Article 1 General Provisions
Article 3 Individual Accident and Health Policies
Article 5 Group Accident and Health Insurance
Article 9 Blanket Accident and Health Insurance
Article 11 Franchise Accident and Health Insurance
Article 13 Small Employer Health Insurance Availability Act
Article 15 Access to Emergency Medical Care Act
Article 17 (B) Out-of-Network Coverage May Be Underwritten by and Provided Through the Health Maintenance Organization or Through a Licensed Insurance Company. the Director of Insurance May Promulgate Regulations as Necessary or Appropriate to Implement the Provisi
Article 18 Pharmacy Audit Rights
Article 18 Pharmacy Audit Rights
Article 19 Health Carrier External Review Act
Article 20 Pharmacy Benefit Managers [Repealed]
Article 21 Pharmacy Benefits Managers
Article 21 Pharmacy Benefits Managers
Article 23 Pharmacy Services Administrative Organizations

Terms Used In South Carolina Code > Title 38 > Chapter 71 - Accident and Health Insurance

  • Accident and health insurance: means insurance of human beings against death or personal injury by accident, and each insurance of human beings against sickness, ailment, and any type of physical disability resulting from accident or disease, and prepaid dental service, but not including coverages required by the Workers' Compensation Law of this State. See South Carolina Code 38-1-20
  • Administrator: means the administrator of the Department of Consumer Affairs. See South Carolina Code 40-68-10
  • Administrator: means the individual to whom the director has delegated authority to administer the programs of a specific board or of a professional or occupational group for which the department has regulatory authority or has delegated authority to administer the programs of a specific board;

    (2) "Authorization to practice" or "Practice authorization" means the approval to practice the specified profession, engage in the specified occupation, or use a title protected under this article, which has been granted by the applicable board. See South Carolina Code 40-1-20
  • Admitted assets: means assets of an insurer considered admitted on the most recent statutory financial statement of the insurer filed with the department pursuant to § 38-13-80. See South Carolina Code 38-1-20
  • Advanced Practice Supervision: means an interactional professional and educational relationship between an advanced practice supervisor and a social worker that provides evaluation and direction over the supervisee's practice of advanced practice social work and promotes continued development of the social worker's knowledge, skills, and abilities to engage in the practice of advanced practice social work in an ethical and competent manner. See South Carolina Code 40-63-20
  • 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.
  • Alarm business: means an entity that is licensed by the South Carolina Contractor's Licensing Board to engage in the burglar or fire alarm system business, or both. See South Carolina Code 40-79-20
  • Alarm technician: means an individual who specializes in any activity or work related to the set up or installation, repair, alteration, or connection of an alarm system to a client's property. See South Carolina Code 40-79-20
  • 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: means each contract or agreement to make periodic payments, whether in fixed or variable dollar amounts, or both, at specified intervals. See South Carolina Code 38-1-20
  • 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.
  • 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.
  • Applicant: means a business seeking to be licensed under this chapter or seeking the renewal of a license under this chapter. See South Carolina Code 40-68-10
  • Appointment: means an individual designated by an official or authorized representative of an authorized insurer to act on its behalf as a producer. See South Carolina Code 38-1-20
  • Approved Advanced Practice Supervisor: means a licensed advanced practice social worker who has met the qualifications as determined by the board. See South Carolina Code 40-63-20
  • Approved Clinical Supervisor: means a licensed clinical social worker who has met the qualifications as determined by the board. See South Carolina Code 40-63-20
  • Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
  • Assigned employee: means a person performing services for a client company as affected by a contract between a licensee and client company in which employment responsibilities are shared. See South Carolina Code 40-68-10
  • Attachment: A procedure by which a person's property is seized to pay judgments levied by the court.
  • Baccalaureate Social Worker: means a person duly licensed to practice baccalaureate social work under this act. See South Carolina Code 40-63-20
  • Balanced budget: A budget in which receipts equal outlays.
  • Bankruptcy: Refers to statutes and judicial proceedings involving persons or businesses that cannot pay their debts and seek the assistance of the court in getting a fresh start. Under the protection of the bankruptcy court, debtors may discharge their debts, perhaps by paying a portion of each debt. Bankruptcy judges preside over these proceedings.
  • Basic health insurance plan: means a lower cost health insurance plan developed pursuant to § 38-71-1420. See South Carolina Code 38-71-1330
  • 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
  • Bid: means an offer to furnish labor, equipment or materials, or other services regulated by this chapter. See South Carolina Code 40-79-20
  • Board: means the South Carolina Board of Social Work Examiners. See South Carolina Code 40-63-20
  • Board: means the State Board of Registration for Geologists. See South Carolina Code 40-77-20
  • Board: means the South Carolina Contractor's Licensing Board. See South Carolina Code 40-79-20
  • Board: means the board of directors of the program established pursuant to § 38-71-1410. See South Carolina Code 38-71-1330
  • Burglar alarm system business: means a person, firm, association, partnership, corporation, or other legal entity authorized by law and approved by the board that designs, installs, services, maintains, or alters burglar alarm systems, including burglar alarm systems with an electric fence as defined herein, and heat and smoke sensors installed within a burglar alarm system; a burglar alarm system detects intrusion, burglary, and breaking or entering but does not include home health care signaling devices. See South Carolina Code 40-79-20
  • Certificate of insurance: means a memorandum copy, complete or abbreviated, of an insurance contract. See South Carolina Code 38-1-20
  • Claim: means a request from a pharmacy or pharmacist to be reimbursed for the cost of administering, filling, or refilling a prescription for a drug or for providing a medical supply or device. See South Carolina Code 38-71-2200
  • Claim: means a request from a pharmacy or pharmacist to be reimbursed for the cost of administering, filling, or refilling a prescription for a drug or for providing a medical supply or device. See South Carolina Code 38-71-2200 v2
  • Claims processing services: means the administrative services performed in connection with the processing and adjudicating of claims relating to pharmacist services that include:

    (a) receiving payments for pharmacist services;

    (b) making payments to pharmacists or pharmacies for pharmacist services; or

    (c) both receiving and making payments. See South Carolina Code 38-71-2200
  • Claims processing services: means the administrative services performed in connection with the processing and adjudicating of claims relating to pharmacist services that include:

    (a) receiving payments for pharmacist services;

    (b) making payments to pharmacists or pharmacies for pharmacist services; or

    (c) both receiving and making payments. See South Carolina Code 38-71-2200 v2
  • Clerk of court: An officer appointed by the court to work with the chief judge in overseeing the court's administration, especially to assist in managing the flow of cases through the court and to maintain court records.
  • Client: means the individual, couple, family, group, organization, or community that seeks or receives social work services. See South Carolina Code 40-63-20
  • Client company: means a person that contracts with a licensee and is assigned employees by the licensee under that contract. See South Carolina Code 40-68-10
  • Clinical Supervision: means an interactional professional and educational relationship between a clinical supervisor and a social worker that provides evaluation and direction over the supervisee's practice of clinical social work and promotes continued development of the social worker's knowledge, skills, and abilities to engage in the practice of clinical social work in an ethical and competent manner. See South Carolina Code 40-63-20
  • Coinsurance: means a stipulation or requirement that the insured undertakes to be his own insurer to the extent that he fails to maintain insurance of a given percentage of the value of the property against loss or damage. See South Carolina Code 38-1-20
  • Commission: means the part of the premium paid to the producer as compensation for his services. See South Carolina Code 38-1-20
  • Committee: means the advisory committee to the commissioner referred to in § 38-71-1420. See South Carolina Code 38-71-1330
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • Continuance: Putting off of a hearing ot trial until a later time.
  • Continuing Education: means education and training, which are oriented to maintain, improve, or enhance social work practice. See South Carolina Code 40-63-20
  • Contract: A legal written agreement that becomes binding when signed.
  • Contractor: means an entity licensed to engage in the burglar or fire alarm system business. See South Carolina Code 40-79-20
  • Controlling person: means :

    (a) an officer or director of a corporation seeking to offer professional employer services, a shareholder holding ten percent or more of the voting stock of a corporation seeking to offer professional employer services, or a partner of a partnership seeking to offer professional employer services;

    (b) an individual who possesses, directly or indirectly, the power to direct or cause the direction of the management or policies of a company seeking to offer professional employer services through the ownership of voting securities, by contract or otherwise, and who is actively involved in the day-to-day management of the company; or

