§ 27-13-34-0.1 Application of certain amendments to chapter
§ 27-13-34-1 “Enrollee” defined
§ 27-13-34-2 “Evidence of coverage” defined
§ 27-13-34-3 “Limited health services” defined
§ 27-13-34-4 “Limited service health maintenance organization” defined
§ 27-13-34-5 “Provider” defined
§ 27-13-34-6 “Subscriber” defined
§ 27-13-34-7 Certificate of authority required; foreign entities
§ 27-13-34-8 Application for certificate of authority; requirements
§ 27-13-34-9 Issuance of certificate of authority; application deficiencies; denial of application
§ 27-13-34-10 Powers of limited service health maintenance organization
§ 27-13-34-11 Modification of documents; filing; disapproval
§ 27-13-34-12 Applicable statutes
§ 27-13-34-13 Evidence of coverage; required information
§ 27-13-34-14 Examinations by commissioner
§ 27-13-34-15 Required contract terms and conditions; exemptions
§ 27-13-34-16 “Net worth” and “uncovered expense” defined; computation of net worth; minimum net worth
§ 27-13-34-17 Required deposit
§ 27-13-34-18 Fidelity bonds; deposit in place of bond
§ 27-13-34-19 Annual reports; additional reports
§ 27-13-34-20 Suspension or revocation of certificate of authority
§ 27-13-34-21 Chapter violations; fines and penalties
§ 27-13-34-22 Supervision, rehabilitation, or liquidation; remedies and measures
§ 27-13-34-23 Fees
§ 27-13-34-24 Dental care services and director; review of adverse decisions; complaints
§ 27-13-34-26 Complaints; records

Terms Used In Indiana Code > Title 27 > Article 13 > Chapter 34 - Limited Service Health Maintenance Organizations

  • 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.
  • Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
  • Attorney: includes a counselor or other person authorized to appear and represent a party in an action or special proceeding. See Indiana Code 1-1-4-5
  • 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.
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • 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.
  • Dependent: A person dependent for support upon another.
  • enrollee: means an individual who is entitled to limited health services under a contract with an entity authorized to provide or arrange for limited health services under this chapter. See Indiana Code 27-13-34-1
  • 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 the certificate, agreement, or contract issued under section 13 of this chapter setting forth the coverage to which an enrollee is entitled. See Indiana Code 27-13-34-2
  • in writing: include printing, lithographing, or other mode of representing words and letters. See Indiana Code 1-1-4-5
  • 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.
  • 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.
  • limited health services: refers to :

    Indiana Code 27-13-34-3

  • limited service health maintenance organization: means a corporation, partnership, limited liability company, or other entity that undertakes to provide or arrange a limited health service on a prepayment basis or other basis. See Indiana Code 27-13-34-4
  • 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.
  • Oversight: Committee review of the activities of a Federal agency or program.
  • 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.
  • Power of attorney: A written instrument which authorizes one person to act as another's agent or attorney. The power of attorney may be for a definite, specific act, or it may be general in nature. The terms of the written power of attorney may specify when it will expire. If not, the power of attorney usually expires when the person granting it dies. Source: OCC
  • Property: includes personal and real property. See Indiana Code 1-1-4-5
  • provider: means a physician, a dentist, an optometrist, a health facility, or other person or institution that is licensed or otherwise authorized to deliver or furnish limited health service. See Indiana Code 27-13-34-5
  • subscriber: means a person whose employment status or other status, except for family dependency, is the basis for eligibility for limited health services under a contract with an entity authorized to provide or arrange for limited health services under this chapter. See Indiana Code 27-13-34-6
  • Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.
  • Trustee: A person or institution holding and administering property in trust.
  • United States: includes the District of Columbia and the commonwealths, possessions, states in free association with the United States, and the territories. See Indiana Code 1-1-4-5
  • Verified: when applied to pleadings, means supported by oath or affirmation in writing. See Indiana Code 1-1-4-5
  • Year: means a calendar year, unless otherwise expressed. See Indiana Code 1-1-4-5