Sections
Subpart A Health and Accident Insurance; Standards and Contract Requirements in General 22:971 – 22:1018
Subpart A-1 Network Adequacy Act 22:1019.1 – 22:1020.6
Subpart A-3 Protecting Patient Access to Physician-Administered Medications 22:1020.51 – 22:1020.53
Subpart A-4 Reducing Administrative Burdens in Health Insurance 22:1020.61 – 22:1020.62
Subpart B State Mandated Health Benefits 22:1021 – 22:1059.3
Subpart B-1 Coverage of Prescription Drugs Through a Drug Formulary 22:1060.1 – 22:1060.8
Subpart B-2 Cancer Patient’s Right to Prompt Coverage Act 22:1060.11 – 22:1060.16
Subpart C Assuring Portability, Availability, Renewability of Health Insurance Coverage 22:1061 – 22:1080
Subpart D Rate Review 22:1091 – 22:1099
Subpart E Medicare Supplement Minimum Standards 22:1111 – 22:1112
Subpart F Healthcare Coverage for Louisiana Families Protection Act 22:1121 – 22:1130
Subpart F-1 Louisiana Guaranteed Benefits Pool 22:1131 – 22:1138
Subpart G Dental Service Contractors 22:1151 – 22:1157.1
Subpart H-1 Network Leasing Act 22:1171 – 22:1172
Subpart I Long-Term Care Insurance 22:1181 – 22:1191
Subpart J Louisiana Health Plan 22:1201 – 22:1217
Subpart K Limitations On Assignment of Obligations 22:1221 – 22:1222
Subpart L Transplant Centers 22:1231 – 22:1233
Subpart M Louisiana Safety Net Health Insurance Program 22:1241 – 22:1252
Subpart N The Louisiana Discount Medical Plan Act 22:1260.1 – 22:1260.11
Subpart O Physician and Provider Notification of Patients in Health Insurance Exchange Grace Period Act 22:1260.31 – 22:1260.48

Terms Used In Louisiana Revised Statutes > Title 22 > Chapter 4 > Part III - Health and Accident Coverage

  • Acquittal:
    1. Judgement that a criminal defendant has not been proved guilty beyond a reasonable doubt.
    2. A verdict of "not guilty."
     
  • Actuarial certification: means a written statement by a member of the American Academy of Actuaries that a health insurance issuer is in compliance with the provisions of this Subpart, based upon the actuary's examination, including a review of the appropriate records and of the actuarial assumptions and methods utilized by the health insurance issuer in establishing rates for applicable health benefit plans. See Louisiana Revised Statutes 22:1091
  • Administrator: means a third party other than the warrantor who is designated by the warrantor to be responsible for the administration of vehicle protection product warranties. See Louisiana Revised Statutes 32:1272
  • Advice and consent: Under the Constitution, presidential nominations for executive and judicial posts take effect only when confirmed by the Senate, and international treaties become effective only when the Senate approves them by a two-thirds vote.
  • 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.
  • agency: means any political subdivision, including any parish, municipality, school board, or special district, and any other unit of local government and any department, office, agency, board, commission, district, governing authority, committee, subcommittee, advisory board, task force, or other instrumentality of a political subdivision or other unit of local government. See Louisiana Revised Statutes 33:9662
  • Agricultural movements: means the operation of a motor vehicle or combination of vehicles by a farmer to transport agricultural products, farm machinery, and farm supplies; or agricultural crop production fertilizers, agricultural chemicals, or agricultural related fuels, found to be hazardous under the provisions of the Hazardous Materials Transportation Act which requires the motor vehicle to bear a placard under the provisions of the Hazardous Materials Regulations (99 C. See Louisiana Revised Statutes 32:401
  • Allegation: something that someone says happened.
  • Ambulatory surgical center: means an establishment in this state as defined in and licensed under the provisions of La. See Louisiana Revised Statutes 22:1202
  • 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.
  • Antique vehicle: shall mean a vehicle twenty-five years old or older. See Louisiana Revised Statutes 32:702
  • 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.
  • Appellate: About appeals; an appellate court has the power to review the judgement of another lower court or tribunal.
  • Appraisal: A determination of property value.
  • Arrest: Taking physical custody of a person by lawful authority.
  • Articles: means the original articles of incorporation and all amendments thereto including those contained in merger agreements or, if restated, the latest restatement thereof except in those instances in which the context refers expressly to the original articles of incorporation only. See Louisiana Revised Statutes 6:201
  • Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
  • Assets: means all of a state bank's property and rights of every kind. See Louisiana Revised Statutes 6:201
  • Authorized officer: means any officer of a federally insured financial institution operating in Louisiana who is designated to witness the endorsement of a seller, on behalf of a federally insured financial institution, for the purpose of executing the transfer of a titled motor vehicle or titled vehicle in accordance with the requirements of this Chapter. See Louisiana Revised Statutes 32:702
  • Authorized prescriber: means a person licensed, registered, or otherwise authorized by the appropriate licensing board to prescribe prescription drugs in the course of professional practice. See Louisiana Revised Statutes 22:1060.1
  • Auto hulk: means any material which is or may have been a motor vehicle, with or without all component parts, which is not self-propelled nor capable of carrying persons or property upon a public highway and which material is in such condition that its highest or primary value is its sale or transfer as parts or scrap metal. See Louisiana Revised Statutes 32:702
  • Auto title company: means any person, firm, association, or corporation which is engaged primarily in the transfer and recordation of sales, leases, or mortgages of vehicles including but not limited to mobile homes, trailers, and motor vehicles. See Louisiana Revised Statutes 32:702
  • Autocycle: means a three-wheeled motorcycle on which the driver and all passengers ride in either a partially or completely enclosed seating area or in a side-by-side seating area that is equipped with a rollbar or roll cage, safety belts for all occupants, and is designed to be controlled with a steering mechanism and pedals. See Louisiana Revised Statutes 32:401
  • 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.
  • Base health care facility: means a facility or institution providing health care services, including but not limited to a hospital or other licensed inpatient center, ambulatory surgical or treatment center, skilled nursing facility, inpatient hospice facility, residential treatment center, diagnostic, laboratory, or imaging center, or rehabilitation or other therapeutic health setting that has entered into a contract or agreement with a facility-based physician. See Louisiana Revised Statutes 22:1019.1
  • Baseline: Projection of the receipts, outlays, and other budget amounts that would ensue in the future without any change in existing policy. Baseline projections are used to gauge the extent to which proposed legislation, if enacted into law, would alter current spending and revenue levels.
  • 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
  • Benefits plan: means the coverages offered by the plan to eligible persons as defined by La. See Louisiana Revised Statutes 22:1202
  • Board: means the board of directors of the plan. See Louisiana Revised Statutes 22:1202
  • Board: means the Board of Supervisors of Community and Technical Colleges. See Louisiana Revised Statutes 17:3394.2
  • Board: means the State Board of Elementary and Secondary Education. See Louisiana Revised Statutes 17:3822
  • booting: means the act of placing on a parked motor vehicle a mechanical device that is designed to be attached to the wheel or tire or other part of such vehicle so as to prohibit its usual manner of movement. See Louisiana Revised Statutes 32:1741
  • bureau: means the Louisiana Bureau of Criminal Identification and Information. See Louisiana Revised Statutes 15:576
  • Cancellation: means that a driver's license is annulled because of some error or defect or because the licensee is no longer entitled to such license, but the cancellation of a license is without prejudice and application for a new license may be made at any time after such cancellation. See Louisiana Revised Statutes 32:401
  • Caucus: From the Algonquian Indian language, a caucus meant "to meet together." An informal organization of members of the legislature that exists to discuss issues of mutual concern and possibly to perform legislative research and policy planning for its members. There are regional, political or ideological, ethnic, and economic-based caucuses.
  • Certificate of destruction: means a type of certificate of title issued by the office of motor vehicles for a "water-damaged vehicle" other than an antique vehicle or a vehicle in excess of twenty thousand pounds gross vehicle weight rating (GVWR), whose power train, computer, or electrical system has been damaged by flooding as the result of a gubernatorially declared disaster or emergency and that is a "total loss" as defined in this Section. See Louisiana Revised Statutes 32:702
  • Chancellor: means the chief executive officer of a public postsecondary education institution. See Louisiana Revised Statutes 17:3399.12
  • Charity: An agency, institution, or organization in existence and operating for the benefit of an indefinite number of persons and conducted for educational, religious, scientific, medical, or other beneficent purposes.
  • Chief judge: The judge who has primary responsibility for the administration of a court but also decides cases; chief judges are determined by seniority.
  • Civil forfeiture: The loss of ownership of property used to conduct illegal activity.
  • Commerce: means transportation for the purpose of compensation, remuneration, employment, trade, or payment of any thing of value. See Louisiana Revised Statutes 32:401
  • Commercial motor vehicle: means a motor vehicle or combination of motor vehicles used in commerce to transport passengers or property if the motor vehicle meets one of the following requirements:

                (a) Has a gross combination weight rating of twenty-six thousand one or more pounds inclusive of a towed unit with a gross vehicle weight rating of more than ten thousand pounds. See Louisiana Revised Statutes 32:401

  • Commission: means the Louisiana Motor Vehicle Commission. See Louisiana Revised Statutes 32:1272
  • Commissioner: means the commissioner of insurance. See Louisiana Revised Statutes 22:1132
  • Commissioner: means the commissioner of insurance. See Louisiana Revised Statutes 22:1202
  • Commissioner: means the commissioner of insurance. See Louisiana Revised Statutes 22:1242
  • Commissioner: shall mean the commissioner of insurance. See Louisiana Revised Statutes 22:1260.2
  • Commissioner: means the commissioner of insurance. See Louisiana Revised Statutes 22:1019.1
  • Commissioner: shall mean the director of public safety as provided for in La. See Louisiana Revised Statutes 32:702
  • Committee: means the Teacher Incentive Pay Models Program Advisory Committee. See Louisiana Revised Statutes 17:3822
  • Committee membership: Legislators are assigned to specific committees by their party. Seniority, regional balance, and political philosophy are the most prominent factors in the committee assignment process.
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • Confidential advisor: means a person designated by an institution to provide emergency and ongoing support to students who are alleged victims of power-based violence. See Louisiana Revised Statutes 17:3399.12
  • Contracted health care provider: means a health care provider that has entered into a contract or agreement directly with a health insurance issuer or through a network of providers for the provision of covered health care services. See Louisiana Revised Statutes 22:1242
  • Contracting entity: means any person or entity, including a third-party administrator and a dental carrier, that enters into a direct contract with a provider for the delivery of dental services in the ordinary course of business. See Louisiana Revised Statutes 22:1171
  • conviction: includes the entry of a plea of guilty or nolo contendere to an offense; the forfeiture of bail of any person charged with an offense; and the adjudication of a person as a delinquent for the commission of an offense pursuant to juvenile proceedings. See Louisiana Revised Statutes 32:401
  • Corporation: means the nonprofit corporation which may be utilized to accomplish the purposes of this Part. See Louisiana Revised Statutes 17:3394.2
  • 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.
  • Covered health care services: means services, items, supplies, or drugs for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease that are either covered and payable under the terms of the health insurance coverage. See Louisiana Revised Statutes 22:1242
  • Covered health care services: means health care services that are either covered and payable under the terms of health insurance coverage or required by law to be covered. See Louisiana Revised Statutes 22:1019.1
  • Covered person: means a policyholder, subscriber, enrollee, insured, or other individual participating in a health benefit plan. See Louisiana Revised Statutes 22:1019.1
  • criminal justice agency: means any government agency or subunit thereof, or private agency which, through statutory authorization or a legal formal agreement with a governmental unit or agency has the power of investigation, arrest, detention, prosecution, adjudication, treatment, supervision, rehabilitation, or release of persons suspected, charged, or convicted of a crime; or which collects, stores, processes, transmits, or disseminates criminal history record or crime information. See Louisiana Revised Statutes 15:576
  • criminal justice information system: means all agencies, procedures, mechanisms, media, and forms as well as the information itself which are or become involved in the origination, collection, transmittal, storage, retrieval, and dissemination of information related to offenses or offenders in Louisiana. See Louisiana Revised Statutes 15:576
  • criminal justice system: means that body of agencies at the federal, state, or local level, which may legally arrest, detain, prosecute, adjudicate, treat, supervise, rehabilitate or release, or collect, store, process, transmit, or disseminate criminal history record or crime information. See Louisiana Revised Statutes 15:576
  • criminal street gang: means any ongoing organization, association, or group of three or more persons, whether formal or informal, which has as one of its primary activities the commission of one or more of the criminal acts enumerated in Paragraphs (1) through (13) of Subsection B of this Section or which has a common name or common identifying sign or symbol, whose members individually or collectively engage in or have engaged in a pattern of criminal gang activity. See Louisiana Revised Statutes 15:1404
  • Cross examine: Questioning of a witness by the attorney for the other side.
  • Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
  • Dealer: shall mean any person engaged in the business of buying, selling or exchanging motor vehicles which are subject to license under Chapter 4 of the Subtitle II of Title 47 of the Louisiana Revised Statutes of 1950. See Louisiana Revised Statutes 32:702
  • Deed: The legal instrument used to transfer title in real property from one person to another.
  • Defendant: In a civil suit, the person complained against; in a criminal case, the person accused of the crime.
  • Dental benefit plan: means a benefit plan which pays or provides dental expense benefits for covered dental services and is delivered or issued for delivery by or through a dental carrier on a stand-alone basis. See Louisiana Revised Statutes 22:1171
  • Dental carrier: means a dental insurance company, dental service corporation, dental plan organization authorized to provide dental benefits, or a health insurance plan that includes coverage for dental services. See Louisiana Revised Statutes 22:1171
  • Dental services: means services for the diagnosis, prevention, treatment, or cure of a dental condition, illness, injury, or disease. See Louisiana Revised Statutes 22:1171
  • Dentist: means any person lawfully licensed by the Louisiana State Board of Dentistry to practice dentistry in this state. See Louisiana Revised Statutes 22:1171
  • Department: means the Department of Insurance. See Louisiana Revised Statutes 22:1202
  • Department: means the Department of Insurance. See Louisiana Revised Statutes 22:1242
  • Department: means the Department of Education. See Louisiana Revised Statutes 17:3602
  • Department: means the state Department of Education. See Louisiana Revised Statutes 17:3822
  • Department: means the Department of Public Safety and Corrections. See Louisiana Revised Statutes 32:401
  • Department: means the Department of Insurance. See Louisiana Revised Statutes 22:1020.1
  • Dependent: means a resident spouse or resident unmarried child under the age of twenty-one years, a child who is a student under the age of twenty-four years and who is financially dependent upon the parent, or a child of any age who is disabled and dependent upon the parent. See Louisiana Revised Statutes 22:1202
  • Devise: To gift property by will.
  • Discount medical plan: shall mean a business arrangement or contract in which a person, in exchange for fees, dues, charges or other valuable consideration, provides access for plan members to providers of medical services and the right to receive medical services from those providers at a discount. See Louisiana Revised Statutes 22:1260.2
  • Discount medical plan card: shall mean a card or any other purchasing mechanism or device, which is not insurance, that purports to offer discounts or access to discounts in health-related purchases from health care providers. See Louisiana Revised Statutes 22:1260.2
  • Discount medical plan organization: shall mean any person or organization that operates a discount medical plan and contracts with providers, provider networks or other discount medical plan organizations to offer access to medical services at a discount and determines the charge to discount medical plan members. See Louisiana Revised Statutes 22:1260.2
  • Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
  • Division of administration: means the division of administration created within the office of the governor by Title 39 of the Louisiana Revised Statutes of 1950. See Louisiana Revised Statutes 17:3394.2
  • Docket: A log containing brief entries of court proceedings.
  • Donee: The recipient of a gift.
  • Donor: The person who makes a gift.
  • Driver rehabilitation specialist: means an individual who provides comprehensive services in clinical evaluation of physical functioning, visual/perceptual/cognitive screening, as it pertains to the driving test, and wheelchair/seating assessment, driving assessment, vehicle modification prescription, and driver education; possesses at a minimum an undergraduate degree in a rehabilitation, education, health, safety, physical, occupational, kinesio, or recreational therapy, or related profession or an equivalent of eight years experience in driver rehabilitation/education; and has a minimum of one year of experience in the area of driver evaluation and training for persons with disabilities or possesses current recognition from the Association for Driver Rehabilitation Specialists (ADED) as a driver rehabilitation specialist. See Louisiana Revised Statutes 32:401
  • drug: means any of the following:

    (a)  A substance for which federal or state law requires a prescription before the substance may be legally dispensed to the public. See Louisiana Revised Statutes 22:1060.1

  • Electronic funds transfer: The transfer of money between accounts by consumer electronic systems-such as automated teller machines (ATMs) and electronic payment of bills-rather than by check or cash. (Wire transfers, checks, drafts, and paper instruments do not fall into this category.) Source: OCC
  • Embezzlement: In most states, embezzlement is defined as theft/larceny of assets (money or property) by a person in a position of trust or responsibility over those assets. Embezzlement typically occurs in the employment and corporate settings. Source: OCC
  • Emergency medical condition: means a medical condition manifesting itself by symptoms of sufficient severity, including severe pain, such that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect that the absence of immediate medical attention would result in serious impairment to bodily functions, serious dysfunction of a bodily organ or part, or would place the person's health or, with respect to a pregnant woman, the health of the woman or her unborn child, in serious jeopardy. See Louisiana Revised Statutes 22:1019.1
  • Emergency services: means health care items and services furnished or required to evaluate and treat an emergency medical condition. See Louisiana Revised Statutes 22:1019.1
  • Employee: means :

                (a)(i) An administrative officer, official, or employee of a public postsecondary education board or institution. See Louisiana Revised Statutes 17:3399.12

  • En banc: In the bench or "full bench." Refers to court sessions with the entire membership of a court participating rather than the usual quorum. U.S. courts of appeals usually sit in panels of three judges, but may expand to a larger number in certain cases. They are then said to be sitting en banc.
  • Enrolled bill: The final copy of a bill or joint resolution which has passed both chambers in identical form. It is printed on parchment paper, signed by appropriate officials, and submitted to the President/Governor for signature.
  • Enrollee: means a qualified individual or qualified employee enrolled in a qualified health plan. See Louisiana Revised Statutes 22:1260.32
  • Enterprise: means any individual, sole proprietorship, partnership, corporation or other legal entity, or any unchartered association, or group of individuals associated in fact and includes unlawful as well as lawful enterprises and governmental as well as other entities. See Louisiana Revised Statutes 15:1352
  • Entitlement: A Federal program or provision of law that requires payments to any person or unit of government that meets the eligibility criteria established by law. Entitlements constitute a binding obligation on the part of the Federal Government, and eligible recipients have legal recourse if the obligation is not fulfilled. Social Security and veterans' compensation and pensions are examples of entitlement programs.
  • Entity: shall mean a corporation, association, partnership, limited liability company, limited liability partnership or other legal entity. See Louisiana Revised Statutes 22:1260.2
  • 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
  • Escrow: Money given to a third party to be held for payment until certain conditions are met.
  • Essential community providers: means providers that serve predominantly low-income, medically underserved individuals, including those providers defined in Section 340B(a)(4) of the Public Health Service Act and providers described in Section 1927(c)(1)(D)(i)(IV) of the Social Security Act as set forth by Section 221 of Public Law 111-8. See Louisiana Revised Statutes 22:1019.1
  • Ethics board: means the ethics body which has jurisdiction over elected officials under Chapter 15 of Title 42 of the Louisiana Revised Statutes of 1950. See Louisiana Revised Statutes 33:9662
  • Excessive: means the rate charged for the health insurance coverage causes the premium or premiums charged for the health insurance coverage to be unreasonably high in relation to the benefits provided under the particular product. See Louisiana Revised Statutes 22:1091
  • exchange: means a governmental agency or nonprofit entity that meets the applicable standards of the Patient Protection and Affordable Care Act and makes qualified health plans available to qualified individuals and qualified employers. See Louisiana Revised Statutes 22:1260.32
  • Executive director: means the executive director of the Louisiana Motor Vehicle Commission. See Louisiana Revised Statutes 32:1272
  • Executive session: A portion of the Senate's daily session in which it considers executive business.
  • Executor: A male person named in a will to carry out the decedent
  • Expenditure: means the gift or payment of money or any thing of value for the purchase of food, drink, or refreshment for a local government official or for the spouse or minor child of a local government official for the purpose of lobbying or any gift or payment permitted by La. See Louisiana Revised Statutes 33:9662
  • Expressive activities: include but are not limited to any lawful verbal or written means by which individuals or groups communicate ideas to one another, as provided by the First Amendment of the Constitution of the United States of America and by the Constitution of Louisiana, including all forms of peaceful assembly, protest, speech, distribution of literature, carrying signs, and circulating petitions. See Louisiana Revised Statutes 17:3399.31
  • Facility-based physician: means a physician licensed to practice medicine who is required by the base health care facility to provide services in a base health care facility, including an anesthesiologist, hospitalist, intensivist, neonatologist, pathologist, radiologist, emergency room physician, or other on-call physician, who is required by the base health care facility to provide covered health care services related to any medical condition. See Louisiana Revised Statutes 22:1019.1
  • Fair market value: The price at which an asset would change hands in a transaction between a willing, informed buyer and a willing, informed seller.
  • Farmer: means any person who operates a farm or is directly involved in the cultivation of land, crops, or livestock which are owned by that person, or are under the direct control of that person. See Louisiana Revised Statutes 32:401
  • FBI rap back system: means a service maintained by the Federal Bureau of Investigation to provide authorized noncriminal and criminal justice agencies ongoing status notifications of any criminal history subsequently reported to the FBI in its criminal history system after the initial criminal or civil transaction. See Louisiana Revised Statutes 15:576
  • Federal Deposit Insurance Corporation: A government corporation that insures the deposits of all national and state banks that are members of the Federal Reserve System. Source: OCC
  • Federal Reserve System: The central bank of the United States. The Fed, as it is commonly called, regulates the U.S. monetary and financial system. The Federal Reserve System is composed of a central governmental agency in Washington, D.C. (the Board of Governors) and twelve regional Federal Reserve Banks in major cities throughout the United States. Source: OCC
  • Federal review threshold: means any rate increase that results in a ten percent or greater rate increase, or such other threshold as required by federal law or regulation or any rate that, when combined with all rate increases and decreases during the previous twelve-month period, would result in an aggregate ten percent or greater rate increase. See Louisiana Revised Statutes 22:1091
  • Federally defined eligible individual: means an individual as defined by La. See Louisiana Revised Statutes 22:1202
  • Fiduciary: A trustee, executor, or administrator.
  • Forgery: The fraudulent signing or alteration of another's name to an instrument such as a deed, mortgage, or check. The intent of the forgery is to deceive or defraud. Source: OCC
  • formulary: means a list of prescription drugs which meets any of the following criteria:

    (a)  For which a health benefit plan provides coverage. See Louisiana Revised Statutes 22:1060.1

  • Foster youth: means any individual in the care, custody, or guardianship of the Department of Children and Family Services in the foster care program for any six of the seventy-two months immediately prior to his eighteenth birthday. See Louisiana Revised Statutes 17:3399.21
  • Fraud: Intentional deception resulting in injury to another.
  • Gift: A voluntary transfer or conveyance of property without consideration, or for less than full and adequate consideration based on fair market value.
  • Grace period: is a period that applies to recipients of advance payments of the premium tax credit allowed for certain individuals to purchase health insurance coverage on the exchange. See Louisiana Revised Statutes 22:1260.32
  • Grace period: The number of days you'll have to pay your bill for purchases in full without triggering a finance charge. Source: Federal Reserve
  • Grantor: The person who establishes a trust and places property into it.
  • 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.
  • Habeas corpus: A writ that is usually used to bring a prisoner before the court to determine the legality of his imprisonment. It may also be used to bring a person in custody before the court to give testimony, or to be prosecuted.
  • Health and accident insurance: means hospital and medical expense incurred policies, nonprofit service plan corporation contracts, and coverages provided by health maintenance organizations, individual practices, associations, the Office of Group Benefits, and other similar entities and self-insurers. See Louisiana Revised Statutes 22:1202
  • Health benefit plan: means a policy, contract, certificate, or subscriber agreement entered into, offered, or issued by a health insurance issuer to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services. See Louisiana Revised Statutes 22:1019.1
  • Health care facility: means a facility or institution providing health care services including but not limited to a hospital or other licensed inpatient center, ambulatory surgical or treatment center, skilled nursing facility, inpatient hospice facility, residential treatment center, diagnostic, laboratory, or imaging center, or rehabilitation or other therapeutic health setting. See Louisiana Revised Statutes 22:1242
  • Health care facility: means an institution providing health care services or a health care setting, including but not limited to hospitals and other licensed inpatient centers, ambulatory surgical or treatment centers, skilled nursing centers, diagnostic, laboratory and imaging centers, and rehabilitation and other therapeutic health settings. See Louisiana Revised Statutes 22:1019.1
  • Health care professional: means a physician or other health care practitioner licensed, certified, or registered to perform specified health care services consistent with state law. See Louisiana Revised Statutes 22:1242
  • Health care professional: means a physician or other health care practitioner licensed, certified, or registered to perform specified health care services consistent with state law. See Louisiana Revised Statutes 22:1019.1
  • Health care provider: means a person licensed by this state to provide health care or professional services under the provisions of Title 37 of the Louisiana Revised Statutes of 1950 or any professional corporation, as a health care provider, authorized to form under the provisions of Title 12 of the Louisiana Revised Statutes of 1950 or such a person licensed by the appropriate laws of another state. See Louisiana Revised Statutes 22:1202
  • Health care provider: shall mean any person licensed, certified, or registered in this state to provide health care services, including but not limited to physicians, hospitals, home health agencies, chiropractors, pharmacies and dentists. See Louisiana Revised Statutes 22:1260.2
  • Health care services: means services, items, supplies, or drugs for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease. See Louisiana Revised Statutes 22:1242
  • Health care services: means services, items, supplies, or drugs for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease. See Louisiana Revised Statutes 22:1019.1
  • Health care services: means services, items, supplies, or prescription drugs for the diagnosis, treatment, cure, or relief of a health condition, illness, injury, or disease. See Louisiana Revised Statutes 22:1060.1
  • Health coverage plan: means any hospital, health, or medical expense insurance policy, hospital or medical service contract, employee welfare benefit plan, contract, or other agreement with a health maintenance organization or a preferred provider organization, health and accident including a group insurance plan or self-insurance plan and the office of group benefits. See Louisiana Revised Statutes 22:1060.12
  • Health insurance coverage: means benefits consisting of medical care provided or arranged for directly, through insurance or reimbursement, or otherwise, and includes health care services paid for under any plan, policy, or certificate of insurance. See Louisiana Revised Statutes 22:1242
  • Health insurance coverage: means benefits consisting of medical care provided or arranged for directly, through insurance or reimbursement, or otherwise, and includes health care services paid for under any health benefit plan. See Louisiana Revised Statutes 22:1019.1
  • health insurance coverage: means services consisting of medical care, provided directly, through insurance or reimbursement, or otherwise, and including items and services paid for as medical care under any hospital or medical service policy or certificate, hospital or medical service plan contract, preferred provider organization, or health maintenance organization contract offered by a health insurance issuer. See Louisiana Revised Statutes 22:1091
  • Health insurance issuer: means any entity that offers health insurance coverage through a policy or certificate of insurance subject to state law that regulates the business of insurance. See Louisiana Revised Statutes 22:1242
  • Health insurance issuer: means an entity subject to the insurance laws and regulations of this state, or subject to the jurisdiction of the commissioner, that contracts or offers to contract, or enters into an agreement to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services, including a sickness and accident insurance company, a health maintenance organization, a preferred provider organization or any similar entity, or any other entity providing a plan of health insurance or health benefits. See Louisiana Revised Statutes 22:1019.1
  • Health insurance issuer: means an entity subject to the Louisiana Insurance Code and applicable regulations, or subject to the jurisdiction of the commissioner, that contracts or offers to contract, or enters into an agreement to provide, deliver, arrange for, pay for, or reimburse any of the costs of healthcare services, including a sickness and accident insurance company, a health maintenance organization, a preferred provider organization or any similar entity, or any other entity providing a plan of health insurance or health benefits. See Louisiana Revised Statutes 22:1060.12
  • Health insurance issuer: means any entity that offers health insurance coverage through a policy, certificate of insurance, or subscriber agreement subject to state law that regulates the business of insurance. See Louisiana Revised Statutes 22:1091