    (c) an individual employed, appointed, or authorized by a business seeking to offer professional employer services to enter into a contractual relationship with a client company on behalf of the business. See South Carolina Code 40-68-10
  • Conviction: A judgement of guilt against a criminal defendant.
  • cooperative: means a private purchasing cooperative composed of small employers formed under this article. See South Carolina Code 38-71-1330
  • 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.
  • Customer service personnel: means an individual working for a licensed alarm entity who provides support for customer problems, complaints, questions, and concerns involving an alarm system. See South Carolina Code 40-79-20
  • 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 Insurance of South Carolina. See South Carolina Code 38-1-20
  • Department: means the Department of Labor, Licensing and Regulation. See South Carolina Code 40-65-20
  • Department: means the South Carolina Department of Consumer Affairs. See South Carolina Code 40-68-10
  • Department: means the Department of Labor, Licensing and Regulation;

    (5) "Director" means the Director of the Department of Labor, Licensing and Regulation or the director's official designee;

    (6) "Licensee" means a person granted an authorization to practice pursuant to this article and refers to a person holding a license, permit, certification, or registration granted pursuant to this article;

    (7) "Licensing act" means the individual statute or regulations, or both, of each regulated profession or occupation which include, but are not limited to, board governance, the qualifications and requirements for authorization to practice, prohibitions, and disciplinary procedures;

    (8) "Person" means an individual, partnership, or corporation;

    (9) "Profession" or "occupation" means a profession or occupation regulated or administered, or both, by the department pursuant to this article. See South Carolina Code 40-1-20
  • Department: means the Department of Labor, Licensing and Regulation. See South Carolina Code 40-79-20
  • Dependent: A person dependent for support upon another.
  • Dependent: means a spouse, an unmarried child under the age of nineteen years, an unmarried child who is a full-time student between the ages of nineteen and twenty-two and who is financially dependent upon the parent, and an unmarried child of any age who is medically certified as disabled and dependent upon the parent. See South Carolina Code 38-71-1330
  • Designee or deputy director: means the person or persons appointed by the director, serving at the will and pleasure of the director as his designee, to supervise and carry out the functions and duties of the department as provided by law. See South Carolina Code 38-1-20
  • Director: means the person who is appointed by the Governor upon the advice and consent of the Senate and who is responsible for the operation and management of the department. See South Carolina Code 38-1-20
  • Director: means the Director of the Department of Insurance of this State. See South Carolina Code 38-71-1330
  • Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
  • Domestic insurer: means an insurer incorporated or organized under the laws of this State. See South Carolina Code 38-1-20
  • Electric fence: means an electrified fence with a height not to exceed ten feet or two feet higher than the perimeter fence, whichever is higher, that is equipped with an energizer, driven by a commercial storage battery that does not exceed twelve volts DC. See South Carolina Code 40-79-20
  • Eligible employee: means an employee:

    (a) as defined in § 38-71-710(1) or § 38-71-840(7) who works on a full-time basis and has a normal workweek of thirty or more hours; or

    (b) who is a licensed real estate person engaged in the sale, leasing, or rental of real estate for a licensed real estate broker on a straight commission basis, who has signed a valid independent contractor agreement with the broker who works on a full-time basis and has a normal workweek of thirty or more hours. See South Carolina Code 38-71-1330
  • Emergency medical care: means those health care services provided in a hospital emergency facility to evaluate and treat an emergency medical condition. See South Carolina Code 38-71-1520
  • Emergency medical condition: means a medical condition manifesting itself by acute symptoms of sufficient severity, including severe pain, such that a prudent layperson who possesses an average knowledge of health and medicine could reasonably expect the absence of immediate medical attention to result in:

    (a) placing the health of the individual, or with respect to a pregnant woman, the health of the woman or her unborn child, in serious jeopardy;

