Terms Used In California Codes > Public Contract Code > Division 2 > Part 2 > Chapter 1 > Article 10 - Ineligibility to Contract

• Affiliation period: means a period that, under the terms of the health care service plan contract, must expire before health care services under the contract become effective. See California Health and Safety Code 1357.600
• Basic health care services: includes ambulance and ambulance transport services provided through the "911" emergency response system. See California Health and Safety Code 1345
• Contract: A legal written agreement that becomes binding when signed.
• Conviction: A judgement of guilt against a criminal defendant.
• Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
• Dependent: means the spouse or registered domestic partner, or child, of an eligible employee, subject to applicable terms of the health care service plan contract covering the employee, and includes dependents of guaranteed association members if the association elects to include dependents under its health coverage at the same time it determines its membership composition pursuant to subdivision (n). See California Health and Safety Code 1357.600
• Dependent: A person dependent for support upon another.
• Director: means "State Director of Health Services. See California Health and Safety Code 21
• Eligible employee: means either of the following:

  California Health and Safety Code 1357.600

• Fraud: Intentional deception resulting in injury to another.
• Grandfathered health plan: has the meaning set forth in Section 1251 of PPACA. See California Health and Safety Code 1357.600
• Guaranteed association: means a nonprofit organization comprised of a group of individuals or employers who associate based solely on participation in a specified profession or industry, accepting for membership any individual or employer meeting its membership criteria, and that (1) includes one or more small employers as defined in subparagraph (A) of paragraph (1) of subdivision (k), (2) does not condition membership directly or indirectly on the health or claims history of any person, (3) uses membership dues solely for and in consideration of the membership and membership benefits, except that the amount of the dues shall not depend on whether the member applies for or purchases insurance offered to the association, (4) is organized and maintained in good faith for purposes unrelated to insurance, (5) has been in active existence on January 1, 1992, and for at least five years prior to that date, (6) has included health insurance as a membership benefit for at least five years prior to January 1, 1992, (7) has a constitution and bylaws, or other analogous governing documents that provide for election of the governing board of the association by its members, (8) offers any plan contract that is purchased to all individual members and employer members in this state, (9) includes any member choosing to enroll in the plan contracts offered to the association provided that the member has agreed to make the required premium payments, and (10) covers at least 1,000 persons with the health care service plan with which it contracts. See California Health and Safety Code 1357.600
• 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.
• 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, 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: as used in this article , means any individual, partnership, joint venture, or association or any other organization or any combination thereof. See California Public Contract Code 10285
• 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
• PPACA: means the federal Patient Protection and Affordable Care Act (Public Law 111-148), as amended by the federal Health Care and Education Reconciliation Act of 2010 (Public Law 111-152), and any rules, regulations, or guidance issued thereunder. See California Health and Safety Code 1357.600
• Preexisting condition provision: means a contract provision that excludes coverage for charges or expenses incurred during a specified period following the enrollee's effective date of coverage, as to a condition for which medical advice, diagnosis, care, or treatment was recommended or received during a specified period immediately preceding the effective date of coverage. See California Health and Safety Code 1357.600
• project: includes the erection, construction, alteration, repair, or improvement of any state structure, building, road, or other state improvement of any kind that will exceed a total cost calculated pursuant to subdivision (b). See California Public Contract Code 10105
• 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
• Small employer: means any of the following:

  California Health and Safety Code 1357.600

• Solicitor: means any person who engages in the acts defined in subdivision ( l). See 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