Terms Used In Hawaii Revised Statutes > Chapter 269 > Part I - Public Utilities, Generally

• Adverse action: means an adverse determination or a final adverse determination. See Hawaii Revised Statutes 432E-1
• Adverse determination: means a determination by a health carrier or its designated utilization review organization that an admission, availability of care, continued stay, or other health care service that is a covered benefit has been reviewed and, based upon the information provided, does not meet the health carrier's requirements for medical necessity, appropriateness, health care setting, level of care, or effectiveness, and the requested service or payment for the service is therefore denied, reduced, or terminated. See Hawaii Revised Statutes 432E-1
• 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.
• Agricultural activities: means a commercial agricultural, silvicultural, or aquacultural facility or pursuit conducted, in whole or in part, including the care and production of livestock and livestock products, poultry and poultry products, apiary products, and plant and animal production for nonfood uses; the planting, cultivating, harvesting, and processing of crops; and the farming or ranching of any plant or animal species in a controlled salt, brackish, or freshwater environment. See Hawaii Revised Statutes 269-1
• Ambulatory review: means a utilization review of health care services performed or provided in an outpatient setting. See Hawaii Revised Statutes 432E-1
• 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.
• Amortization: Paying off a loan by regular installments.
• Answer: The formal written statement by a defendant responding to a civil complaint and setting forth the grounds for defense.
• 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.
• Appeal: means a request from an enrollee to change a previous decision made by the health carrier. See Hawaii Revised Statutes 432E-1
• Appellate: About appeals; an appellate court has the power to review the judgement of another lower court or tribunal.
• Appointed representative: means a person who is expressly permitted by the enrollee or who has the power under Hawaii law to make health care decisions on behalf of the enrollee, including:

  (1) A person to whom an enrollee has given express written consent to represent the enrollee in an external review;

  (2) A person authorized by law to provide substituted consent for an enrollee;

  (3) A family member of the enrollee or the enrollee's treating health care professional, only when the enrollee is unable to provide consent;

  (4) A court-appointed legal guardian;

  (5) A person who has a durable power of attorney for health care; or

  (6) A person who is designated in a written advance directive;

  provided that an appointed representative shall include an "authorized representative" as used in the federal Patient Protection and Affordable Care Act. See Hawaii Revised Statutes 432E-1

• Appropriation: The provision of funds, through an annual appropriations act or a permanent law, for federal agencies to make payments out of the Treasury for specified purposes. The formal federal spending process consists of two sequential steps: authorization
• Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
• Attachment: A procedure by which a person's property is seized to pay judgments levied by the court.
• Ballot: includes :

  (1) A ballot summary reflecting a complete record of the ballot selections made by a voter utilizing an HTML ballot or similar accessible ballot that produces a ballot summary;

  (2) A voter verifiable paper audit trail in the event there is a discrepancy between a voting machine's electronic record of the voted ballot and the voter verifiable paper audit trail; and

  (3) A ballot used in an election by mail pursuant to part VIIA, including a ballot approved for electronic transmission. See Hawaii Revised Statutes 11-1

• Ballot summary: means a complete record of ballot selections that is verified by the voter. See Hawaii Revised Statutes 11-1
• 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 exchange service: means those services consisting of single-line dial tone, touch-tone dialing, access to operator service, access to enhanced 911, telecommunications relay service, telephone directory, and access to directory-assistance service via 411 dialing. See Hawaii Revised Statutes 269-1
• 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}
• beneficiary: means a person who is a member, subscriber, enrollee, or dependent of a member, subscriber, or enrollee of or otherwise covered under a prescription drug benefit plan. See Hawaii Revised Statutes 431R-1
• benefits: means those health care services to which an enrollee is entitled under the terms of a health benefit plan. See Hawaii Revised Statutes 432E-1
• Best evidence: means evidence based on:

  (1) Randomized clinical trials;

  (2) If randomized clinical trials are not available, cohort studies or case-control studies;

  (3) If the trials in paragraphs (1) and (2) are not available, case-series; or

  (4) If the sources of information in paragraphs (1), (2), and (3) are not available, expert opinion. See Hawaii Revised Statutes 432E-1

