Terms Used In California Codes > Health and Safety Code > Division 8 > Part 3 > Chapter 2 - Operation and Management

• Aggrieved party: means a party entitled to pursue a remedy. See California Commercial Code 1201
• agreement: means the total legal obligation that results from the parties' agreement as determined by this code and as supplemented by any other applicable laws. See California Commercial Code 1201
• 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.
• 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.
• Appropriation: The provision of funds, through an annual appropriations act or a permanent law, for federal agencies to make payments out of the Treasury for specified purposes. The formal federal spending process consists of two sequential steps: authorization
• Arrest: Taking physical custody of a person by lawful authority.
• Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
• battalion: when used in connection with the infantry of the National Guard. See California Military and Veterans Code 281
• Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. ^{Source: OCC}
• Carrier: shall mean the health care service plan or other entity responsible for the payment of benefits or provision of services under a group contract. See California Health and Safety Code 1399.61
• Chambers: A judge's office.
• Changes: as used in this chapter shall include corrections, alterations, modifications, additions, omissions, increases or decreases. See California Public Contract Code 20446
• Child: means any individual under 19 years of age. See California Health and Safety Code 1399.825
• City: includes "city and county" and "incorporated town" but does not include "unincorporated town" or "village. See California Government Code 20
• company: when used in connection with the infantry of the National Guard. See California Military and Veterans Code 281
• Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
• Contract: shall mean any group health care service plan or contract subject to the provisions of this article. See California Health and Safety Code 1399.61
• 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 Health and Safety Code 14
• County: includes city and county. See California Business and Professions Code 17
• Creditable coverage: means :

  California Health and Safety Code 1399.801

• Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
• Decedent: A deceased person.
• 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
• Director: means "State Director of Health Services. See California Health and Safety Code 21
• Discontinuance: shall mean the termination of the contract between the entire employer unit under a contract and the health care service plan, and does not refer to the termination of any agreement between any individual member under a contract and the health care service plan. See California Health and Safety Code 1399.61
• Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
• Dismissal: The dropping of a case by the judge without further consideration or hearing. ^Source:
• Dues: shall mean the consideration payable to the carrier. See California Health and Safety Code 1399.61
• Embezzlement: In most states, embezzlement is defined as theft/larceny of assets (money or property) by a person in a position of trust or responsibility over those assets. Embezzlement typically occurs in the employment and corporate settings. ^{Source: OCC}
• Employee: shall mean all agents, employees, and members of unions or associations to whom benefits are provided under a contract. See California Health and Safety Code 1399.61
• 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
• Extension of benefits: shall mean the continuation of coverage under a particular benefit provided under a contract following discontinuance with respect to an employee or dependent who is totally disabled on the date of discontinuance. See California Health and Safety Code 1399.61
• Fair market value: The price at which an asset would change hands in a transaction between a willing, informed buyer and a willing, informed seller.
• Federally eligible defined individual: means an individual who as of the date on which the individual seeks coverage under this part, (1) has 18 or more months of creditable coverage, and whose most recent prior creditable coverage was under a group health plan, a federal governmental plan maintained for federal employees, or a governmental plan or church plan as defined in the federal Employee Retirement Income Security Act of 1974 (29 U. See California Health and Safety Code 1399.801
• 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.
• 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}
• Forgery: The fraudulent signing or alteration of another's name to an instrument such as a deed, mortgage, or check. The intent of the forgery is to deceive or defraud. ^{Source: OCC}
• Fraud: Intentional deception resulting in injury to another.
• Genuine: means free of forgery or counterfeiting. See California Commercial Code 1201
• Holder: means :

  California Commercial Code 1201

• In force business: means an existing health benefit plan contract issued by the plan to a federally eligible defined individual. See California Health and Safety Code 1399.801
• Indian: as used in this article , means a person who is enrolled or who is a lineal descendant of one enrolled upon an enrollment listing of the Bureau of Indian Affairs, or upon the enrollment listing of a recognized Indian tribe, band or pueblo. See California Business and Professions Code 17569.9
• Individual grandfathered plan coverage: means health care coverage in which an individual was enrolled on March 23, 2010, consistent with Section 1251 of PPACA and any rules or regulations adopted pursuant to that law. See California Health and Safety Code 1399.825
• Initial open enrollment period: means the open enrollment period beginning on January 1, 2011, and ending 60 days thereafter. See California Health and Safety Code 1399.825
• Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
• Late enrollee: means a child without coverage who did not enroll in a health care service plan contract during an open enrollment period because of any of the following:

  California Health and Safety Code 1399.825

• Lease: A contract transferring the use of property or occupancy of land, space, structures, or equipment in consideration of a payment (e.g., rent). ^{Source: OCC}
• Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
• 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
• Lien: A claim against real or personal property in satisfaction of a debt.
• Lineal descendant: Direct descendant of the same ancestors.
• Litigation: A case, controversy, or lawsuit. Participants (plaintiffs and defendants) in lawsuits are called litigants.
• Money: means a medium of exchange that is currently authorized or adopted by a domestic or foreign government. See California Commercial Code 1201
• Mortgage: The written agreement pledging property to a creditor as collateral for a loan.
• National Bank: A bank that is subject to the supervision of the Comptroller of the Currency. The Office of the Comptroller of the Currency is a bureau of the U.S. Treasury Department. A national bank can be recognized because it must have "national" or "national association" in its name. ^{Source: OCC}
• New business: means a health care service plan contract issued to an eligible individual that is not the plan's in force business. See California Health and Safety Code 1399.801
• Oath: includes affirmation. See California Military and Veterans Code 15
• Oath: A promise to tell the truth.
• 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.
• Open enrollment period: means the annual open enrollment period, subsequent to the initial open enrollment period, applicable to each individual child that is the month of the child's birth date. See California Health and Safety Code 1399.825
• 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: includes any person, firm, association, organization, partnership, limited liability company, business trust, corporation, or company. See California Government Code 17
• Person: means any person, firm, association, organization, partnership, business trust, corporation, limited liability company, or company. See California Health and Safety Code 19
• Person: means an individual, corporation, business trust, estate, trust, partnership, limited liability company, association, joint venture, government, governmental subdivision, agency, or instrumentality, or any other legal or commercial entity. See California Commercial Code 1201
• 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
• person: includes any individual, partnership, firm, association, or corporation. See California Business and Professions Code 17506
• Person: means any individual, partnership, corporation, limited liability company, or association. See California Government Code 7260
• 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
• Plans and specifications: means the unit price catalog and the job order contract technical specifications. See California Public Contract Code 20919.21
• Pleadings: Written statements of the parties in a civil case of their positions. In the federal courts, the principal pleadings are the complaint and the answer.
• PPACA: means the federal Patient Protection and Affordable Care Act (Public Law 111-148), as amended by the Health Care and Education Reconciliation Act of 2010 (Public Law 111-152), and any subsequent rules or regulations issued pursuant to that law. See California Health and Safety Code 1399.825
• Probable cause: A reasonable ground for belief that the offender violated a specific law.
• Probation: A sentencing alternative to imprisonment in which the court releases convicted defendants under supervision as long as certain conditions are observed.
• Project: means the specific requirements and work to be accomplished by the job order contractor in connection with an individual job order. See California Public Contract Code 20919.21
• 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
• Public entity: means any city, charter city, city and county, county, district, public corporation, or political subdivision of the state. See California Public Contract Code 20671
• Public entity: includes the state, the Regents of the University of California, a county, city, city and county, district, public authority, public agency, and any other political subdivision or public corporation in the state or any entity acting on behalf of these agencies when acquiring real property, or any interest therein, in any city or county for public use, and any person who has the authority to acquire property by eminent domain under state law. See California Government Code 7260
• Public law: A public bill or joint resolution that has passed both chambers and been enacted into law. Public laws have general applicability nationwide.
• public project: means :

  California Public Contract Code 20161

• qualified: means one of the following:

  California Government Code 7296

• Quorum: The number of legislators that must be present to do business.
• Real property: Land, and all immovable fixtures erected on, growing on, or affixed to the land.
• Recourse: An arrangement in which a bank retains, in form or in substance, any credit risk directly or indirectly associated with an asset it has sold (in accordance with generally accepted accounting principles) that exceeds a pro rata share of the bank's claim on the asset. If a bank has no claim on an asset it has sold, then the retention of any credit risk is recourse. ^{Source: FDIC}
• referral agency: means a private, profit or nonprofit agency which is engaged in the business of referring persons for remuneration to any extended care, skilled nursing home or intermediate care facility or a distinct part of a facility providing extended care, skilled nursing home care, or intermediate care. See California Health and Safety Code 1401
• Remedy: means any remedial right to which an aggrieved party is entitled with or without resort to a tribunal. See California Commercial Code 1201
• Replacement coverage: shall mean the benefits provided by a succeeding carrier. See California Health and Safety Code 1399.61
• 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.
• Responsible party for a child: means an adult having custody of the child or with responsibility for the financial needs of the child, including the responsibility to provide health care coverage. See California Health and Safety Code 1399.825
• Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.
• Right: includes remedy. See California Commercial Code 1201
• Right of rescission: Right to cancel, within three business days, a contract that uses the home of a person as collateral, except in the case of a first mortgage loan. There is no fee to the borrower, who receives a full refund of all fees paid. The right of rescission is guaranteed by the Truth in Lending Act (TILA). ^{Source: OCC}
• school building: as used in this article includes a facility that a county office of education is authorized to use pursuant to Article 3 (commencing with Section 17280) of Chapter 3. See California Education Code 17582
• Security interest: includes any interest of a consignor and a buyer of accounts, chattel paper, a payment intangible, or a promissory note in a transaction that is subject to Division 9 (commencing with Section 9101). See California Commercial Code 1201
• 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
• 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.
• Sign: means , with present intent to authenticate or adopt a record:

  California Commercial Code 1201

• Solicitation: means any presentation or advertising conducted by, or on behalf of, a plan, where information regarding the plan, or services offered and charges therefor, is disseminated for the purpose of inducing persons to subscribe to, or enroll in, the plan. See California Health and Safety Code 1345
• Solicitor: means any person who engages in the acts defined in subdivision ( l). See California Health and Safety Code 1345
• specialized health care service plan: means either of the following:

  California Health and Safety Code 1345

• Spouse: includes "registered domestic partner" as required by §. See California Health and Safety Code 12.2
• Standard risk rate: means the lowest rate that can be offered for a child with the same benefit plan, effective date, age, geographic region, and family status. See California Health and Safety Code 1399.825
• State: means a state of the United States, the District of Columbia, Puerto Rico, the United States Virgin Islands, or any territory or insular possession subject to the jurisdiction of the United States. See California Commercial Code 1201
• Statute: A law passed by a legislature.
• Subcontractor: means any person, firm, or corporation, other than the employees of the job order contractor, who is bonded and general liability insured and who contracts to furnish labor, or labor and materials, at the worksite or in connection with a job order, whether directly or indirectly on behalf of the job order contractor. See California Public Contract Code 20919.21
• Subdivision: means a subdivision of the section in which that term occurs, unless some other section is expressly mentioned. See California Business and Professions Code 15
• Subpoena: A command to a witness to appear and give testimony.
• 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
• Term: means a portion of an agreement that relates to a particular matter. See California Commercial Code 1201
• Testimony: Evidence presented orally by witnesses during trials or before grand juries.
• Tort: A civil wrong or breach of a duty to another person, as outlined by law. A very common tort is negligent operation of a motor vehicle that results in property damage and personal injury in an automobile accident.
• Trustee: A person or institution holding and administering property in trust.
• Truth in Lending Act: The Truth in Lending Act is a federal law that requires lenders to provide standardized information so that borrowers can compare loan terms. In general, lenders must provide information on ^{Source: OCC}
• User fees: Fees charged to users of goods or services provided by the government. In levying or authorizing these fees, the legislature determines whether the revenue should go into the treasury or should be available to the agency providing the goods or services.
• war: shall mean : (a) whenever Congress has declared war and peace has not been formally restored. See California Military and Veterans Code 18