Terms Used In California Codes > Health and Safety Code > Division 107 > Part 2 > Chapter 2.6 > Article 3 - Health Care Cost Targets

• Administrative costs and profits: means the total sum of all expenses not included in the numerator of the medical loss ratio calculation under state or federal law, including, but not limited to, all of the following:

  California Health and Safety Code 127500.2

• 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
• Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
• 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
• 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
• 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.
• 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
• Insurance market: means the public and private health insurance markets. 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
• 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.
• 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
• Person: includes any person, firm, partnership, association, corporation, company, limited liability company, syndicate, estate, trust, business trust, or organization of any kind. See California Financial Code 18
• 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
• Testimony: Evidence presented orally by witnesses during trials or before grand juries.
• 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

• Writ: A formal written command, issued from the court, requiring the performance of a specific act.