Terms Used In South Carolina Code > Title 38 > Chapter 71 > Article 13 - Small Employer Health Insurance Availability Act

• 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
• 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
• 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
• 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.
• 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
• Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
• 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 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
• 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.
• 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.
• 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
• 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.
• 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 40-79-20
• 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
• Director: means the Director of the Department of Insurance of this State. See South Carolina Code 38-71-1330
• 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
• 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.
• 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.
• Fraud: Intentional deception resulting in injury to another.
• Individual: means a natural person. 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
• 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.
• 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
• 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
• 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.
• 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
• 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
• 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
• 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 South Carolina Small Employer Insurer Reinsurance Program pursuant to § 38-71-1410. See South Carolina Code 38-71-1330
• 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
• 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.
• 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
• 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
• Standard health insurance plan: means a health insurance plan developed pursuant to § 38-71-1420. See South Carolina Code 38-71-1330
• 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
• Verdict: The decision of a petit jury or a judge.