  • Health insurance plan: means any hospital or medical insurance policy or certificate, qualified higher deductible health plan, health maintenance organization subscriber contract, contract providing benefits for dental care whether such contract is pursuant to a medical insurance policy or certificate, stand-alone dental plan, health maintenance provider contract, or managed healthcare plan. See Louisiana Revised Statutes 22:1171
  • Health insurer: means any entity or person that issues health insurance plans as described in this Section. See Louisiana Revised Statutes 22:1171
  • Health maintenance organization: means an organization as defined in La. See Louisiana Revised Statutes 22:1202
  • Healthcare facility: means an institution providing healthcare services or a healthcare setting, including but not limited to hospitals and other licensed inpatient centers, ambulatory surgical or treatment centers, skilled nursing centers, diagnostic, laboratory, and imaging centers, and rehabilitation and other therapeutic health settings. See Louisiana Revised Statutes 22:1020.1
  • Healthcare professional: means a physician or other healthcare practitioner licensed, certified, or registered to perform specified healthcare services consistent with state law. See Louisiana Revised Statutes 22:1020.1
  • Healthcare services: means services, items, supplies, or drugs for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease. See Louisiana Revised Statutes 22:1020.1
  • Hospital: means any facility as defined in La. See Louisiana Revised Statutes 22:1202
  • Hydrocarbon gas: means a combustible organic gas containing only one carbon and hydrogen. See Louisiana Revised Statutes 32:1601
  • Inadequate: means rates for a particular product are clearly insufficient to sustain projected losses and expenses, or the use of such rates. See Louisiana Revised Statutes 22:1091
  • Incidental costs: means expenses specified in the warranty incurred by the warranty holder related to the failure of the vehicle protection product to perform as provided in the warranty. See Louisiana Revised Statutes 32:1272
  • 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
  • Index rate: means the average rate resulting from the estimated combined claims experience for all Essential Health Benefits, pursuant to 42 U. See Louisiana Revised Statutes 22:1091
  • Indictment: The formal charge issued by a grand jury stating that there is enough evidence that the defendant committed the crime to justify having a trial; it is used primarily for felonies.
  • Individual: shall mean a natural person. See Louisiana Revised Statutes 22:1260.2
  • Individual market: means the market for health insurance coverage offered to individuals other than in connection with a group health plan. See Louisiana Revised Statutes 22:1091
  • Injunction: An order of the court prohibiting (or compelling) the performance of a specific act to prevent irreparable damage or injury.
  • Institution: means a public postsecondary education institution. See Louisiana Revised Statutes 17:3399.12
  • Insurance arrangement: means any plan, program, contract, or any other arrangement under which one or more natural or juridical persons provide to their employees or participants, whether directly or indirectly, health care services or benefits other than through an insurer. See Louisiana Revised Statutes 22:1202
  • Insured: means any natural person domiciled in this state, other than a member of the plan, who is eligible to receive benefits from any insurer or insurance arrangement as defined in this Section. See Louisiana Revised Statutes 22:1202
  • insured: means a person, including a spouse or dependent, who is enrolled in or insured by a health insurance issuer for health insurance coverage. See Louisiana Revised Statutes 22:1242
  • insured: means an individual who is enrolled or insured by a health insurance issuer under a health benefit plan. See Louisiana Revised Statutes 22:1060.1
  • Insured: includes any policyholder, including a dependent, enrollee, subscriber, or member, who is covered through any policy or subscriber agreement offered by a health insurance issuer. See Louisiana Revised Statutes 22:1091
  • Insurer: means any insurance company or other entity authorized to transact and transacting health and accident insurance business in this state. See Louisiana Revised Statutes 22:1202
  • 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
  • issuer: means any entity that offers a health benefit plan through a policy, contract, or certificate of insurance subject to state law that regulates the business of insurance. See Louisiana Revised Statutes 22:1060.1
  • Joint committee: Committees including membership from both houses of teh legislature. Joint committees are usually established with narrow jurisdictions and normally lack authority to report legislation.
  • large employer: means , in connection with a group health plan with respect to a calendar year and a plan year, an employer who employed an average of at least fifty-one employees on business days during the preceding calendar year and who employs at least two employees on the first day of the plan year. See Louisiana Revised Statutes 22:1091
  • Lawsuit: A legal action started by a plaintiff against a defendant based on a complaint that the defendant failed to perform a legal duty, resulting in harm to the plaintiff.
  • Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
  • License fee: means the privilege, tax, or fee imposed by this Chapter. See Louisiana Revised Statutes 32:401
  • 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.
  • Lobbyist: means any person who acts in a representative capacity and makes an expenditure in excess of five hundred dollars in the aggregate within the calendar year. See Louisiana Revised Statutes 33:9662
  • Local government action: means any act by a local government agency or official to effectuate the public powers, functions, and duties of a local government official or a local government agency, including but not limited to any act in the nature of policymaking, rulemaking, adjudication, licensing, regulation, or enforcement; relative to contracts, requests for proposals, development of specifications, or engaging another person to perform a governmental function; to adopt, repeal, increase, or decrease any fee imposed on the affairs, actions, or persons regulated by a local government agency; or to affect the passage, defeat, or implementation of any legislation. See Louisiana Revised Statutes 33:9662
  • Manufacturer: means any person regularly engaged in the business of manufacturing or assembling new motor vehicles, either within or without this state. See Louisiana Revised Statutes 32:702
  • Marketer: shall mean any person who markets, promotes, sells or distributes a discount medical plan, including but not limited to a private label entity that places its name on and markets or distributes a discount medical plan. See Louisiana Revised Statutes 22:1260.2
  • Material and substantial disruption: means when a person, with the intent and knowledge of doing so, significantly hinders expressive activity, prevents the communication of the message, or prevents the transaction of the business of a lawful meeting, gathering, or procession by either of the following:

                (a) Engaging in fighting, violence, or similar unlawful behavior. See Louisiana Revised Statutes 17:3399.31

  • Medicaid: means coverage provided under the state plan for Title XIX of the Social Security Act, 42 USC 1396 et seq. See Louisiana Revised Statutes 22:1202
  • Medical care: means amounts paid for as defined in La. See Louisiana Revised Statutes 22:1202
  • Medical loss ratio: means the ratio of expected incurred benefits to expected earned premium over the time period of coverage, subject to the requirements of federal law, regulation, or rule. See Louisiana Revised Statutes 22:1091
  • Medical services: shall mean any care, service, or treatment of illness or dysfunction of, or injury to, the human body, including but not limited to physician care, inpatient care, outpatient care, hospital surgical services, emergency services, ambulance services, chiropractic services, dental services, audiology services, vision care services, mental health services, substance abuse services, podiatric care services, laboratory services and medical equipment and supplies. See Louisiana Revised Statutes 22:1260.2
  • Medicare: means coverage under both Parts A and B of Title XVIII of the Social Security Act, 42 U. See Louisiana Revised Statutes 22:1202
  • Member: means a person covered by the plan. See Louisiana Revised Statutes 22:1202
  • Member: shall mean any individual who pays valuable consideration to receive the purported benefits of a discount medical plan. See Louisiana Revised Statutes 22:1260.2
  • Mortgage: The written agreement pledging property to a creditor as collateral for a loan.
  • Motor vehicle: means and includes automobiles, trucks, truck-tractors, trailers, semitrailers, and motorcycles, propelled by steam, gasoline, electricity, or any other source of energy other than muscular power, except electric-assisted bicycles, farm implements temporarily operated or moved on a highway or vehicles operated only on rails or tracks constructed therefor. See Louisiana Revised Statutes 32:401
  • Motor vehicle: means every vehicle which is self-propelled, excluding a motorized bicycle. See Louisiana Revised Statutes 32:1601
  • Motorcycle: means every motor vehicle having a seat or saddle for the use of the rider and designed to travel on not more than three wheels in contact with the ground, but excluding a tractor and an electric-assisted bicycle or a motorized bicycle. See Louisiana Revised Statutes 32:401
  • Motorized bicycle: means a pedal bicycle which may be propelled by human power or helper motor, or by both, with a motor rated no more than one and one-half horsepower, a cylinder capacity not exceeding fifty cubic centimeters, an automatic transmission, and which produces a maximum design speed of no more than twenty-five miles per hour on a flat surface, but excluding an electric-assisted bicycle. See Louisiana Revised Statutes 32:401
  • municipality: as used in this Chapter , means municipalities and parishes to which the Chapter is applicable. See Louisiana Revised Statutes 33:9611
  • National Credit Union Administration: The federal regulatory agency that charters and supervises federal credit unions. (NCUA also administers the National Credit Union Share Insurance Fund, which insures the deposits of federal credit unions.) Source: OCC
  • Nationally recognized clinical practice guidelines: means evidence-based clinical guidelines developed by independent organizations or medical professional societies, including but not limited to the National Comprehensive Cancer Network, the American Society of Clinical Oncology, and the American Society of Hematology, utilizing a transparent methodology and reporting structure and having policies against conflicts of interest. See Louisiana Revised Statutes 22:1060.12
  • network: means an entity other than a health insurance issuer that, through contracts with health care providers, provides or arranges for access by groups of enrollees or insureds to health care services by health care providers who are not otherwise or individually contracted directly with a health insurance issuer. See Louisiana Revised Statutes 22:1242
  • network: means an entity, including a health insurance issuer, that, through contracts or agreements with health care providers, provides or arranges for access by groups of covered persons to health care services by health care providers who are not otherwise or individually contracted directly with a health insurance issuer. See Louisiana Revised Statutes 22:1019.1
  • 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.
  • official: means an elected official, an appointed official, or an employee in a local government agency. See Louisiana Revised Statutes 33:9662
  • Oral argument: An opportunity for lawyers to summarize their position before the court and also to answer the judges' questions.
  • Oversight: Committee review of the activities of a Federal agency or program.
  • Particular product: means a basic insurance policy form, certificate, or subscriber agreement delineating the terms, provisions, and conditions of a specific type of coverage or benefit under a particular type of contract with a discrete set of rating and pricing methodologies that a health insurance issuer offers in the state. See Louisiana Revised Statutes 22:1091
  • 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.
  • pattern of criminal gang activity: means the commission or attempted commission of two or more of the following offenses, provided that the offenses occurred within a three-year period, and the offenses are committed on separate occasions or by two or more persons:

    (1)  Aggravated battery or second degree battery as defined in La. See Louisiana Revised Statutes 15:1404

  • Pattern of racketeering activity: means engaging in at least two incidents of racketeering activity that have the same or similar intents, results, principals, victims, or methods of commission or otherwise are interrelated by distinguishing characteristics and are not isolated incidents, provided at least one of such incidents occurs after August 21, 1992, and that the last of such incidents occurs within five years after a prior incident of racketeering activity. See Louisiana Revised Statutes 15:1352
  • Person: means an individual, partnership, committee, association, corporation, and any other organization or group of persons. See Louisiana Revised Statutes 33:9662
  • Person: shall mean an individual or an entity. See Louisiana Revised Statutes 22:1260.2
  • Person: shall mean any individual, firm, corporation, partnership or association. See Louisiana Revised Statutes 32:702
  • Person: means an individual, a corporation, a partnership, an association, a joint venture, a joint stock company, a trust, an unincorporated organization, any similar entity, or any combination thereof. See Louisiana Revised Statutes 22:1019.1
  • Persons: means any individual, partnership, corporation, association, firm, or other business entity. See Louisiana Revised Statutes 32:1741
  • Physician: means a person licensed by the Louisiana State Board of Medical Examiners. See Louisiana Revised Statutes 22:1060.1
  • Plaintiff: The person who files the complaint in a civil lawsuit.
  • Plan: means the Louisiana Health Plan as created in La. See Louisiana Revised Statutes 22:1202
  • Plan: means an uncompleted professional improvement program. See Louisiana Revised Statutes 17:3602
  • plan: means an entity which provides benefits through or by a health insurance issuer consisting of health care services provided directly, through insurance or reimbursement, or otherwise and including items and services paid for as health care services under any hospital or medical service policy or certificate, hospital or medical service plan contract, preferred provider organization agreement, or health maintenance organization contract; however, "health benefit plan" shall not include benefits due under Chapter 10 of Title 23 of the Louisiana Revised Statutes of 1950 or limited benefit and supplemental health insurance policies, benefits provided under a separate policy, certificate, or contract of insurance for accidents, disability income, limited scope dental or vision benefits,  benefits for long-term care, nursing home care, home health care, or specific diseases or illnesses, or any other limited benefit policy or contract as defined in La. See Louisiana Revised Statutes 22:1060.1
  • Plan of operation: means the plan of operation of the plan, including articles, bylaws, and operating rules, adopted by the board pursuant to La. See Louisiana Revised Statutes 22:1202
  • 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.
  • Positron emission tomography: means an imaging test that uses radioactive substances to visualize and measure metabolic processes in the body to help reveal how tissue and organs are functioning. See Louisiana Revised Statutes 22:1060.12
  • Power cycle: means every motor vehicle propelled by an engine developing not more than five brake horse power, designed to travel on not more than three wheels, at a speed under thirty-five miles per hour, and equipped with brakes adequate to stop such vehicle upon a reasonably clean, dry, level surface within forty-five feet from the spot where the brakes were first applied when the vehicle is travelling at twenty miles per hour. See Louisiana Revised Statutes 32:401
  • 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
  • Power-based violence: means any form of interpersonal violence intended to control or intimidate another person through the assertion of power over the person and shall include the following:

                (a) Dating violence (La. See Louisiana Revised Statutes 17:3399.12

  • 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.
  • President pro tempore: A constitutionally recognized officer of the Senate who presides over the chamber in the absence of the Vice President. The President Pro Tempore (or, "president for a time") is elected by the Senate and is, by custom, the Senator of the majority party with the longest record of continuous service.
  • Prime network: means a network that requires contracted health care providers to accept the amount payable for covered health care services as payment in full for such services. See Louisiana Revised Statutes 22:1242
  • Prior authorization: means a determination by a health insurance issuer or person contracting with a health insurance issuer that healthcare services ordered by the provider to an individual or an enrollee are medically necessary and appropriate. See Louisiana Revised Statutes 22:1060.12
  • Private property: means any privately owned parking facility at any location or any parking lot or street which is privately owned and is located near or contiguous to premises having one or more stores or business establishments which is used for the parking of motor vehicles or for vehicular travel by the owner or customers of such establishments and those having express or implied permission of the owner. See Louisiana Revised Statutes 32:1741
  • Pro se: A Latin term meaning "on one's own behalf"; in courts, it refers to persons who present their own cases without lawyers.
  • Probable cause: A reasonable ground for belief that the offender violated a specific law.
  • Probation: A sentencing alternative to imprisonment in which the court releases convicted defendants under supervision as long as certain conditions are observed.
  • Program: means the Louisiana Guaranteed Benefits Pool. See Louisiana Revised Statutes 22:1132
  • Program: means a completed five-year professional improvement program, or refers to the subject of this Chapter. See Louisiana Revised Statutes 17:3602
  • Program: means the Teacher Incentive Pay Models Program established in this Chapter. See Louisiana Revised Statutes 17:3822
  • Project: means the acquisition, purchase, construction, renovation, improvement, or expansion of a public facility, to be financed as authorized and provided in this Part and La. See Louisiana Revised Statutes 17:3394.2
  • Provider: means an individual or entity which, acting within the scope of licensure or certification, provides dental services or supplies defined by the health insurance plan or dental benefit plan. See Louisiana Revised Statutes 22:1171
  • provider: means a health care professional or a health care facility or the agent or assignee of such professional or facility. See Louisiana Revised Statutes 22:1242
  • provider: means a health care professional or a health care facility. See Louisiana Revised Statutes 22:1019.1
  • Provider network contract: means a contract between a contracting entity and a provider that specifies the rights and responsibilities of the contracting entity and provides for the delivery and payment of dental services to an enrollee. See Louisiana Revised Statutes 22:1171
  • Public defender: Represent defendants who can't afford an attorney in criminal matters.
  • Public facilities: means buildings, equipment, and other permanent property or immovable property of the colleges within the Louisiana Community and Technical College System, as specifically identified in La. See Louisiana Revised Statutes 17:3394.2
  • Public law: A public bill or joint resolution that has passed both chambers and been enacted into law. Public laws have general applicability nationwide.
  • Public program: means any public assistance program which provides funding for health care services rendered by a health care provider that is directly subsidized by the federal government. See Louisiana Revised Statutes 22:1202
  • Public school: means any public elementary, middle, junior high, or high school in this state. See Louisiana Revised Statutes 17:3602
  • Qualified health plan: means a health insurance plan that has in effect a certification that the qualified health plan meets applicable state or federal standards required for participation in a health insurance exchange. See Louisiana Revised Statutes 22:1260.32
  • Qualified health plan issuer: means a health insurance issuer that offers a qualified health plan in accordance with a certification from an exchange. See Louisiana Revised Statutes 22:1260.32
  • racketeering activity: means committing, attempting to commit, conspiring to commit, or soliciting, coercing, or intimidating another person to commit any crime that is punishable under the following provisions of Title 14 of the Louisiana Revised Statutes of 1950, the Uniform Controlled Dangerous Substances Law, or the Louisiana Securities Law:

                (1) La. See Louisiana Revised Statutes 15:1352

  • Rate: means the rate initially filed or filed as a result of determination of rates by a health insurance issuer for a particular product. See Louisiana Revised Statutes 22:1091
  • rate increase: includes a premium volume-weighted average increase for all insureds for the aggregate rate changes during the twelve-month period preceding the proposed rate increase effective date. See Louisiana Revised Statutes 22:1091
  • Receiver: means the person liquidating a state bank pursuant to Part II of this Subchapter. See Louisiana Revised Statutes 6:381
  • Recourse: An arrangement in which a bank retains, in form or in substance, any credit risk directly or indirectly associated with an asset it has sold (in accordance with generally accepted accounting principles) that exceeds a pro rata share of the bank's claim on the asset. If a bank has no claim on an asset it has sold, then the retention of any credit risk is recourse. Source: FDIC
  • Rescission: The cancellation of budget authority previously provided by Congress. The Impoundment Control Act of 1974 specifies that the President may propose to Congress that funds be rescinded. If both Houses have not approved a rescission proposal (by passing legislation) within 45 days of continuous session, any funds being withheld must be made available for obligation.
  • Responsible employee: means an employee as defined in this Section who receives a direct statement regarding or witnesses an incident of power-based violence. See Louisiana Revised Statutes 17:3399.12
  • Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.
  • Revocation: means that the driver's license to drive a motor vehicle on the highways is terminated and shall not be renewed, except that an application for a new license may be presented and acted upon by the department after the expiration of at least one year after revocation. See Louisiana Revised Statutes 32:401
  • roll cage: shall mean supports that will bear the vehicle's weight and are so designed as to protect the occupants when the vehicle is resting on the supports. See Louisiana Revised Statutes 32:401
  • Salvage title: shall mean a certificate used to evidence the declaration in an insurance settlement that a motor vehicle is a "total loss" motor vehicle as provided in this Chapter, to be prescribed and distributed by the office of motor vehicles, to an insurance company, its authorized agent, or the owner of a "total loss" motor vehicle. See Louisiana Revised Statutes 32:702
  • Self-insurer: means a natural or juridical person which provides health care services or reimbursement for all or any part of the costs of health care for its employees or participants in this state other than through an insurer. See Louisiana Revised Statutes 22:1202
  • 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.
  • Shares: means the units into which the stockholders' rights to participate in the control of the state bank, in its profits, or in the distribution of corporate assets are divided. See Louisiana Revised Statutes 6:201
  • small employer: means any person, firm, corporation, partnership, trust, or association actively engaged in business which has employed an average of at least one but not more than fifty employees on business days during the preceding calendar year and who employs at least one employee on the first day of the plan year. See Louisiana Revised Statutes 22:1091
  • Small employer: means any person, firm, corporation, partnership, or association actively engaged in business which, on at least fifty percent of its working days during the preceding year, employed not less than one nor more than twenty-five eligible employees. See Louisiana Revised Statutes 22:1202
  • Stockholder: means the holder of record of one or more shares. See Louisiana Revised Statutes 6:201
  • Student: means any person who is enrolled on a full-time or part-time basis in a public postsecondary education institution. See Louisiana Revised Statutes 17:3399.31
  • Student organization: means an officially recognized group at a public postsecondary education institution, or a group seeking official recognition, comprised of enrolled students. See Louisiana Revised Statutes 17:3399.31
  • Student-on-student discriminatory harassment: means unwelcome conduct that targets its victim on the basis of a class protected under federal, state, or local law and that is so severe, pervasive, and objectively offensive and so undermines and detracts from the victim's educational experience that the victim is effectively denied equal access to an institution's resources and opportunities. See Louisiana Revised Statutes 17:3399.31
  • Subpoena duces tecum: A command to a witness to produce documents.
  • Summons: Another word for subpoena used by the criminal justice system.
  • Superintendent: means the state superintendent of education. See Louisiana Revised Statutes 17:3822
  • Suspension: means that the driver's license to drive a motor vehicle on the highways is temporarily withdrawn during the period of such suspension. See Louisiana Revised Statutes 32:401
  • Teacher: means any public school classroom teacher, librarian, school counselor, secondary vocational instructor, principal, assistant principal, or other personnel for whom a valid Louisiana teaching certificate is required for employment; any teacher in an institution which offers thirteenth and fourteenth grade instruction; any speech therapist who possesses a valid Louisiana ancillary certificate issued by the State Board of Elementary and Secondary Education; and any instructor seeking to continue in the program who has been transferred from the Department of Public Safety and Corrections to vocational-technical schools under the State Board of Elementary and Secondary Education. See Louisiana Revised Statutes 17:3602
  • Teaching certificate: means a certificate issued by the department to school personnel pursuant to the requirements fixed by the department or by law. See Louisiana Revised Statutes 17:3602
  • Temporary restraining order: Prohibits a person from an action that is likely to cause irreparable harm. This differs from an injunction in that it may be granted immediately, without notice to the opposing party, and without a hearing. It is intended to last only until a hearing can be held.
  • Third party: means a person or entity that enters into a contract with a contracting entity or with another third party to gain access to the dental services or contractual discounts of a provider network contract. See Louisiana Revised Statutes 22:1171
  • Title IX coordinator: means the individual designated by a public postsecondary education institution as the institution's official for coordinating the institution's efforts to comply with and carry out its responsibilities under Title IX of the Education Amendments of 1972. See Louisiana Revised Statutes 17:3399.12
  • Tort: A civil wrong or breach of a duty to another person, as outlined by law. A very common tort is negligent operation of a motor vehicle that results in property damage and personal injury in an automobile accident.
  • Total loss: means a motor vehicle which has sustained damages equivalent to seventy-five percent or more of the market value as determined by the most current National Automobile Dealers Association Handbook. See Louisiana Revised Statutes 32:702
  • Total voting power: means the entirety of the voting power. See Louisiana Revised Statutes 6:201
  • Transportation of passengers for hire or fee: means the movement of passengers by motor vehicle for direct monetary payment to a taxicab, limousine service, livery, and/or any common carrier of passengers. See Louisiana Revised Statutes 32:401
  • Trustee: A person or institution holding and administering property in trust.
  • Unfairly discriminatory: means rates that result in premium differences between insureds within similar risk categories that do not reasonably correspond to differences in expected costs. See Louisiana Revised Statutes 22:1091
  • Unjustified: means a rate for which a health insurance issuer has provided data or documentation to the department in connection with rates for a particular product that is incomplete, inadequate, or otherwise does not provide a basis upon which the reasonableness of the rate may be determined or is otherwise inadequate insofar as the rate charged is clearly insufficient to sustain projected losses and expenses. See Louisiana Revised Statutes 22:1091
  • Unreasonable: means any rate that contains a provision or provisions that are any of the following:

                (a) Excessive. See Louisiana Revised Statutes 22:1091

  • User: shall mean any person who acquires a vehicle for purposes other than resale and is required to register same under the provisions of the Louisiana Vehicle Registration License Tax Law, Chapter 4 of Subtitle II of Title 47 of the Louisiana Revised Statutes of 1950. See Louisiana Revised Statutes 32:702
  • Utilization review: means a set of formal techniques designed to monitor the use of, or evaluate the clinical necessity, appropriateness, efficacy, or efficiency of, healthcare services, procedures, or settings. See Louisiana Revised Statutes 22:1060.12
  • Vehicle: shall include those devices sometimes referred to as mobile homes as defined in La. See Louisiana Revised Statutes 32:702
  • Vehicle protection product: means a vehicle protection device, system, or service that is:

    (i)  Installed on or applied to a vehicle. See Louisiana Revised Statutes 32:1272

  • Venue: The geographical location in which a case is tried.
  • Verdict: The decision of a petit jury or a judge.
  • Victim advocate: work with prosecutors and assist the victims of a crime.
  • Voting power: means the right vested by law or by the articles or the bylaws in the stockholder or in one or more classes of stockholder to vote in the determination of any particular question or matter coming before meetings of the stockholders. See Louisiana Revised Statutes 6:201
  • warrantor: means a person who is contractually obligated to the warranty holder under the terms of the vehicle protection product warranty agreement. See Louisiana Revised Statutes 32:1272
  • warranty: means a written agreement by a warrantor that provides if the vehicle protection product fails to prevent loss or damage to a vehicle from a specific cause, that the warrantor will pay to or on behalf of the warranty holder specified incidental costs as a result of the failure of the vehicle protection product to perform pursuant to the terms of the warranty. See Louisiana Revised Statutes 32:1272
  • Warranty holder: means a person who purchases a vehicle protection product or who is a permitted transferee. See Louisiana Revised Statutes 32:1272
  • Warranty reimbursement insurance policy: means a policy of insurance that is issued to the vehicle protection product warrantor to provide reimbursement to the warrantor or to pay on behalf of the warrantor all covered contractual obligations incurred by the warrantor under the terms and conditions of the insured vehicle protection product warranties issued by the warrantor. See Louisiana Revised Statutes 32:1272
  • Water-damaged vehicle: means any vehicle whose power train, computer, or electrical system has been damaged by flooding and that is a "total loss" as defined in this Section. See Louisiana Revised Statutes 32:702
  • Writ: A formal written command, issued from the court, requiring the performance of a specific act.