    (b) serious impairment to bodily functions; or

    (c) serious dysfunction of any bodily organ or part. See South Carolina Code 38-71-1520
  • Employees: as used in this article includes, for the purposes of insurance hereunder, as employees of a single employer, the officers, managers, and employees of the employer and of subsidiary or affiliated corporations of a corporate employer and the individual proprietors, partners, and employees of individuals and firms the business of which is controlled by the insured employer through stock ownership, contract, or otherwise. See South Carolina Code 38-71-710
  • Employer: as used in this article may include any municipal corporation or the proper officers, as such, of any unincorporated municipality or any department of the municipal corporation or unincorporated municipality determined by conditions pertaining to the employment. See South Carolina Code 38-71-710
  • Entire work force: means all persons engaged by a client company and are employees as defined in Title 42 including persons considered employees under Sections 42-1-400, 42-1-410, and 42-1-420. See South Carolina Code 40-68-10
  • Entity: means a sole proprietorship, partnership, limited liability partnership, limited liability company, association, joint venture, cooperative, corporation, or other legal entity authorized by law and approved by the board. See South Carolina Code 40-79-20
  • 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
  • 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.
  • Ex officio: Literally, by virtue of one's office.
  • Examination: means a standardized test of social work knowledge, skills, and abilities approved by the board. See South Carolina Code 40-63-20
  • Fiduciary: A trustee, executor, or administrator.
  • Fire alarm system business: means an individual, firm, association, partnership, corporation, or other legal entity authorized by law and approved by the board that designs, installs, services, maintains, or alters fire alarm systems. See South Carolina Code 40-79-20
  • Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006.
  • Foreign insurer: means an insurer incorporated or organized under the laws of the United States or of any jurisdiction within the United States other than this State. See South Carolina Code 38-1-20
  • Fraud: Intentional deception resulting in injury to another.
  • Freedom of Information Act: A federal law that mandates that all the records created and kept by federal agencies in the executive branch of government must be open for public inspection and copying. The only exceptions are those records that fall into one of nine exempted categories listed in the statute. Source: OCC
  • Geologist: means a person with special knowledge of the science of geology, hydrology, geophysics, and related earth sciences and principles and methods of geological analysis acquired by professional education and practical experience. See South Carolina Code 40-77-20
  • Geologist-in-training: means a person who possesses the qualifications prescribed in § 40-77-230 and who has been certified as a geologist-in-training. See South Carolina Code 40-77-20
  • Geology: means the science dealing with the earth and its history; investigation, prediction, and location of the materials and structures which compose it; the natural processes that cause change in the earth; and the applied science of utilizing knowledge of the earth and its constituent rocks, minerals, liquids, gases, and other materials for the benefit of mankind. See South Carolina Code 40-77-20
  • Germane: On the subject of the pending bill or other business; a strict standard of relevance.
  • 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
  • group health insurance policy: is a policy or contract which insures against disablement, disease, or sickness of the insured, excluding disablement which results from accident or from accidental means, which covers more than one person, except blanket health policies, family health policies, franchise health policies, and accident and health policies. See South Carolina Code 38-71-710
  • Guarantor: A party who agrees to be responsible for the payment of another party's debts should that party default. Source: OCC
  • 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.
  • Health benefit plan: means any individual, blanket, or group plan, policy, or contract for health care services issued or delivered by a health care insurer in this State as defined in § 38-71-670(6) and 38-71-840(14), including the state health plan as defined in § 1-11-710. See South Carolina Code 38-71-2200
  • Health benefit plan: means any individual, blanket, or group plan, policy, or contract for health care services issued or delivered by a health care insurer in this State as defined in § 38-71-670(6) and 38-71-840(14), including the state health plan as defined in § 1-11-710. See South Carolina Code 38-71-2200 v2
  • 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
  • Independent Social Worker-Advanced Practice: means a person duly licensed to practice Independent Social Work-Advanced Practice under this act. See South Carolina Code 40-63-20
  • Independent Social Worker-Clinical Practice: means a person duly licensed to practice Independent Social Work-Clinical Practice under this act. See South Carolina Code 40-63-20
  • Individual: means a natural person. See South Carolina Code 40-79-20
  • Injunction: An order of the court prohibiting (or compelling) the performance of a specific act to prevent irreparable damage or injury.
  • Installs: means activity or work which involves the set-up, installation, or connection of alarm system equipment in any manner to a client's property. See South Carolina Code 40-79-20
  • insurance: includes annuities. See South Carolina Code 38-1-20
  • Insurance company: means an "insurer". See South Carolina Code 38-1-20
  • insured: as used in this article may not be construed as preventing a person other than the insured, with a proper insurable interest, from making application for and owning a policy covering the insured or from being entitled under such a policy to any indemnities, benefits, and rights provided therein. See South Carolina Code 38-71-640
  • Insurer: includes a corporation, fraternal organization, burial association, other association, partnership, society, order, individual, or aggregation of individuals engaging or proposing or attempting to engage as principals in any kind of insurance or surety business, including the exchanging of reciprocal or interinsurance contracts between individuals, partnerships, and corporations. See South Carolina Code 38-1-20
  • Insurer: means an entity that provides health insurance in this State. See South Carolina Code 38-71-1330
  • 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.
  • Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
  • License: means an authorization to practice social work issued by the board pursuant to this chapter. See South Carolina Code 40-63-20
  • License: means a document issued by the state's director or his designee authorizing a person to act as an insurance producer for the lines of authority specified in the document. See South Carolina Code 38-1-20
  • Licensee: means an individual who has met the requirements for licensure under this chapter and has been issued a license to practice as a social worker. See South Carolina Code 40-63-20
  • Licensee: means a person licensed under this chapter as a professional employer organization to provide professional employer services. See South Carolina Code 40-68-10
  • Licensee: means an alarm business that has been issued a license by the board pursuant to this chapter. See South Carolina Code 40-79-20
  • Life insurance: means a contract of insurance upon the lives of human beings. See South Carolina Code 38-1-20
  • Managed care organization: means a licensed insurance company, a hospital or medical services plan contract, a health maintenance organization, or any other entity which is subject to regulation by the department and which operates a managed care plan. See South Carolina Code 38-71-1520
  • Managed care plan: means a plan operated by a managed care organization which provides for the financing and delivery of health care and treatment services to individuals enrolled in the plan through its own employed health care providers or contracting with selected specific providers that conform to explicit selection standards, or both. See South Carolina Code 38-71-1520
  • Masters Social Worker: means a person licensed to engage in the practice of Masters Social Work. See South Carolina Code 40-63-20
  • Maximum Allowable Cost List: means a listing of generic drugs used by a pharmacy benefits manager to set the maximum allowable cost at which reimbursement to a pharmacy or pharmacist may be made. See South Carolina Code 38-71-2200
  • Maximum Allowable Cost List: means a listing of generic drugs used by a pharmacy benefits manager to set the maximum allowable cost at which reimbursement to a pharmacy or pharmacist may be made. See South Carolina Code 38-71-2200 v2
  • Medical care: means amounts paid for:

    (a) the diagnosis, cure, mitigation, treatment, or prevention of disease or amounts paid for the purpose of affecting a structure or function of the body;

    (b) amounts paid for transportation primarily for and essential to medical care referred to in subitem (a); and

    (c) amounts paid for insurance covering medical care referred to in subitems (a) and (b). See South Carolina Code 38-71-1330
  • Monitoring personnel: means an individual who performs daily office functions, observing the operation and activation of alarm systems from a monitoring station. See South Carolina Code 40-79-20
  • Negotiate: means the act of conferring directly with or offering advice directly to a purchaser or prospective purchaser of a particular contract of insurance concerning substantive benefits, terms, or conditions of the contract, provided that the person engaged in that act either sells insurance or obtains insurance from insurers for purchasers. See South Carolina Code 38-1-20
  • Network plan: means a health insurance plan issued by an insurer under which the financing and delivery of medical care, including items and services paid for as medical care, are provided, in whole or in part, through a defined set of providers under contract with the insurer. See South Carolina Code 38-71-1330
  • 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.
  • Oath: A promise to tell the truth.
  • 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.
  • Other prescription drug or device services: means services other than claims processing services, provided directly or indirectly by a pharmacy benefits manager, whether in connection with or separate from claims processing services, including without limitation:

    (a) negotiating rebates, discounts, or other financial incentives and arrangements with drug companies;

    (b) disbursing or distributing rebates;

    (c) managing or participating in incentive programs or arrangements for pharmacist services;

    (d) negotiating or entering into contractual arrangements with pharmacists or pharmacies, or both;

    (e) developing formularies;

    (f) designing prescription benefit programs; or

    (g) advertising or promoting services. See South Carolina Code 38-71-2200
  • Other prescription drug or device services: means services other than claims processing services, provided directly or indirectly by a pharmacy benefits manager, whether in connection with or separate from claims processing services, including without limitation:

    (a) negotiating rebates, discounts, or other financial incentives and arrangements with drug companies;

    (b) disbursing or distributing rebates;

    (c) managing or participating in incentive programs or arrangements for pharmacist services;

    (d) negotiating or entering into contractual arrangements with pharmacists or pharmacies, or both;

    (e) developing formularies;

