insurer's enrollees at agreed on rates. See Arizona Laws 20-3111
  • Contractor: means the person who has a contract with the department of insurance to approve continuing education providers and courses and to administer the continuing education program and who is paid through fees collected from approved providers when the approved providers apply for continuing education course approval. See Arizona Laws 20-2901
  • 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.
  • Cost sharing requirements: means an enrollee's applicable out-of-network coinsurance, copayment and deductible requirements under a health plan based on the adjudicated claim. See Arizona Laws 20-3111
  • Coverage: means the contractual obligation of a health care services plan to pay its enrollee or a contracted or noncontracted provider for medically necessary emergency services rendered by the provider to an enrollee, as specified in the governing agreement, contract or policy between the plan and the enrollee, subject to applicable copayments, coinsurance and deductibles. See Arizona Laws 20-2801
  • Covered service: means a service that is included in a policy, evidence of coverage or similar document that specifies which services, insurance or other benefits are included or covered. See Arizona Laws 20-2501
  • Creditable coverage: means coverage solely for an individual, other than limited benefits coverage, under any of the following:

    (a) An employee welfare benefit plan that provides medical care to employees or the employees' dependents directly or through insurance or reimbursement or otherwise pursuant to the employee retirement income security act of 1974. See Arizona Laws 20-2301

  • Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
  • Damaging: means damage as defined in section 13-1701. See Arizona Laws 13-1601
  • Defacing: means any unnecessary act of substantially marring any surface or place, by any means, or any act of putting up, affixing, fastening, printing or painting any notice on any structure, without permission from the owner. See Arizona Laws 13-1601
  • Defendant: In a civil suit, the person complained against; in a criminal case, the person accused of the crime.
  • Demographic characteristics: means objective factors an insurer considers in determining premium rates. See Arizona Laws 20-2301
  • Denial: means a direct or indirect determination regarding all or part of a request for any service or a direct determination regarding a claim that may trigger a request for review or reconsideration. See Arizona Laws 20-2501
  • Department: means the department of financial institutions. See Arizona Laws 6-101
  • Department: means the department of insurance. See Arizona Laws 20-2501
  • Dependent: A person dependent for support upon another.
  • Desktop audit: means an audit that is conducted by an auditing entity at a location other than the location of the pharmacist or pharmacy. See Arizona Laws 20-3321
  • Director: means the director of the department. See Arizona Laws 3-101
  • Director: means the director of the department of insurance. See Arizona Laws 20-2501
  • Division: means the pest management division of the department. See Arizona Laws 3-3601
  • Embezzlement: In most states, embezzlement is defined as theft/larceny of assets (money or property) by a person in a position of trust or responsibility over those assets. Embezzlement typically occurs in the employment and corporate settings. Source: OCC
  • Emergency ambulance services: means services provided by an ambulance service authorized to operate pursuant to title 36, chapter 21. See Arizona Laws 20-2801
  • Emergency services: means health care services that are provided to an enrollee in a licensed hospital emergency facility by a provider after the recent onset of a medical condition that manifests itself by symptoms of sufficient severity that the absence of immediate medical attention could reasonably be expected to result in any of the following:

    (a) Serious jeopardy to the patient's health. See Arizona Laws 20-2801

  • employee: shall include the employees of the employer and the individual proprietor or self-employed person if the employer is an individual proprietor or self-employed person. See Arizona Laws 20-2301
  • Enrollee: means an individual, or a dependent of that individual, who is currently enrolled with and covered by a health care services plan. See Arizona Laws 20-2801
  • Enrollee: means an individual who is enrolled under a health care insurer's policy, contract or evidence of coverage. See Arizona Laws 20-3101
  • Enrollee: means an individual who is eligible to receive benefits through a health plan. See Arizona Laws 20-3111
  • Enrollee: means an individual or a dependent of that individual who is currently enrolled with and covered by a health care services plan. See Arizona Laws 20-3401
  • Enterprise: includes any corporation, association, labor union or other legal entity. See Arizona Laws 13-105
  • 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
  • Ethics training: means continuing education course content regarding the ethical responsibilities insurance producers owe to insurers, applicants, policyholders, regulators, insurance professionals and the public. See Arizona Laws 20-2901
  • Felony: A crime carrying a penalty of more than a year in prison.
  • Felony: means an offense for which a sentence to a term of imprisonment in the custody of the state department of corrections is authorized by any law of this state. See Arizona Laws 13-105
  • Fiduciary: A trustee, executor, or administrator.
  • Final grade treatment: means the establishment of a complete vertical barrier at the exterior of foundation walls in stem wall or monolithic construction. See Arizona Laws 3-3601
  • Finance charge: The total cost of credit a customer must pay on a consumer loan, including interest. The Truth in Lending Act requires disclosure of the finance charge. Source: OCC
  • Financial institution: means banks, trust companies, savings and loan associations, credit unions, consumer lenders, international banking facilities and financial institution holding companies under the jurisdiction of the department. See Arizona Laws 6-101
  • 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.
  • Forgery: The fraudulent signing or alteration of another's name to an instrument such as a deed, mortgage, or check. The intent of the forgery is to deceive or defraud. Source: OCC
  • Fraud: Intentional deception resulting in injury to another.
  • General account: means all of the assets of an insurer other than assets in separate accounts established pursuant to section 20-651 or the insurance laws of the insurer's state of domicile if the insurer is a foreign or alien insurer. See Arizona Laws 20-2601
  • Genetic information: means information about genes, gene products and inherited characteristics that may derive from the individual or a family member, including information regarding carrier status and information derived from laboratory tests that identify mutations in specific genes or chromosomes, physical medical examinations, family histories and direct analyses of genes or chromosomes. See Arizona Laws 20-2301
  • 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
  • Grievance: means any written complaint that is subject to resolution through the insurer's system that is prescribed in section 20-3102, subsection F and submitted by a health care provider and received by a health care insurer. See Arizona Laws 20-3101
  • 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.
  • Hazardous financial condition: means that, based on its present or reasonably anticipated financial condition, a risk retention group, although not yet financially impaired or insolvent, is unlikely to be able to either:

    (a) Meet obligations to policyholders with respect to known claims and reasonably anticipated claims. See Arizona Laws 20-2401

  • Health benefits plan: means a hospital and medical service corporation policy or certificate, a health care services organization contract, a group disability policy, a certificate of insurance of a group disability policy that is not issued in this state, a multiple employer welfare arrangement or any other arrangement under which health services or health benefits are provided to two or more individuals. See Arizona Laws 20-2301
  • Health care insurer: means a disability insurer, group disability insurer, blanket disability insurer, health care services organization, hospital service corporation, medical service corporation or hospital and medical service corporation. See Arizona Laws 20-2341
  • Health care insurer: means a disability insurer, group disability insurer, blanket disability insurer, health care services organization, prepaid dental plan organization, hospital service corporation, medical service corporation, dental service corporation, optometric service corporation, or hospital, medical, dental and optometric service corporation. See Arizona Laws 20-3101
  • Health care insurer: means a disability insurer, group disability insurer, blanket disability insurer, health care services organization, hospital service corporation, prepaid dental plan organization, medical service corporation, dental service corporation or optometric service corporation or a hospital, medical, dental and optometric service corporation. See Arizona Laws 20-2501
  • Health care provider: means a person who is licensed, registered or certified as a health care professional under title 32 or a laboratory or durable medical equipment provider that furnishes services to a patient in a network facility and that separately bills the patient for the services. See Arizona Laws 20-3111
  • Health care services: means treatment, services, medications, tests, equipment, devices, durable medical equipment, laboratory services or supplies rendered or provided to an enrollee for the purpose of diagnosing, preventing, alleviating, curing or healing human disease, illness or injury. See Arizona Laws 20-3111
  • Health care services plan: means a plan offered by a disability insurer, group disability insurer, blanket disability insurer, health care services organization, hospital service corporation or medical service corporation that contractually agrees to pay or make reimbursement for health care expenses for one or more individuals residing in Arizona but does not apply to benefits provided under limited benefit coverage as defined in section 20-1137. See Arizona Laws 20-2801
  • Health insurer: means a disability insurer, group disability insurer, blanket disability insurer, hospital service corporation or medical service corporation that provides health insurance in this state. See Arizona Laws 20-3111
  • Health plan: means a group or individual health plan that finances or furnishes health care services and that is issued by a health insurer. See Arizona Laws 20-3111
  • Health status-related factor: means any factor in relation to the health of the individual or a dependent of the individual enrolled or to be enrolled in an accountable health plan, including:

    (a) Health status. See Arizona Laws 20-2301

  • Higher level of coverage: means a health benefits plan offered by an accountable health plan for which the actuarial value of the benefits under the coverage is at least fifteen per cent more than the actuarial value of the health benefits plan offered by the accountable health plan as a lower level of coverage in this state but not more than one hundred twenty per cent of a policy form weighted average. See Arizona Laws 20-2301
  • In-pharmacy audit: means an audit that is conducted by an auditing entity at the physical business address of the pharmacy where the claim was adjudicated. See Arizona Laws 20-3321
  • Incidental insurance benefit: means all of the insurance benefits in a variable life insurance policy except the variable death benefit and the minimum death benefit. See Arizona Laws 20-2601
  • including: means not limited to and is not a term of exclusion. See Arizona Laws 1-215
  • Index rate: means , as to a rating period, the arithmetic average of the applicable base premium rate and the highest premium rate that could have been charged under a rating system by the accountable health plan to small employers for a health benefits plan involving the same or similar coverage, family size and composition, and geographic area. See Arizona Laws 20-2301
  • Indictment: The formal charge issued by a grand jury stating that there is enough evidence that the defendant committed the crime to justify having a trial; it is used primarily for felonies.
  • Initial corrective treatment: means the first postconstruction treatment of any kind performed by a licensee, excluding a treatment performed under warranty by a licensee who has performed the pretreatment or new-construction treatment. See Arizona Laws 3-3601
  • Injunction: An order of the court prohibiting (or compelling) the performance of a specific act to prevent irreparable damage or injury.
  • Inquiry: means an initial investigation of possible violations of this chapter or rules adopted pursuant to this chapter based on information received from the public or division staff. See Arizona Laws 3-3601
  • Insurance: means primary insurance, excess insurance, reinsurance, surplus lines insurance and any other arrangement for shifting and distributing risk which is determined to be insurance under the laws of this state. See Arizona Laws 20-2401
  • Insurance compliance audit: means a voluntary, internal evaluation, review, assessment, audit or investigation that follows adopted written standards and criteria for the purpose of identifying or preventing noncompliance with or promoting compliance with laws, regulations, orders or industry or professional standards that is conducted by or on behalf of a company licensed or regulated under this title and specified in subsection B of this section, or that involves an activity regulated under this title. See Arizona Laws 20-3301
  • Insurance producer: means any person, corporation, partnership, or other legal entity that is licensed by this state as a life insurance producer. See Arizona Laws 20-2601
  • Insured: means any person covered under an insurance contract or other evidence of insurance coverage subject to regulation under title 20. See Arizona Laws 6-1401
  • Insurer: means a disability insurer, group disability insurer, blanket disability insurer, health care services organization, hospital service corporation, medical service corporation or hospital and medical service corporation. See Arizona Laws 20-3321
  • Interest rate: The amount paid by a borrower to a lender in exchange for the use of the lender's money for a certain period of time. Interest is paid on loans or on debt instruments, such as notes or bonds, either at regular intervals or as part of a lump sum payment when the issue matures. Source: OCC
  • 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.
  • Late enrollee: means an employee or dependent who requests enrollment in a health benefits plan after the initial enrollment period that is provided under the terms of the health benefits plan if the initial enrollment period is at least thirty-one days. See Arizona Laws 20-2301
  • Lawsuit: A legal action started by a plaintiff against a defendant based on a complaint that the defendant failed to perform a legal duty, resulting in harm to the plaintiff.
  • 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.
  • License period: means the period between the date an Arizona insurance license is issued or last renewed and the expiration date of the Arizona insurance license. See Arizona Laws 20-2901
  • Licensee: means an individual insurance producer licensed for major line insurance as defined in section 20-281. See Arizona Laws 20-2901
  • List: means the list of drugs for which a pharmacy benefit manager has established a maximum allowable cost. See Arizona Laws 20-3321