• Board: means the board of directors of the Hawaii hurricane relief fund. See Hawaii Revised Statutes 431P-1
• capitated basis: includes the cost associated with operating staff model facilities. See Hawaii Revised Statutes 432G-1
• Carrier: means a dental insurer, a health maintenance organization, an insurer, a nonprofit hospital and medical service corporation, a mutual benefit society, or other entity responsible for the payment of benefits or provision of services under a group contract. See Hawaii Revised Statutes 432G-1
• Carrier of last resort: means a telecommunications carrier designated by the commission to provide universal service in a given local exchange service area determined to be lacking in effective competition. See Hawaii Revised Statutes 269-1
• Case management: means a coordinated set of activities conducted for individual patient management of serious, complicated, protracted, or other health conditions. See Hawaii Revised Statutes 432E-1
• Case-series: means an evaluation of patients with a particular outcome, without the use of a control group. See Hawaii Revised Statutes 432E-1
• Certification: means a determination by a health carrier or its designated utilization review organization that an admission, availability of care, continued stay, or other health care service has been reviewed and, based on the information provided, satisfies the health carrier's requirements for medical necessity, appropriateness, health care setting, level of care, and effectiveness. See Hawaii Revised Statutes 432E-1
• Clinical review criteria: means the written screening procedures, decision abstracts, clinical protocols, and practice guidelines used by a health carrier to determine the necessity and appropriateness of health care services. See Hawaii Revised Statutes 432E-1
• Commission: means the Kaho'olawe island reserve commission. See Hawaii Revised Statutes 6K-2
• Commissioner: means the insurance commissioner. See Hawaii Revised Statutes 431S-1
• Commissioner: means the insurance commissioner. See Hawaii Revised Statutes 432C-1
• Commissioner: means the insurance commissioner. See Hawaii Revised Statutes 432G-1
• Commissioner: means the insurance commissioner as defined in § 431:2-102. See Hawaii Revised Statutes 431P-1
• Commissioner: means the insurance commissioner. See Hawaii Revised Statutes 432E-1
• Companion policy: means a policy of property insurance issued by a servicing facility in conjunction with a fund policy of hurricane property insurance that provides, at a minimum, coverage equivalent to a standard fire policy for the peril of fire and windstorm and, after considering all exclusions and endorsements, that provides insurance for wind related losses or damage created by a weather system that has not resulted in the declaration and definition of a hurricane watch or warning. See Hawaii Revised Statutes 431P-1
• Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
• Complaint: means an expression of dissatisfaction, either oral or written. See Hawaii Revised Statutes 432E-1
• Concurrent review: means a utilization review conducted during a patient's hospital stay or course of treatment. See Hawaii Revised Statutes 432E-1
• Contract: A legal written agreement that becomes binding when signed.
• Conversion: means the transfer or sale of a significant amount of a nonprofit entity's assets to a for-profit entity or through any other means as determined by the commissioner. See Hawaii Revised Statutes 432C-1
• Conviction: A judgement of guilt against a criminal defendant.
• Copayment: means an amount an enrollee must pay to receive a specific service which is not fully prepaid. See Hawaii Revised Statutes 432G-1
• 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.
• county: includes the city and county of Honolulu. See Hawaii Revised Statutes 1-22
• Covered event: means each hurricane that directly causes windstorm damage in the State. See Hawaii Revised Statutes 431P-1
• 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.
• Dental care services: include the practices, acts, and operations pertaining to dentistry as defined in section 448-1. See Hawaii Revised Statutes 432G-1
• Dental insurer: means any person who undertakes to provide or to arrange for or administer one or more dental insurance plans and who has met the requirements of chapter 423. See Hawaii Revised Statutes 432G-1
• Dental service corporation: means a corporation established pursuant to section 423-1. See Hawaii Revised Statutes 432G-1
• Department: means the department of land and natural resources. See Hawaii Revised Statutes 6K-2
• Department: means the department of commerce and consumer affairs. See Hawaii Revised Statutes 431P-1
• Dependent: A person dependent for support upon another.
• Designated local exchange service area: means an area as determined by the commission to be best served by designating a carrier of last resort pursuant to § 269-43. See Hawaii Revised Statutes 269-1
• Dial tone: means the ability to make or receive telephone calls with or without operator intervention. See Hawaii Revised Statutes 269-1
• Director: means the director of finance. See Hawaii Revised Statutes 431P-1
• Discharge planning: means the formal process for determining, prior to discharge from a facility, the coordination and management of the care that an enrollee receives following discharge from a facility. See Hawaii Revised Statutes 432E-1
• Disclose: means to release, transfer, or otherwise divulge protected health information to any person other than the individual who is the subject of the protected health information. See Hawaii Revised Statutes 432E-1
• Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
• Dismissal: The dropping of a case by the judge without further consideration or hearing. ^Source:
• District: means , unless otherwise specified, the district of political representation associated with a state representative. See Hawaii Revised Statutes 11-1
• Docket: A log containing brief entries of court proceedings.
• Document: includes any application, complaint, pleading, brief, answer, motion, memorandum, declaration, exhibit, certificate of service, and other papers filed by or with the commission. See Hawaii Revised Statutes 269-1
• Electronic transmission: means the transmission of a blank or voted ballot by facsimile or electronic mail delivery, or the use of an online absentee ballot delivery and return system, which may include the ability to mark the ballot. See Hawaii Revised Statutes 11-1
• Eligible property: means :

