§ 22:1641 As used in this Part, unless the context requires otherwise, the following definitions shall be applicable:
§ 22:1642 Necessity of written agreement
§ 22:1643 Payment to administrator
§ 22:1644 Maintenance of information
§ 22:1645 Insurer; underwriting; advertisement
§ 22:1646 Duties of the insurer
§ 22:1647 Premium collection and payment of claims
§ 22:1648 Administrator; compensation
§ 22:1649 Notice to covered individuals; disclosure of charges and fees
§ 22:1650 Coverage; notice to individuals
§ 22:1651 A. No person shall act as, or offer to act as, or hold himself out to be an administrator in this state without a valid license as an administrator issued by the commissioner. The co
§ 22:1652 Waiver of application for certification
§ 22:1653 A. Each administrator shall file an annual report for the preceding calendar year with the commissioner on or before March first of each year, or within such extension of time theref
§ 22:1654 A. The commissioner shall suspend or revoke the license of an administrator, deny the application for a license, or, in lieu thereof, impose a fine for each separate violation not to
§ 22:1655 Rules and regulations
§ 22:1656 Confidentiality; documents, information
§ 22:1657 A. A pharmacy benefit manager shall be deemed to be a third-party administrator for purposes of this Part. As such, all provisions of this Part shall apply to pharmacy benefit manage
§ 22:1657.1 A. Each pharmacy benefit manager licensed by the commissioner of insurance shall submit an annual transparency report as a condition of maintaining licensure.

Terms Used In Louisiana Revised Statutes > Title 22 > Chapter 5 > Part III - Third-Party Administrators

  • 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.
  • affiliated: means any entity or person who directly or indirectly through one or more intermediaries, controls or is controlled by, or is under common control with, a specified entity or person. See Louisiana Revised Statutes 22:1641
  • Agency: means and includes the boards, commissions, departments, agencies, offices, officers, and other instrumentalities, or any or all of these, within the executive branch of state government which are abolished by this Title or which are transferred and placed within departments of the state government created and established or continued by this Title or transferred to and placed within the office of the governor as provided by this Title. See Louisiana Revised Statutes 36:3
  • 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
  • Commissioner: means the commissioner of insurance through the Department of Insurance. See Louisiana Revised Statutes 22:1641
  • Control: means as defined in La. See Louisiana Revised Statutes 22:1641
  • 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.
  • Defendant: In a civil suit, the person complained against; in a criminal case, the person accused of the crime.
  • Department: means the Department of Environmental Quality. See Louisiana Revised Statutes 30:2004
  • Deputy secretary: means the officer authorized to be appointed by the secretary to serve as his principal administrative assistant. See Louisiana Revised Statutes 36:3
  • Discharge: means the placing, releasing, spilling, percolating, draining, pumping, leaking, seeping, emitting, or other escaping of pollutants into the air, waters, subsurface water, or ground as the result of a prior act or omission; or the placing of pollutants into pits, drums, barrels, or similar containers under conditions and circumstances that leaking, seeping, draining, or escaping of the pollutants can be reasonably anticipated. See Louisiana Revised Statutes 30:2004
  • Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
  • Docket: A log containing brief entries of court proceedings.
  • 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.
  • Fiduciary: A trustee, executor, or administrator.
  • insurance coverage: means any coverage offered or provided by an insurer. See Louisiana Revised Statutes 22:1641
  • Insurer: means any person undertaking to provide life or health and accident insurance coverage or workers' compensation insurance in this state. See Louisiana Revised Statutes 22:1641
  • Inter vivos: Transfer of property from one living person to another living person.
  • 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
  • Legislative session: That part of a chamber's daily session in which it considers legislative business (bills, resolutions, and actions related thereto).
  • Loan: means a loan of money from the Brownfields Cleanup Revolving Loan Fund. See Louisiana Revised Statutes 30:2551
  • Mortgage: The written agreement pledging property to a creditor as collateral for a loan.
  • Nolo contendere: No contest-has the same effect as a plea of guilty, as far as the criminal sentence is concerned, but may not be considered as an admission of guilt for any other purpose.
  • Nonprofit organization: means any corporation, trust, association, cooperative, or other organization that is operated primarily for scientific, educational, service, charitable, or similar purpose in the public interest; is not organized principally for profit; and uses net proceeds to maintain, improve, or expand the operation of the organization. See Louisiana Revised Statutes 30:2551
  • 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.
  • Office: means each principal operational unit within a department, except the executive office of the secretary. See Louisiana Revised Statutes 36:3
  • 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 individual, municipality, public or private corporation, partnership, firm, the United States Government, and any agent or subdivision thereof or any other juridical person, which shall include, but not be limited to, trusts, joint stock companies, associations, the state of Louisiana, political subdivisions of the state of Louisiana, commissions, and interstate bodies. See Louisiana Revised Statutes 30:2004
  • Pharmacy benefit manager: means a person, business, or other entity and any wholly or partially owned or controlled subsidiary of such entity that either directly or through an intermediary manages or administers the prescription drug and device portion of one or more health benefit plans on behalf of a third party, including insurers, plan sponsors, insurance companies, unions, and health maintenance organizations, in accordance with a pharmacy benefit management plan. See Louisiana Revised Statutes 22:1641
  • Plaintiff: The person who files the complaint in a civil lawsuit.
  • 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.
  • Pollutant: means those elements or compounds defined or identified as hazardous, toxic, or noxious, or as hazardous, solid, or radioactive wastes under this Subtitle and regulations, or by the secretary, consistent with applicable laws and regulations. See Louisiana Revised Statutes 30:2004
  • Presiding officer: A majority-party Senator who presides over the Senate and is charged with maintaining order and decorum, recognizing Members to speak, and interpreting the Senate's rules, practices and precedents.
  • Public defender: Represent defendants who can't afford an attorney in criminal matters.
  • Real property: Land, and all immovable fixtures erected on, growing on, or affixed to the land.
  • Responsible person: means responsible person or responsible owner as those terms are defined in La. See Louisiana Revised Statutes 30:2551
  • Secretary: means the officer appointed by the governor as the executive head and chief administrative officer of certain departments created and provided for by this Title. See Louisiana Revised Statutes 36:3
  • Secretary: means the secretary of the Department of Environmental Quality. See Louisiana Revised Statutes 30:2004
  • 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.
  • Statute: A law passed by a legislature.
  • Subpoena: A command to a witness to appear and give testimony.
  • Summons: Another word for subpoena used by the criminal justice system.
  • Undersecretary: means the officer designated to direct and be responsible for the functions of the office of management and finance of certain departments. See Louisiana Revised Statutes 36:3
  • underwriting: means but is not limited to the acceptance of employer or individual applications for coverage of individuals in accordance with the written rules of the insurer, the overall planning and coordinating of an insurance program, and the ability to procure bonds and excess insurance. See Louisiana Revised Statutes 22:1641
  • Veto: The procedure established under the Constitution by which the President/Governor refuses to approve a bill or joint resolution and thus prevents its enactment into law. A regular veto occurs when the President/Governor returns the legislation to the house in which it originated. The President/Governor usually returns a vetoed bill with a message indicating his reasons for rejecting the measure. In Congress, the veto can be overridden only by a two-thirds vote in both the Senate and the House.
  • Violation: means a failure to comply with the requirements of this Subtitle, the rules issued under this Subtitle, and conditions of permits under this Subtitle. See Louisiana Revised Statutes 30:2004