  • Litter: includes any rubbish, refuse, waste material, offal, paper, glass, cans, bottles, organic or inorganic trash, debris, filthy or odoriferous objects, dead animals or any foreign substance of whatever kind or description, including junked or abandoned vehicles, whether or not any of these items are of value. See Arizona Laws 13-1601
  • Lower level of coverage: means a health benefits plan offered by an accountable health plan for which the actuarial value of the benefits under the health benefits plan is at least eighty-five per cent but not more than one hundred per cent of the policy form weighted average. See Arizona Laws 20-2301
  • Minimum death benefit: means the amount of the guaranteed death benefit, except incidental insurance benefits, that is payable under a variable life insurance policy regardless of the investment performance of the separate account. See Arizona Laws 20-2601
  • Minor: means a person under the age of eighteen years. See Arizona Laws 1-215
  • Misdemeanor: means an offense for which a sentence to a term of imprisonment other than to the custody of the state department of corrections is authorized by any law of this state. See Arizona Laws 13-105
  • Month: means a calendar month unless otherwise expressed. See Arizona Laws 1-215
  • Mortgage: The written agreement pledging property to a creditor as collateral for a loan.
  • Mortgagee: The person to whom property is mortgaged and who has loaned the money.
  • Net investment return: means the rate of investment return in a separate account that is applied to the benefit base. See Arizona Laws 20-2601
  • Network facility: means a health care facility that has entered into a contract with a health insurer to provide health care services to the health insurer's enrollees at agreed on rates. See Arizona Laws 20-3111
  • Network plan: means a health benefits plan provided by an accountable health plan under which the financing and delivery of health benefits are provided, in whole or in part, through a defined set of providers under contract with the accountable health plan in accordance with the determination made by the director pursuant to section 20-1053 regarding the geographic or service area in which an accountable health plan may operate. See Arizona Laws 20-2301
  • New-construction treatment: means a treatment that protects all cellulose components of a structure from subterranean termites and that is performed after a permanent concrete slab foundation is installed or footings and supports for a raised foundation are installed, but before the structure or a final grade treatment is completed. See Arizona Laws 3-3601
  • Nonresident licensee: means a licensee who is applying to renew a nonresident license in this state. See Arizona Laws 20-2901
  • Oath: includes an affirmation or declaration. See Arizona Laws 1-215
  • 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.
  • 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: means a human being and, as the context requires, an enterprise, a public or private corporation, an unincorporated association, a partnership, a firm, a society, a government, a governmental authority or an individual or entity capable of holding a legal or beneficial interest in property. See Arizona Laws 13-105
  • Personal property: includes money, goods, chattels, things in action and evidences of debt. See Arizona Laws 1-215
  • Personal risk liability: means liability for damages because of injury to a person, damage to property or other loss or damage resulting from any personal, familial or household responsibilities or activities other than those listed in paragraph 5. See Arizona Laws 20-2401
  • Pest management services: means identifying infestations or making inspections for the purpose of identifying or attempting to identify infestations, making written or oral inspection reports or recommendations with respect to infestations and the application of pesticides or the use of devices not exempt by section  3-3603, subsection B, paragraph  17 for the purpose of eliminating, exterminating, controlling or preventing infestations. See Arizona Laws 3-3601
  • Pesticide: means any substance or mixture of substances intended to be used for preventing, destroying, repelling or mitigating insects, fungi, bacteria, microbes, weeds, rodents, predatory animals or any form of plant or animal life that is, or that the director may declare to be, a pest and that may infest or be detrimental to vegetation, humans, animals or households or be present in any environment. See Arizona Laws 3-3601
  • Pharmacy benefit manager: means a person, business or other entity that, pursuant to a contract or under an employment relationship with an insurer or other third-party payor, either directly or through an intermediary manages the prescription drug coverage provided by the insurer or other third-party payor, including the processing and payment of claims for prescription drugs, the performance of drug utilization review, the processing of drug prior authorization requests, the adjudication of appeals or grievances related to prescription drug coverage, contracting with network pharmacies and controlling the cost of covered prescription drugs. See Arizona Laws 20-3321
