Terms Used In Delaware Code > Title 18 > Chapter 33A - Pharmacy Benefits Managers [For Application of This Chapter, See 80 Del. Laws, C. 245, &Sect;? 2]

• Abuse: means the occurrence of 1 or more of the following acts between family members, current or former household members, or current or former intimate partners:

  a. See Delaware Code Title 18 Sec. 2302

• adult person: means a person of the age of 18 years or older. See Delaware Code Title 1 Sec. 302
• Affidavit: A written statement of facts confirmed by the oath of the party making it, before a notary or officer having authority to administer oaths.
• Affirmed: In the practice of the appellate courts, the decree or order is declared valid and will stand as rendered in the lower court.
• Allegation: something that someone says happened.
• 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.
• Annuity: A periodic (usually annual) payment of a fixed sum of money for either the life of the recipient or for a fixed number of years. A series of payments under a contract from an insurance company, a trust company, or an individual. Annuity payments are made at regular intervals over a period of more than one full year.
• Answer: The formal written statement by a defendant responding to a civil complaint and setting forth the grounds for defense.
• 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.
• Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
• Attorney-at-law: A person who is legally qualified and licensed to practice law, and to represent and act for clients in legal proceedings.
• Bail: Security given for the release of a criminal defendant or witness from legal custody (usually in the form of money) to secure his/her appearance on the day and time appointed.
• 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.
• 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}
• Bequest: Property gifted by will.
• Business day: means , with respect to recission under § 2235A of this title, all calendar days except Sundays and legal public holidays. See Delaware Code Title 5 Sec. 2227
• Child: means a person who has not reached the age of 18 years. See Delaware Code Title 1 Sec. 302
• Claim: means a request from a pharmacy or pharmacist to be reimbursed for the cost of filling or refilling a prescription for a drug or for providing a medical supply or device. See Delaware Code Title 18 Sec. 3321A
• Closed end credit: means the extension of credit by a licensee to a borrower pursuant to an arrangement or agreement which is not a revolving credit plan as defined in subchapter II of this chapter. See Delaware Code Title 5 Sec. 2227
• Commissioner: shall mean the Commissioner of Insurance of this State. See Delaware Code Title 18 Sec. 2302
• Commissioner: means the State Bank Commissioner. See Delaware Code Title 5 Sec. 2201
• Common law: The legal system that originated in England and is now in use in the United States. It is based on judicial decisions rather than legislative action.
• Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
• Continuance: Putting off of a hearing ot trial until a later time.
• Contracted pharmacy: means a pharmacy that participates in the network of a pharmacy benefits manager through a contract with a pharmacy benefits manager, a pharmacy services administration organization, or a group purchasing organization. See Delaware Code Title 18 Sec. 3321A
• Dependent: A person dependent for support upon another.
• Deposition: An oral statement made before an officer authorized by law to administer oaths. Such statements are often taken to examine potential witnesses, to obtain discovery, or to be used later in trial.
• Devise: To gift property by will.
• 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:
• Docket: A log containing brief entries of court proceedings.
• Donor: The person who makes a gift.
• Drug shortage list: means a list of drug products listed on the federal Food and Drug Administration's Drug Shortages website. See Delaware Code Title 18 Sec. 3321A
• Emergency: means a situation that will result in loss of life, limb or organ function. See Delaware Code Title 18 Sec. 3335A
• Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. ^{Source: U.S. Courts}
• Executor: A male person named in a will to carry out the decedent
• Fixed Rate: Having a "fixed" rate means that the APR doesn't change based on fluctuations of some external rate (such as the "Prime Rate"). In other words, a fixed rate is a rate that is not a variable rate. A fixed APR can change over time, in several circumstances:
  • You are late making a payment or commit some other default, triggering an increase to a penalty rate
  • The bank changes the terms of your account and you do not reject the change.
  • The rate expires (if the rate was fixed for only a certain period of time).
• Fraud: Intentional deception resulting in injury to another.
• Freedom of Information Act: A federal law that mandates that all the records created and kept by federal agencies in the executive branch of government must be open for public inspection and copying. The only exceptions are those records that fall into one of nine exempted categories listed in the statute. ^{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.