    (f) designing prescription benefit programs; or

    (g) advertising or promoting services. See South Carolina Code 38-71-2200 v2
  • 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 a corporation, agency, partnership, association, voluntary organization, individual, or another entity, organization, or aggregation of individuals. See South Carolina Code 38-1-20
  • Person: means an individual, association, corporation, partnership, or other private legal entity. See South Carolina Code 40-68-10
  • Personal property: All property that is not real property.
  • Pharmacist services: means products, goods, and services, or any combination of products, goods, and services, provided as a part of the practice of pharmacy. See South Carolina Code 38-71-2200
  • Pharmacist services: means products, goods, and services, or any combination of products, goods, and services, provided as a part of the practice of pharmacy. See South Carolina Code 38-71-2200 v2
  • Pharmacy benefits manager: means an entity that contracts with pharmacists or pharmacies on behalf of an insurer, third party administrator, or the South Carolina Public Employee Benefit Authority to:

    (a) process claims for prescription drugs or medical supplies or provide retail network management for pharmacies or pharmacists;

    (b) pay pharmacies or pharmacists for prescription drugs or medical supplies; or

    (c) negotiate rebates with manufacturers for drugs paid for or procured as described in this article. See South Carolina Code 38-71-2200
  • Pharmacy benefits manager: means an entity that contracts with pharmacists or pharmacies on behalf of an insurer, third party administrator, or the South Carolina Public Employee Benefit Authority to:

    (a) process claims for prescription drugs or medical supplies or provide retail network management for pharmacies or pharmacists;