  • Policy form weighted average: means the average actuarial value of the benefits provided by all health benefits plans issued by either the accountable health plan or, if the data are available, by all accountable health plans in the group market in this state during the previous calendar year, weighted by the enrollment for all coverage forms. See Arizona Laws 20-2301
  • Policy processing day: means the day on which the charges that are authorized in a policy are deducted from the policy's cash value. See Arizona Laws 20-2601
  • 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
  • Preexisting condition: means a condition, regardless of the cause of the condition, for which medical advice, diagnosis, care or treatment was recommended or received within not more than six months before the date of the enrollment of the individual under a health benefits plan issued by an accountable health plan. See Arizona Laws 20-2301
  • preexisting condition exclusion: means a limitation or exclusion of benefits for a preexisting condition under a health benefits plan offered by an accountable health plan. See Arizona Laws 20-2301
  • Premium finance agreement: means a written agreement by which an insured or prospective insured agrees to pay to a premium finance company the amount advanced or to be advanced under the written agreement to an insurance producer in payment of premiums of an insurance contract together with interest or discount and a service charge as authorized and limited by this article. See Arizona Laws 6-1401
  • Premium finance company: means a person engaged in whole or in part in the business of financing insurance premiums, entering into premium finance agreements with insureds or otherwise acquiring premium finance agreements from insurance producers or other premium finance companies. See Arizona Laws 6-1401
  • Pretreatment: means a termite treatment that protects all cellulose components of a structure from subterranean termites, that is performed before a permanent concrete slab foundation is installed or in conjunction with establishing footings and supports for a raised foundation and that establishes thorough and complete horizontal and vertical treated barriers. See Arizona Laws 3-3601
  • Prior authorization: means authorization by telephone or telefacsimile given in advance of the performance of an emergency service on an enrollee, by a health care services plan after receipt of necessary medical and enrollment information on the enrollee. See Arizona Laws 20-2801
  • Prior violation: means any violation for which disciplinary action was taken within a five-year period before the date of the violation for which current disciplinary action is sought. See Arizona Laws 3-3601
  • Probation: A sentencing alternative to imprisonment in which the court releases convicted defendants under supervision as long as certain conditions are observed.
  • Process: means a citation, writ or summons issued in the course of judicial proceedings. See Arizona Laws 1-215
  • Product liability: means liability for damages because of any personal injury, death, emotional harm, consequential economic damage or property damage, including damages resulting from the loss of use of property, arising out of the manufacture, design, importation, distribution, packaging, labeling, lease or sale of a product. See Arizona Laws 20-2401
  • Property: means anything of value, tangible or intangible. See Arizona Laws 13-105
  • Property: includes both real and personal property. See Arizona Laws 1-215
  • Property of another: means property in which any person other than the defendant has an interest, including community property and other property in which the defendant also has an interest and, for damage caused by theft of scrap metal, the property of other persons damaged directly or indirectly as a result of the acts of the defendant. See Arizona Laws 13-1601
  • 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 to furnish emergency services in this state. See Arizona Laws 20-2801
  • Provider: means a physician, health care institution or other person or entity that is licensed or otherwise authorized to furnish health care services in this state. See Arizona Laws 20-3401
  • Provider: means the physician or other licensed practitioner identified to the utilization review agent as having primary responsibility for providing care, treatment and services rendered to a patient. See Arizona Laws 20-2501
  • Provider organization: means a person that provides continuing education courses but that has not yet been accepted as an approved provider pursuant to section 20-2904. See Arizona Laws 20-2901
  • Purchasing group: means a group which meets all of the following criteria:

    (a) Has as one of its purposes the purchase of liability insurance on a group basis. See Arizona Laws 20-2401

  • Qualifying party: means a certified qualified applicator registered with the division as the individual responsible for ensuring the training, equipping and supervision of all applicators of a business licensee or school district. See Arizona Laws 3-3601
  • Recklessly: means , with respect to a result or to a circumstance described by a statute defining an offense, that a person is aware of and consciously disregards a substantial and unjustifiable risk that the result will occur or that the circumstance exists. See Arizona Laws 13-105
  • Recourse: An arrangement in which a bank retains, in form or in substance, any credit risk directly or indirectly associated with an asset it has sold (in accordance with generally accepted accounting principles) that exceeds a pro rata share of the bank's claim on the asset. If a bank has no claim on an asset it has sold, then the retention of any credit risk is recourse. Source: FDIC
  • 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.
  • Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.
  • Risk retention group: means a corporation or other limited liability association formed under the laws of any state which meets all of the following criteria:

    (a) Its primary activity consists of assuming and spreading all or any portion of the liability exposure of its group members. See Arizona Laws 20-2401

  • Scheduled premium policy: means a variable life insurance policy under which both the amount and timing of premium payments are fixed by the insurer. See Arizona Laws 20-2601
  • Separate account: means a separate account established pursuant to section 20-651 or the insurance laws of the insurer's state of domicile if the insurer is a foreign or alien insurer. See Arizona Laws 20-2601
  • Service: means a diagnostic or therapeutic medical or health care service, benefit or treatment. See Arizona Laws 20-2501
  • Service of process: The service of writs or summonses to the appropriate party.
  • 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.
  • Small employer: means an employer who employs at least two but not more than fifty eligible employees on a typical business day during any one calendar year. See Arizona Laws 20-2301
  • State: means any state of the United States or the District of Columbia. See Arizona Laws 20-2401
  • Statute: A law passed by a legislature.
  • Subpoena: A command to a witness to appear and give testimony.
  • subscription: includes a mark, if a person cannot write, with the person's name written near it and witnessed by a person who writes the person's own name as witness. See Arizona Laws 1-215
  • Superintendent: means the superintendent of financial institutions. See Arizona Laws 6-101
  • Surprise out-of-network bill: means a bill for a health care service that was provided in a network facility by a health care provider that is not a contracted provider and that meets one of the requirements listed in section 20-3113. See Arizona Laws 20-3111
  • Testify: includes every manner of oral statement under oath or affirmation. See Arizona Laws 1-215
  • Testimony: Evidence presented orally by witnesses during trials or before grand juries.
  • Title: includes this title, title 32, chapters 9 and 36 and title 44, chapter 2. See Arizona Laws 6-101
  • Tort: A civil wrong or breach of a duty to another person, as outlined by law. A very common tort is negligent operation of a motor vehicle that results in property damage and personal injury in an automobile accident.
  • Trustee: A person or institution holding and administering property in trust.
  • Uninsured small business: means a small employer that did not provide a health benefits plan for at least ninety days immediately before the effective date of coverage provided pursuant to this section, except that this requirement does not apply at the renewal of coverage pursuant to this section. See Arizona Laws 20-2341
  • Utility: means any enterprise, public or private, that provides gas, electric, irrigation, steam, water, water conservation, sewer or communications services, as well as any common carrier on land, rail, sea or air. See Arizona Laws 13-1601
  • Utilization review: means a system for reviewing the appropriate and efficient allocation of inpatient hospital resources, inpatient medical services and outpatient surgery services that are being given or are proposed to be given to a patient, and of any medical, surgical and health care services or claims for services that may be covered by a health care insurer depending on determinable contingencies, including without limitation outpatient services, in-office consultations with medical specialists, specialized diagnostic testing, mental health services, emergency care and inpatient and outpatient hospital services. See Arizona Laws 20-2501
  • Utilization review agent: means a person or entity that performs utilization review. See Arizona Laws 20-2501
  • Utilization review plan: means a summary description of the utilization review guidelines, protocols, procedures and written standards and criteria of a utilization review agent. See Arizona Laws 20-2501
  • Variable annuity: means an individual policy or contract that provides for annuity benefits that vary according to the investment experience of a separate account or accounts that the insurer maintains pursuant to section 20-651 or the corresponding insurance laws of a foreign insurer's domiciliary state. See Arizona Laws 20-2631
  • Variable contracts: means a variable life insurance policy or a variable annuity as defined in sections 20-2601 and 20-2631, respectively. See Arizona Laws 20-2661
  • Variable death benefit: means the amount of the death benefit, except incidental insurance benefits, that is payable under a variable life insurance policy, that is dependent on the investment performance of the separate account and that the insurer must pay in the absence of any minimum death benefit. See Arizona Laws 20-2601
  • Variable group annuity: means a group policy or contract of two or more individuals that provides for annuity benefits that vary according to the investment experience of a separate account or accounts that the insurer maintains pursuant to section 20-651 or the corresponding insurance laws of a foreign insurer's domiciliary state. See Arizona Laws 20-2661
  • Variable group contracts: means a variable group annuity or a variable group life insurance policy. See Arizona Laws 20-2661
  • Variable life insurance policy: means an individual policy that provides for life insurance, the amount or duration of which varies according to the investment experience of any separate account or accounts that are established and maintained by the insurer pursuant to section 20-651 or the insurance laws of the insurer's state of domicile if the insurer is a foreign or alien insurer. See Arizona Laws 20-2601
  • Venue: The geographical location in which a case is tried.
  • Waiting period: means the period that must pass before a potential participant or beneficiary in a health benefits plan offered by an accountable health plan is eligible to be covered for benefits as determined by the individual's employer. See Arizona Laws 20-2301
  • Wilfully: means , with respect to conduct or to a circumstance described by a statute defining an offense, that a person is aware or believes that the person's conduct is of that nature or that the circumstance exists. See Arizona Laws 1-215
  • Wood-destroying insect inspection report: means a written inspection report on a form approved by the director that is prepared in connection with the sale or refinancing of real property whether or not the report is used as part of the transaction. See Arizona Laws 3-3601
  • Writing: includes printing. See Arizona Laws 1-215