§ 1374.60 For purpose of this article, the following definitions shall …
§ 1374.62 A point-of-service plan contract, in which any risk for …
§ 1374.64 (a) Only a plan that has been licensed under this chapter and in …
§ 1374.65 Point-of-service plan contracts shall:(a) Provide incentives, …
§ 1374.66 Any health care service plan that offers a point-of-service plan …
§ 1374.67 A health care service plan offering a point-of-service plan contract …
§ 1374.68 A health care service plan that offers a point-of-service plan …
§ 1374.69 At least 20 business days prior to offering a point-of-service plan …
§ 1374.71 No plan formerly registered under the Knox-Mills Health Plan Act …
§ 1374.72 (a) (1) Every health care service plan contract issued, …
§ 1374.721 (a) A health care service plan that provides hospital, medical, …
§ 1374.722 (a) (1) A health care service plan contract issued, …
§ 1374.723 (a) A health care service plan contract issued, amended, …
§ 1374.724 (a) Coverage of mental health and substance use disorder …
§ 1374.73 (a) (1) Every health care service plan contract that …
§ 1374.74 (a) The department, in consultation with the Department of …
§ 1374.76 (a) No later than January 1, 2015, a large group health care …

Terms Used In California Codes > Health and Safety Code > Division 2 > Chapter 2.2 > Article 5.6 - Point-of-Service Health Care Service Plan Contracts

  • Aggrieved employee: means either of the following:

    California Public Contract Code 10510.51

  • Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
  • Basic payroll information: means , for each vendor-supplied employee who performed services at any time during the preceding six-month period, the following information:

    California Public Contract Code 10510.51

  • Contract: includes any written instrument, purchase order, change order, order, requisition, service agreement, or other written or electronic document, however titled, reflecting an agreement that the vendor will perform services or supply the university with employees to perform services in exchange for payment. See California Public Contract Code 10510.51
  • Deed: The legal instrument used to transfer title in real property from one person to another.
  • department: means State Department of Health Services. See California Health and Safety Code 20
  • Devise: To gift property by will.
  • Director: means "State Director of Health Services. See California Health and Safety Code 21
  • Dismissal: The dropping of a case by the judge without further consideration or hearing. Source:
  • Employee: includes any contract worker, or individual employed by any vendor, or otherwise supplied to the university by any vendor, to perform services for the university. See California Public Contract Code 10510.51
  • Enrollee: means a person who is enrolled in a plan and who is a recipient of services from the plan. See California Health and Safety Code 1345
  • Entitlement: A Federal program or provision of law that requires payments to any person or unit of government that meets the eligibility criteria established by law. Entitlements constitute a binding obligation on the part of the Federal Government, and eligible recipients have legal recourse if the obligation is not fulfilled. Social Security and veterans' compensation and pensions are examples of entitlement programs.
  • 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.
  • Evidence of coverage: means any certificate, agreement, contract, brochure, or letter of entitlement issued to a subscriber or enrollee setting forth the coverage to which the subscriber or enrollee is entitled. See California Health and Safety Code 1345
  • Foreclosure: A legal process in which property that is collateral or security for a loan may be sold to help repay the loan when the loan is in default. Source: OCC
  • Gift: A voluntary transfer or conveyance of property without consideration, or for less than full and adequate consideration based on fair market value.
  • Hourly value of employer-provided benefits: means the employer's actual cost for the employee's benefits, including, but not limited to, retirement, health, dental, vision, and life and disability benefits calculated as an hourly dollar amount. See California Public Contract Code 10510.51
  • Injunction: An order of the court prohibiting (or compelling) the performance of a specific act to prevent irreparable damage or injury.
  • Joint labor-management committee: includes any joint labor-management committee or similar meeting body or committee established jointly by the university and the exclusive representative of university employees who perform the same or similar services as the employees performing services for the university. See California Public Contract Code 10510.51
  • License: means , and "licensed" refers to, a license as a plan pursuant to Section 1353. See California Health and Safety Code 1345
  • licensed: refers to , a license as a plan pursuant to Section 1353. See California Health and Safety Code 1345
  • Mortgage: The written agreement pledging property to a creditor as collateral for a loan.
  • 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.
  • Person: means any person, individual, firm, association, organization, partnership, business trust, foundation, labor organization, corporation, limited liability company, public agency, or political subdivision of the state. See California Health and Safety Code 1345
  • plan: refers to health care service plans and specialized health care service plans. See California Health and Safety Code 1345
  • Plan contract: means a contract between a plan and its subscribers or enrollees or a person contracting on their behalf pursuant to which health care services, including basic health care services, are furnished. See California Health and Safety Code 1345
  • Provider: means any professional person, organization, health facility, or other person or institution licensed by the state to deliver or furnish health care services. See California Health and Safety Code 1345
  • Rescission: The cancellation of budget authority previously provided by Congress. The Impoundment Control Act of 1974 specifies that the President may propose to Congress that funds be rescinded. If both Houses have not approved a rescission proposal (by passing legislation) within 45 days of continuous session, any funds being withheld must be made available for obligation.
  • Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.
  • Service area: means a geographical area designated by the plan within which a plan shall provide health care services. See California Health and Safety Code 1345
  • Services: includes services that have been customarily performed by bargaining unit employees of the university, including, but not limited to, the following services: cleaning, custodial, janitorial, or housekeeping services. See California Public Contract Code 10510.51
  • 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.
  • specialized health care service plan: means either of the following:

    California Health and Safety Code 1345

  • State: means the State of California, unless applied to the different parts of the United States. See California Health and Safety Code 23
  • Subscriber: means the person who is responsible for payment to a plan or whose employment or other status, except for family dependency, is the basis for eligibility for membership in the plan. See California Health and Safety Code 1345
  • Total compensation rate: means the employee's hourly rate of pay plus the hourly value of employer-provided benefits, or the equivalent compensation. See California Public Contract Code 10510.51
  • Trustee: A person or institution holding and administering property in trust.
  • University: means the University of California. See California Public Contract Code 10510.51
  • University policy: means a policy or collective bargaining agreement adopted or approved by the university that requires vendors to provide employees wages and benefits of equivalent value to the wages and benefits provided to university employees performing the same work. See California Public Contract Code 10510.51
  • Vendor: means contractor and includes any person, employer, supplier of labor, staffing agency, temporary services employer, labor broker, management services provider, or other entity that contracts with the university to provide services or to supply the university with its own employees or those of a subcontractor to perform services. See California Public Contract Code 10510.51