• Grand jury: agreement providing that a lender will delay exercising its rights (in the case of a mortgage,
• 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.
• Indemnification: In general, a collateral contract or assurance under which one person agrees to secure another person against either anticipated financial losses or potential adverse legal consequences. ^{Source: FDIC}
• Injunction: An order of the court prohibiting (or compelling) the performance of a specific act to prevent irreparable damage or injury.
• insurance contract: shall mean any contract of insurance, indemnity, medical or hospital service, suretyship, or annuity issued, proposed for issuance or intended for issuance by any person. See Delaware Code Title 18 Sec. 2302
• Insurer: means any entity that provides health insurance coverage in this State as defined in § 903 of this title. See Delaware Code Title 18 Sec. 3321A
• Interest rate: The amount paid by a borrower to a lender in exchange for the use of the lender's money for a certain period of time. Interest is paid on loans or on debt instruments, such as notes or bonds, either at regular intervals or as part of a lump sum payment when the issue matures. ^{Source: OCC}
• Interrogatories: Written questions asked by one party of an opposing party, who must answer them in writing under oath; a discovery device in a lawsuit.
• lender: means any person duly licensed or regulated by the Commissioner pursuant to this chapter and, in addition, means any person or class of persons exempt from any or all of the provisions of this chapter in accordance with § 2202(b) of this title, to the extent and for such purposes as determined by the Commissioner in order to effectuate the purposes of this chapter. See Delaware Code Title 5 Sec. 2201
• Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
• Lien: A claim against real or personal property in satisfaction of a debt.
• Litigation: A case, controversy, or lawsuit. Participants (plaintiffs and defendants) in lawsuits are called litigants.
• Loan: means cash advances or loans to be paid to or for the account of the borrower. See Delaware Code Title 5 Sec. 2214
• Loan: means any single extension of closed end credit. See Delaware Code Title 5 Sec. 2227
• Maximum allowable cost: means the maximum amount that a pharmacy benefits manager will reimburse a pharmacist or pharmacy for the cost of a multi-sourced drug, medical product, or device. See Delaware Code Title 18 Sec. 3321A
• Maximum allowable cost list: means the multi-source generic drugs, medical products, and devices for which a maximum allowable cost has been established by a pharmacy benefits manager or a purchaser. See Delaware Code Title 18 Sec. 3321A
• Month: means a calendar month, unless otherwise expressed. See Delaware Code Title 1 Sec. 302
• Mortgagee: The person to whom property is mortgaged and who has loaned the money.
• Mortgagor: The person who pledges property to a creditor as collateral for a loan and who receives the money.
• Network providers: means those pharmacists and pharmacies who provide covered health-care services or supplies to an insured or a member pursuant to a contract with an insurer or pharmacy benefits manager. See Delaware Code Title 18 Sec. 3321A
• 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.
• Occupant: means a person or the person's sublesee, successor, or assign entitled to the use of a storage space or spaces at a self-service storage facility, to the exclusion of others. See Delaware Code Title 18 Sec. 2061
• Outstanding unpaid indebtedness: means on any day an amount not in excess of the total amount of purchases from participating merchants and loans charged to the borrower's account under the plan which is outstanding and unpaid at the end of the day, after adding the aggregate amount of any new purchases from participating merchants and loans charged to the account as of that day and deducting the aggregate amount of any payments and credits applied to that indebtedness as of any day and, if the agreement providing the plan so provides, may include the amount of any interest and additional charges, including late or delinquency charges, which have accrued to the account and which are unpaid at the end of the day. See Delaware Code Title 5 Sec. 2214
• Owner: means the owner, operator, lessor, or sublessor of a self-service storage facility, him or her agent or any other person authorized by him or her to manage the facility or to receive rent from an occupant under a rental agreement. See Delaware Code Title 18 Sec. 2061
• Person: shall mean any individual, corporation, association, partnership, reciprocal exchange, interinsurer, Lloyds insurer, fraternal benefit society and other legal entity engaged in the business of insurance, including agents, brokers and adjusters. See Delaware Code Title 18 Sec. 2302
• Personal property: means movable property that is not affixed to land and includes but is not limited to all of the following:

