Terms Used In California Codes > Health and Safety Code > Division 11 > Part 2 > Chapter 7 - Violations

• Ancillary benefit plan: means a policy or contract written or administered by a participating carrier that covers dental or vision benefits for the covered eligible employees of an employer or small employer and their dependents. See California Insurance Code 10810
• Arraignment: A proceeding in which an individual who is accused of committing a crime is brought into court, told of the charges, and asked to plead guilty or not guilty.
• Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
• Benefit plan design: means a specific health coverage product issued by a carrier to employers or small employers, to trustees of associations, or to individuals if the coverage is offered through employment or sponsored by an employer or small employer. See California Insurance Code 10810
• Board: means the governing body of the purchasing alliance. See California Insurance Code 10810
• Carrier: means any licensed disability insurance company or licensed health care service plan or any other entity that writes, issues, or administers any health benefit plan or ancillary benefit plan to employers or small employers in this state. See California Insurance Code 10810
• 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 10755
• Commissioner: means the Insurance Commissioner, who shall have regulatory jurisdiction over purchasing alliances. See California Insurance Code 10810
• Commissioner: means the Insurance Commissioner of this State. See California Insurance Code 20
• Contract: A legal written agreement that becomes binding when signed.
• 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: includes "city and county. See California Insurance Code 14
• Dependent: A person dependent for support upon another.
• Donor: The person who makes a gift.
• Eligible employee: means any permanent employee who is actively engaged on a full-time basis in the conduct of business of the employer or small employer and, who has satisfied any employer or small employer waiting period requirements. See California Insurance Code 10810
• Employer: means any corporation, partnership, sole proprietorship, or other business entity doing business in this state that may be eligible to participate in a purchasing alliance. See California Insurance Code 10810
• Enrollee: means an eligible employee or a dependent of an eligible employee who is enrolled in a health benefit plan or ancillary benefit plan offered through the purchasing alliance by a participating carrier. See California Insurance Code 10810
• 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.
• 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.
• Fraud: Intentional deception resulting in injury to another.
• 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 benefit plan: means a policy or contract written or administered by a participating carrier that arranges or provides health care benefits for the covered eligible employees of an employer or small employer and their dependents. See California Insurance Code 10810
• Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
• licensee: means an insurer, agent, broker, or any other person who is required to be licensed by the department. See California Insurance Code 38.6
• Management company: means the company under contract to the purchasing alliance to provide managerial services for the operation of the purchasing alliance. See California Insurance Code 10810
• Participating carrier: means a carrier that contracts with a purchasing alliance to provide coverage to enrollees under a health benefit plan or ancillary benefit plan. See California Insurance Code 10810
• Participating employer: means an employer or small employer who contracts with a purchasing alliance to provide coverage to the employer's or small employer's employees. See California Insurance Code 10810
• 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
• Probation: A sentencing alternative to imprisonment in which the court releases convicted defendants under supervision as long as certain conditions are observed.
• Purchasing alliance: means a non-risk-bearing entity issued a certificate of registration pursuant to this chapter to provide health benefits through multiple unaffiliated participating carriers to multiple participating employers, small employers and their employees within this state as authorized by the commissioner. See California Insurance Code 10810
• Service region: means that portion of the state, designated by the commissioner pursuant to regulations as described in this chapter in which each purchasing alliance must fairly and affirmatively offer, market, and sell all of the health benefit plan designs offered through the purchasing alliance that are sold or offered to a small employer to all small employers. See California Insurance Code 10810
• Small employer: means either of the following:

  California Insurance Code 10755

• State: means the State of California, unless applied to the different parts of the United States. See California Insurance Code 28
• Third-party administrator: means the company contracted by the purchasing alliance to provide administrative services for the purchasing alliance and that is licensed to provide those services by the department pursuant to Section 1759. See California Insurance Code 10810
• Trust account: A general term that covers all types of accounts in a trust department, such as estates, guardianships, and agencies. ^{Source: OCC}