Terms Used In California Codes > Health and Safety Code > Division 11 > Part 2 > Chapter 1 - General Provisions and Definitions

• Agent or broker: means a person or entity licensed under Chapter 5 (commencing with Section 1621) of Part 2 of Division 1. See California Insurance Code 10700
• 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.
• Attachment: A procedure by which a person's property is seized to pay judgments levied by the court.
• Attachment point: means the amount of health claims incurred by a small employer in a policy year for its employees and their dependents, and covered by a stop-loss insurance policy, above which the stop-loss insurer incurs a liability for payment. See California Insurance Code 10752
• Board: means the Major Risk Medical Insurance Board. See California Insurance Code 10700
• Carrier: means any disability insurance company or any other entity that writes, issues, or administers health benefit plans that cover the employees of small employers, regardless of the situs of the contract or master policyholder. See California Insurance Code 10700
• Commissioner: means the Insurance Commissioner of this State. See California Insurance Code 20
• 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.
• Dependent: A person dependent for support upon another.
• Dependent: means the spouse, registered domestic partner as described in §. See California Insurance Code 10752
• Direct coverage: means that an insurance company assumes a direct obligation to an employee under an insurance policy to pay or indemnify the employee for health claims incurred by the employee or the employee's dependents. See California Insurance Code 10752
• Domestic: means organized under the laws of this State, whether or not admitted. See California Insurance Code 26
• Enrollee: means an eligible employee or dependent who receives health coverage through the program from a participating carrier. See California Insurance Code 10700
• Expected claims: means , for the purposes of aggregate stop-loss coverage, the total amount of health claims that is projected to be incurred by a small employer for its employees and their dependents in a policy year. See California Insurance Code 10752
• Financially impaired: means , for the purposes of this chapter, a carrier that, on or after the effective date of this chapter, is not insolvent and is either:

  California Insurance Code 10700

• Fraud: Intentional deception resulting in injury to another.
• Fund: means the California Small Group Reinsurance Fund. See California Insurance Code 10700
• 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}
• Health benefit plan: means a policy or contract written or administered by a carrier that arranges or provides health care benefits for the covered eligible employees of a small employer and their dependents. See California Insurance Code 10700
• 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.
• 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 any person, association, organization, partnership, business trust, limited liability company, or corporation. See California Insurance Code 19
• Policy year: means the 12-month period that is designated as the policy year or policy period for the stop-loss insurance policy. See California Insurance Code 10752
• Program: means the Health Insurance Plan of California. See California Insurance Code 10700
• Public law: A public bill or joint resolution that has passed both chambers and been enacted into law. Public laws have general applicability nationwide.
• Small employer: means either of the following:

  California Insurance Code 10700

• State: means the State of California, unless applied to the different parts of the United States. See California Insurance Code 28
• Stop-loss insurance policy: means a policy, contract, certificate, or statement of coverage between a stop-loss insurer and small employer providing individual or aggregate stop-loss insurance coverage, or both, or any other assumption of risk, to a small employer for the liability the small employer incurs related to the covered health claims of its employees and their dependents. See California Insurance Code 10752
• Stop-loss insurer: means an insurance company providing individual or aggregate stop-loss insurance coverage, or both, or any other assumption of risk, to a small employer for the health claims it incurs for its employees and their dependents. See California Insurance Code 10752