  (1) Real property of one to four units used for residential purposes and which is in insurable condition, and which may include tangible personal property located therein or thereon and other structures at the insured location, as provided in the plan of operation or any manual of rules and rates adopted under the plan of operation;

  (2) Real property used for business, commercial, or industrial purposes which is in insurable condition, and which may include tangible personal property located therein or thereon, as provided in the plan of operation or any manual of rules and rates adopted under the plan of operation;

  (3) Tangible personal property owned by an occupant of and located in or on real property of the types described in paragraph (1), as provided in the plan of operation or any manual of rules and rates adopted under the plan of operation; provided that the owner of the tangible personal property does not own the real property in or on which the tangible personal property is located; and

  (4) Tangible personal property owned by an occupant of and located in or on real property of the types described in paragraph (2) as provided in the plan of operation or any manual of rules and rates adopted under the plan of operation; provided that the owner of the tangible personal property does not own the real property in or on which the tangible personal property is located. See Hawaii Revised Statutes 431P-1

• Emergency services: means services provided to an enrollee when the enrollee has symptoms of sufficient severity, including severe pain, such that a layperson could reasonably expect, in the absence of medical treatment, to result in placing the enrollee's health or condition in serious jeopardy, serious impairment of bodily functions, serious dysfunction of any bodily organ or part, or death. See Hawaii Revised Statutes 432E-1
• Enforcement officer: means any person employed and authorized by the commission to investigate any matter on behalf of the commission. See Hawaii Revised Statutes 269-1
• Enrollee: means an individual who is covered by a dental insurer. See Hawaii Revised Statutes 432G-1
• Enrollee: means a person who enters into a contractual relationship under or who is provided with health care services or benefits through a health benefit plan. See Hawaii Revised Statutes 432E-1
• 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.
• 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.
• Expert opinion: means a belief or interpretation by specialists with experience in a specific area about the scientific evidence pertaining to a particular service, intervention, or therapy. See Hawaii Revised Statutes 432E-1
• External review: means a review of an adverse determination (including a final adverse determination) conducted by an independent review organization pursuant to this chapter. See Hawaii Revised Statutes 432E-1
• 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, residential treatment centers, diagnostic, laboratory and imaging centers, and rehabilitation and other therapeutic health settings. See Hawaii Revised Statutes 432E-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.
• 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}
• Fee simple: Absolute title to property with no limitations or restrictions regarding the person who may inherit it.
• Fiduciary: A trustee, executor, or administrator.
• Final adverse determination: means an adverse determination involving a covered benefit that has been upheld by a health carrier or its designated utilization review organization at the completion of the health carrier's internal grievance process procedures, or an adverse determination with respect to which the internal appeals process is deemed to have been exhausted under section 432E-33(b). See Hawaii Revised Statutes 432E-1
• 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.
• For-profit entity: means a corporation organized under chapter 414, including a stock insurance company. See Hawaii Revised Statutes 432C-1
• 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}
• Fraud: Intentional deception resulting in injury to another.
• Fund: means the Hawaii hurricane relief fund established by this chapter. See Hawaii Revised Statutes 431P-1
