Terms Used In California Codes > Financial Code > Division 5 > Chapter 3 > Article 4 - Costs of Administration

• Affordability for consumers: means considering the totality of costs paid by consumers for covered benefits, including the enrollee share of premium and cost-sharing amounts paid towards the maximum out-of-pocket amount, including deductibles, copays, coinsurance, and other forms of cost sharing for public and private health coverage. See California Health and Safety Code 127500.2
• 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.
• Baseline: Projection of the receipts, outlays, and other budget amounts that would ensue in the future without any change in existing policy. Baseline projections are used to gauge the extent to which proposed legislation, if enacted into law, would alter current spending and revenue levels.
• Board: means the Health Care Affordability Board established by Section 127501. See California Health and Safety Code 127500.2
• County: includes city and county. See California Health and Safety Code 14
• department: means State Department of Health Services. See California Health and Safety Code 20
• Director: means the Director of the Department of Health Care Access and Information. See California Health and Safety Code 127500.2
• Exempted provider: means a provider that meets standards established by the board for exemption from either of the following:

  California Health and Safety Code 127500.2

• Fully integrated delivery system: means a system that includes a physician organization, health facility or health system, and a nonprofit health care service plan that provides health care services to enrollees in a specific geographic region of the state through an affiliate hospital system and an exclusive contract between the nonprofit health care service plan and a single physician organization in each geographic region to provide those medical services. See California Health and Safety Code 127500.2
• Health care cost target: means the target percentage for the maximum annual increase in per capita total health care expenditures. See California Health and Safety Code 127500.2
• Health care entity: means a payer, provider, or a fully integrated delivery system. See California Health and Safety Code 127500.2
• Line of business: means the different individual, small, and large group business lines, as defined in Section 1348. See California Health and Safety Code 127500.2
• Oversight: Committee review of the activities of a Federal agency or program.
• Payer: means private and public health care payers, including all of the following:

  California Health and Safety Code 127500.2

• Person: means any person, firm, association, organization, partnership, business trust, corporation, limited liability company, or company. See California Health and Safety Code 19
• Physician organization: includes any of the following:

  California Health and Safety Code 127500.2

• Provider: means any of the following that delivers or furnishes health care services:

  California Health and Safety Code 127500.2

• State: means the State of California, unless applied to the different parts of the United States. See California Health and Safety Code 23
• Total health care expenditures: means all health care spending in the state by public and private sources, including all of the following:

  California Health and Safety Code 127500.2