    (b) pay pharmacies or pharmacists for prescription drugs or medical supplies; or

    (c) negotiate rebates with manufacturers for drugs paid for or procured as described in this article. See South Carolina Code 38-71-2200 v2
  • Pharmacy benefits manager affiliate: means a pharmacy or pharmacist that directly or indirectly, through one or more intermediaries, owns or controls, is owned or controlled by, or is under common ownership or control with a pharmacy benefits manager. See South Carolina Code 38-71-2200
  • Pharmacy benefits manager affiliate: means a pharmacy or pharmacist that directly or indirectly, through one or more intermediaries, owns or controls, is owned or controlled by, or is under common ownership or control with a pharmacy benefits manager. See South Carolina Code 38-71-2200 v2
  • Plaintiff: The person who files the complaint in a civil lawsuit.
  • plan: means any hospital or medical policy or certificate, major medical expense insurance, hospital or medical service plan contract, or health maintenance organization subscriber contract that provides benefits consisting of medical care provided directly through insurance or reimbursement, or otherwise and including items and services paid for medical care. See South Carolina Code 38-71-1330
  • Plan of operation: means the plan of operation of the program established pursuant to § 38-71-1410. See South Carolina Code 38-71-1330
  • 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.
  • Policy: means a contract of insurance. See South Carolina Code 38-1-20
  • Premium: means payment given in consideration of a contract of insurance. See South Carolina Code 38-1-20
  • 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.
  • Primary qualifying party: means a qualifying party who is an owner, partner, or officer of a burglar alarm system business, or a full-time employee holding a managerial or supervisory position within the alarm system business and who qualifies the licensee to engage in the burglar or fire alarm business and is registered as a qualifying party with the department in accordance with this chapter. See South Carolina Code 40-79-20
  • Probate: Proving a will
  • Probation: A sentencing alternative to imprisonment in which the court releases convicted defendants under supervision as long as certain conditions are observed.
  • Professional employer organization: means an individual business entity that offers professional employer services. See South Carolina Code 40-68-10
  • Professional employer organization group: means a combination of professional employer services companies that operates under a group license issued under § 40-68-80. See South Carolina Code 40-68-10
  • Professional employer services: means an arrangement by which employees of a licensee are assigned to work at a client company and in which employment responsibilities are shared by the licensee and the client company. See South Carolina Code 40-68-10
  • Professional society: as used in this chapter includes legal, medical, osteopathic, optometric, chiropractic, psychological, dental, accounting, pharmaceutic, and engineering organizations having as members at least a majority of the eligible licentiates in the area served by the particular society and any foundations composed of members of these societies. See South Carolina Code 40-71-10
  • professional soil classifier: means a person who, by reason of his special knowledge of the physical, chemical, and biological sciences applicable to soils as natural bodies and of the methods and principles of soil classification as acquired by soil education and soil classification experience in the formation, morphology, description, and mapping of soils, is qualified to practice soil classifying, who has been licensed by the Department of Labor, Licensing and Regulation, and who has passed an examination in the fundamental soil and related subjects as provided for in this chapter. See South Carolina Code 40-65-20
  • Program: means the South Carolina Small Employer Insurer Reinsurance Program pursuant to § 38-71-1410. See South Carolina Code 38-71-1330
  • Prosecute: To charge someone with a crime. A prosecutor tries a criminal case on behalf of the government.
  • PSAO-pharmacy contract: means a contractual agreement between a PSAO and a pharmacy by which a PSAO agrees to negotiate with third-party payers or pharmacy benefits managers on behalf of a pharmacy. See South Carolina Code 38-71-2310
  • Public practice of geology: means the performance of geological service or work in the nature of consultation, investigation, surveys, evaluations, planning, mapping, and inspection of geologic work required for or supporting compliance with municipal, county, State of South Carolina, or federal regulations. See South Carolina Code 40-77-20
  • Qualifying party: means an individual, owner, partner, officer, or employee of an alarm system business who has met the necessary requirements of a qualifying party and is registered with the department in accordance with this chapter. See South Carolina Code 40-79-20
  • Registered: means an owner, partner, principle officer, qualifying party, or registered employee of an alarm business whose name and address has been listed or registered with the department as an individual who has access to a client's property or burglar alarm records that can reveal, but not be limited to, the type of burglar alarm system, burglar alarm security numbers or code, or any other information pertaining to the system that could compromise the client's burglar alarm system. See South Carolina Code 40-79-20
  • Registered employee: means an individual of an alarm system business who has not met the requirements of a qualifying party and is employed more than thirty days in any given calendar year and is registered with the department in accordance with this chapter. See South Carolina Code 40-79-20
  • Registered professional geologist: means a person registered as a professional geologist by the board pursuant to § 40-77-230. See South Carolina Code 40-77-20
  • Reinsuring insurer: means a small employer insurer participating in the reinsurance program pursuant to § 38-71-1410. See South Carolina Code 38-71-1330
  • Remainder: An interest in property that takes effect in the future at a specified time or after the occurrence of some event, such as the death of a life tenant.
  • Responsible charge: means direct control and personal supervision of soil classification. See South Carolina Code 40-65-20
  • Risk-assuming insurer: means a small employer insurer whose application is approved by the commissioner pursuant to § 38-71-1390. See South Carolina Code 38-71-1330
  • Sell: means to exchange a contract of insurance by any means, for money or its equivalent, on behalf of an insurance company. See South Carolina Code 38-1-20
  • 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.
  • Small employer: means , in connection with a health insurance plan with respect to a calendar year and a plan year, any person, firm, corporation, partnership, association, or employer, as defined in Section 3(5) of the Employee Retirement Income Security Act of 1974, that is actively engaged in business that, on at least fifty percent of its working days during the preceding calendar year, employed no more than fifty eligible employees or employed an average of 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 South Carolina Code 38-71-1330
  • Small employer insurer: means an insurer that offers health insurance plans covering eligible employees of one or more small employers in this State. See South Carolina Code 38-71-1330
  • Soil: means all of the groups of natural bodies occupying the unconsolidated portion of the earth's surface capable of supporting plant life and having properties due to the combined effect of climate and living organisms, as modified by topography and time, upon parent materials. See South Carolina Code 40-65-20
  • Soil classification: means plotting the boundaries and describing and evaluating the kinds of soil as to their behavior and response to management under various uses. See South Carolina Code 40-65-20
  • Soil-classifier-in-training: means a person who complies with the requirements for education and character and who has passed an examination in the fundamental soil and related subjects as provided for in this chapter. See South Carolina Code 40-65-20
  • Standard health insurance plan: means a health insurance plan developed pursuant to § 38-71-1420. See South Carolina Code 38-71-1330
  • Statute: A law passed by a legislature.
  • Subpoena: A command to a witness to appear and give testimony.
  • 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.
  • Terminate: means the cancellation of the relationship between an insurance producer and the insurer or the termination of a producer's authority to transact insurance. See South Carolina Code 38-1-20
  • Testimony: Evidence presented orally by witnesses during trials or before grand juries.
  • Transcript: A written, word-for-word record of what was said, either in a proceeding such as a trial or during some other conversation, as in a transcript of a hearing or oral deposition.
  • Uphold: The decision of an appellate court not to reverse a lower court decision.
  • Verdict: The decision of a petit jury or a judge.