• Gap group individuals: means medically uninsured persons who are residents of the State. See Hawaii Revised Statutes 431N-2
• Grantor: The person who establishes a trust and places property into it.
• Grievance: means a written complaint submitted in accordance with the dental insurer's formal grievance procedure by or on behalf of an enrollee regarding any aspect of the dental insurer relative to the enrollee. See Hawaii Revised Statutes 432G-1
• Group contract: means a contract for dental care services which by its terms limits eligibility to members of a specified group. See Hawaii Revised Statutes 432G-1
• Group contract holder: means the person to which a group contract has been issued. See Hawaii Revised Statutes 432G-1
• 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 a policy, contract, certificate or agreement offered or issued by a health carrier to provide, deliver, arrange for, pay or reimburse any of the costs of health care services. See Hawaii Revised Statutes 432E-1
• Health care coverage: means contractually arranged medical, personal, or other services, including preventive services, education, case management, and outreach, provided to an eligible member. See Hawaii Revised Statutes 431N-2
• Health care professional: means an individual licensed, accredited, or certified to provide or perform specified health care services in the ordinary course of business or practice of a profession consistent with state law. See Hawaii Revised Statutes 432E-1
• Health care services: means services for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease. See Hawaii Revised Statutes 432E-1
• Health carrier: means an entity subject to the insurance laws and rules of this State, or subject to the jurisdiction of the commissioner, that contracts or offers to contract 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 mutual benefit society, a nonprofit hospital and health service corporation, or any other entity providing a plan of health insurance, health benefits or health care services. See Hawaii Revised Statutes 432E-1
• Health maintenance organization: means a health maintenance organization as defined in § 432D-1. See Hawaii Revised Statutes 432E-1
• Hurricane: means a storm that has been declared and defined by the Central Pacific Hurricane Center of the National Weather Service to be a hurricane. See Hawaii Revised Statutes 431P-1
• Independent review organization: means an independent entity that conducts independent external reviews of adverse determinations and final adverse determinations. See Hawaii Revised Statutes 432E-1
• Individual contract: means a contract for dental care services issued to and covering an individual. See Hawaii Revised Statutes 432G-1
• Injunction: An order of the court prohibiting (or compelling) the performance of a specific act to prevent irreparable damage or injury.
• insolvency: means that the dental insurer has been declared insolvent and placed under an order of supervision, rehabilitation, or liquidation by the commissioner or a court of competent jurisdiction. See Hawaii Revised Statutes 432G-1
• 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}
• Internal review: means the review under § 432E-5 of an enrollee's complaint by a health carrier. See Hawaii Revised Statutes 432E-1
• Island reserve: means the area designated as the island of Kaho'olawe and the submerged lands and waters extending seaward two miles from its shoreline. See Hawaii Revised Statutes 6K-2
• Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
• Lease: A contract transferring the use of property or occupancy of land, space, structures, or equipment in consideration of a payment (e.g., rent). ^{Source: OCC}
• Legacy: A gift of property made by will.
• Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
• Licensed property and casualty insurer: means :

  (1) Any insurer licensed to transact any one or more classes of insurance authorized in § 431:3-204 where premiums written within such authority are required to be reported in the "Exhibit of Premiums and Losses" for this State in the National Association of Insurance Commissioners fire and casualty annual statement convention blank that is required to be filed with the commissioner under § 431:3-302; and

  (2) The Hawaii Property Insurance Association created in article 21 of chapter 431. See Hawaii Revised Statutes 431P-1