  a. See Delaware Code Title 18 Sec. 2061

• Pharmacist: means as defined under § 2502 of Title 24. See Delaware Code Title 18 Sec. 3321A
• Pharmacy: means as defined under § 2502 of Title 24. See Delaware Code Title 18 Sec. 3321A
• Pharmacy benefit manager: has the meaning given in § 3302A of this title. See Delaware Code Title 18 Sec. 3335A
• Pharmacy benefits management services: means as defined under § 3351A of this title. See Delaware Code Title 18 Sec. 3321A
• Pharmacy benefits manager: means as defined under § 3302A of this title. See Delaware Code Title 18 Sec. 3321A
• Plaintiff: The person who files the complaint in a civil lawsuit.
• plan: means a plan contemplating the extension of credit under an account governed by an agreement between a licensee and a borrower pursuant to which:

  a. See Delaware Code Title 5 Sec. 2214

• Plea: In a criminal case, the defendant's statement pleading "guilty" or "not guilty" in answer to the charges, a declaration made in open court.
• 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.
• Precedent: A court decision in an earlier case with facts and law similar to a dispute currently before a court. Precedent will ordinarily govern the decision of a later similar case, unless a party can show that it was wrongly decided or that it differed in some significant way.
• Prior authorization: means a requirement by a carrier or health-insurance plan that providers submit a request or other prior notification to the carrier for evaluation of appropriateness of the request or if the prescription is medically necessary before treatment is rendered. See Delaware Code Title 18 Sec. 3335A
• Probation: A sentencing alternative to imprisonment in which the court releases convicted defendants under supervision as long as certain conditions are observed.
• Purchaser: means as defined under § 3351A of this title. See Delaware Code Title 18 Sec. 3321A
• Quorum: The number of legislators that must be present to do business.
• Remainder: An interest in property that takes effect in the future at a specified time or after the occurrence of some event, such as the death of a life tenant.
• Remand: When an appellate court sends a case back to a lower court for further proceedings.
• Revolving credit: A credit agreement (typically a credit card) that allows a customer to borrow against a preapproved credit line when purchasing goods and services. The borrower is only billed for the amount that is actually borrowed plus any interest due. (Also called a charge account or open-end credit.) ^{Source: OCC}
• Self-service storage facility: means any real property designed and used for the purpose of renting or leasing individual storage space to occupants who are to have access to such for the purpose of storing and removing personal property. See Delaware Code Title 18 Sec. 2061
• Self-service storage producer: means an owner who is licensed under this section. See Delaware Code Title 18 Sec. 2061
• Service of process: The service of writs or summonses to the appropriate party.
• 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.
• Short-term consumer loan: means a loan of $1,000 or less made to an individual borrower that charges interest and/or fees for which the stated repayment period is less than 60 days and is not secured by title to a motor vehicle. See Delaware Code Title 5 Sec. 2227
• Statute: A law passed by a legislature.
• Subpoena: A command to a witness to appear and give testimony.
• subsidiaries: shall include , in addition to those such corporations where the insurer owns a majority of their stock, those corporations formed or acquired by an insurer where it owns less than a majority of such corporation's voting stock due to the laws of a foreign national which require the insurer to own less than a majority of the voting stock of such subsidiary insurance corporation if it is to operate in that nation. See Delaware Code Title 18 Sec. 1313
• Summons: Another word for subpoena used by the criminal justice system.
• Testify: Answer questions in court.
• Testimony: Evidence presented orally by witnesses during trials or before grand juries.
• Transcript: A written, word-for-word record of what was said, either in a proceeding such as a trial or during some other conversation, as in a transcript of a hearing or oral deposition.
• 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}
• Under age: means an age of less than 18 years. See Delaware Code Title 1 Sec. 302
• Variable Rate: Having a "variable" rate means that the APR changes from time to time based on fluctuations in an external rate, normally the Prime Rate. This external rate is known as the "index." If the index changes, the variable rate normally changes. Also see Fixed Rate.
• Venue: The geographical location in which a case is tried.
• Workout agreement: means an agreement between an individual borrower and a licensee for the repayment of an outstanding and unpaid indebtedness. See Delaware Code Title 5 Sec. 2227
• Writ: A formal written command, issued from the court, requiring the performance of a specific act.
• Writ of certiorari: An order issued by the Supreme Court directing the lower court to transmit records for a case for which it will hear on appeal.