Terms Used In California Codes > Public Contract Code > Division 2 > Part 2 > Chapter 1 > Article 2 - Plans and Specifications

• 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.
• 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
• Bankruptcy: Refers to statutes and judicial proceedings involving persons or businesses that cannot pay their debts and seek the assistance of the court in getting a fresh start. Under the protection of the bankruptcy court, debtors may discharge their debts, perhaps by paying a portion of each debt. Bankruptcy judges preside over these proceedings.
• 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.
• 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.
• department: means State Department of Health Services. See California Health and Safety Code 20
• 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

• 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
• 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
• Grandfathered small employer health care service plan contract: means a small employer health care service plan contract that constitutes a grandfathered health plan. See California Health and Safety Code 1357.600
• Group contract: means a contract which by its terms limits the eligibility of subscribers and enrollees to a specified group. See California Health and Safety Code 1345
• In force business: means an existing health benefit plan contract issued by the plan to a small employer. 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.
• licensed: refers to , a license as a plan pursuant to Section 1353. See California Health and Safety Code 1345
• 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
• 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
• 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
• 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 law: A public bill or joint resolution that has passed both chambers and been enacted into law. Public laws have general applicability nationwide.
• Rating period: means the period for which premium rates established by a plan are in effect and shall be no less than 12 months from the date of issuance or renewal of the health care service plan contract. See California Health and Safety Code 1357.600
• Real property: Land, and all immovable fixtures erected on, growing on, or affixed to the land.
• Risk adjusted employee risk rate: means the rate determined for an eligible employee of a small employer in a particular risk category after applying the risk adjustment factor. See California Health and Safety Code 1357.600
• Risk adjustment factor: means the percentage adjustment to be applied equally to each standard employee risk rate for a particular small employer, based upon any expected deviations from standard cost of services. See California Health and Safety Code 1357.600
• Risk category: means the following characteristics of an eligible employee: age, geographic region, and family composition of the employee, plus the health benefit plan selected by the small employer. See California Health and Safety Code 1357.600
• 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.
• Small employer: means any of the following:

  California Health and Safety Code 1357.600

• Small employer health care service plan contract: means a health care service plan contract issued to a small employer. See California Health and Safety Code 1357.600
• 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
• Standard employee risk rate: means the rate applicable to an eligible employee in a particular risk category in a small employer group. See California Health and Safety Code 1357.600
• 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