• 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.
• Loan program: means the activities and policies undertaken by the office to provide assistance to any department of the State or to any county or board, agency, or instrumentality thereof, or to private individuals or organizations, by making loans or causing loans to be made available to them or by buying, refinancing, or guaranteeing loans made to or other obligations incurred by them for the betterment of native Hawaiians. See Hawaii Revised Statutes 10-21
• Managed care plan: means any plan, policy, contract, certificate, or agreement, regardless of form, offered or administered by any person or entity, including but not limited to an insurer governed by chapter 431, a mutual benefit society governed by chapter 432, a health maintenance organization governed by chapter 432D, a preferred provider organization, a point of service organization, a health insurance issuer, a fiscal intermediary, a payor, a prepaid health care plan, and any other mixed model, that provides for the financing or delivery of health care services or benefits to enrollees through:

  (1) Arrangements with selected providers or provider networks to furnish health care services or benefits; and

  (2) Financial incentives for enrollees to use participating providers and procedures provided by a plan;

  provided that for the purposes of this chapter, an employee benefit plan shall not be deemed a managed care plan with respect to any provision of this chapter or to any requirement or rule imposed or permitted by this chapter that is superseded or preempted by federal law. See Hawaii Revised Statutes 432E-1

• mandatory deductible: means the amount of loss assumed by the policyholder that is not included in the coverages provided by the fund. See Hawaii Revised Statutes 431P-1
• Medical director: means the person who is authorized under a health carrier and who makes decisions for the health carrier denying or allowing payment for medical treatments, services, or supplies based on medical necessity or other appropriate medical or health plan benefit standards. See Hawaii Revised Statutes 432E-1
• Medical necessity: means a health intervention that meets the criteria enumerated in section 432E-1. See Hawaii Revised Statutes 432E-1
• Medical or scientific evidence: means evidence found in the following sources:

  (1) Peer-reviewed scientific studies published in or accepted for publication by medical journals that meet nationally-recognized requirements for scientific manuscripts and that submit most of their published articles for review by experts, who are not part of the editorial staff;

  (2) Peer-reviewed medical literature, including literature relating to therapies reviewed and approved by a qualified institutional review board, biomedical compendia, and other medical literature that meet the criteria of the National Institutes of Health's National Library of Medicine for indexing in Index Medicus and Elsevier Science Ltd. See Hawaii Revised Statutes 432E-1

• month: means a calendar month; and the word "year" a calendar year. See Hawaii Revised Statutes 1-20
• Mortgage: The written agreement pledging property to a creditor as collateral for a loan.
• Mortgage: means every transfer of an interest in real property, except fixtures, made as security for the performance of another act or subject to defeasance upon the payment of an obligation, whether the transfer is made in trust or otherwise. See Hawaii Revised Statutes 431P-1
• Mortgagee: The person to whom property is mortgaged and who has loaned the money.
• Net worth: means the excess of total assets over total liabilities; provided that liabilities shall not include fully subordinated debt. See Hawaii Revised Statutes 432G-1
• Nonprofit entity: means any charitable organization operating pursuant to Title Hawaii Revised Statutes 432C-1
• Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
• Oversight: Committee review of the activities of a Federal agency or program.
• Participating provider: means a provider as defined in this section, who, under an express or implied contract with the dental insurer or with its contractor or subcontractor, has agreed to provide dental care services to enrollees with an expectation of receiving payment, other than copayment or deductible, directly or indirectly from the dental insurer. See Hawaii Revised Statutes 432G-1
• Participating provider: means a licensed or certified provider of health care services or benefits, including mental health services and health care supplies, who has entered into an agreement with a health carrier to provide those services or supplies to enrollees. See Hawaii Revised Statutes 432E-1
• 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 an individual, partnership, corporation, organization, or other business entity. See Hawaii Revised Statutes 431S-1
• Person: means an individual, group, partnership, firm, association, corporation, trust, governmental agency, governmental official, administrative body, or tribunal or any form of business or legal entity. See Hawaii Revised Statutes 46-122
• Personal property: All property that is not real property.
• Pharmacy benefit management: means :

  (1) Any of the following services provided with regard to the administration of pharmacy benefits:

  (A) Mail service pharmacy;

  (B) Claims processing, retail network management, and payment of claims to pharmacies for prescription drugs dispensed to covered persons;

  (C) Clinical formulary development and management services;

  (D) Rebate contracting and administration;

  (E) Certain patient compliance, therapeutic intervention, and generic substitution programs; or

  (F) Disease management programs involving prescription drug utilization;

  (2) The procurement of prescription drugs by a pharmacy benefit manager at a negotiated rate for dispensation to covered persons in the State; or

  (3) The administration or management of prescription drug benefits provided by a covered entity for the benefit of covered persons. See Hawaii Revised Statutes 431S-1

• Pharmacy benefit manager: means any person, business, or entity that performs pharmacy benefit management, including but not limited to a person or entity under contract with a pharmacy benefit manager to perform pharmacy benefit management on behalf of a managed care company, nonprofit hospital or medical service organization, insurance company, third-party payor, or health program administered by the State. See Hawaii Revised Statutes 431R-1
• Pharmacy benefit manager: means any person that performs pharmacy benefit management, including but not limited to a person or entity in a contractual or employment relationship with a pharmacy benefit manager to perform pharmacy benefit management for a covered entity. See Hawaii Revised Statutes 431S-1
• Plaintiff: The person who files the complaint in a civil lawsuit.
• Plan of operation: means the plan for providing hurricane property insurance as adopted by the board of directors of the Hawaii hurricane relief fund, and any amendments thereto, under § 431P-7. See Hawaii Revised Statutes 431P-1
• 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.
• Policy of hurricane property insurance: means a policy or endorsement of insurance issued by the fund insuring only against damage or loss to eligible property caused by a covered event in excess of the deductible and up to:

  (1) $750,000 per risk on real property of one to four units used for residential purposes and the personal property located therein or thereon and other structures at the insured location, subject to the limits defined by the plan of operation or any manual of rules and rates adopted under the plan of operation; and

  (2) $500,000 per risk on real and personal property used for business, commercial, or industrial purposes, subject to the limits defined by the plan of operation or any manual of rules and rates adopted under the plan of operation; provided that the board may designate an association of property owners or cooperative housing corporation to be a commercial risk;

  provided that this policy or endorsement shall not include coverage for business interruption and other similar coverages. See Hawaii Revised Statutes 431P-1

• Policy of property insurance: means a policy providing "property insurance" as defined in § 431:1-206. See Hawaii Revised Statutes 431P-1
• 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}
• Precinct: means the smallest political subdivision established by law. See Hawaii Revised Statutes 11-1
• Premises: shall include but not be limited to a lodging or tenement house, group residence, group living arrangement, hotel, boardinghouse, or restaurant as further defined in § 445-90, or any other like facility serving unsupervised or unrelated individuals. See Hawaii Revised Statutes 46-15.6
• Prescription drug benefit plan: means an accident and sickness insurance plan or health benefits plan that includes coverage for prescription drugs. See Hawaii Revised Statutes 431R-1
• Prescription drug benefit plan provider: means a person who provides prescription drug coverage as part of an accident and health or sickness insurance contract or other type of health insurance or benefits plan that is offered by the person and is subject to regulation under article 10A of chapter 431, chapter 432, or chapter 432D. See Hawaii Revised Statutes 431R-1
• Principal: means a person who has entered into a development agreement pursuant to the procedures specified in this chapter, including a successor in interest. See Hawaii Revised Statutes 46-122
• Probable cause: A reasonable ground for belief that the offender violated a specific law.
• project: means :

  (1) The lawful acquisition of any property, real, personal, or mixed, tangible or intangible, or any interests therein, pursuant to section 10-4(2);

  (2) Any capital improvement projects on lands held by the office pursuant to section 10-4(2) or in the public land trust, including but not limited to the construction of buildings and other improvements; infrastructure development, and other enterprises which are acquired, constructed, reconstructed, rehabilitated, improved, altered, or repaired by or on behalf of the office;

  (3) Pilot projects, demonstrations, or both, where those projects or demonstrations fulfill criteria established by the board, pursuant to section 10-5(7); and

  (4) Any other projects determined by rules adopted by the board pursuant to chapter 91 or otherwise authorized by the board in accordance with applicable law to be for the betterment of native Hawaiians and are consistent with the purposes of this chapter. See Hawaii Revised Statutes 10-21

• Property insurance: means policies, riders, or endorsements of insurance that provide indemnity, in whole or in part, for the loss, destruction, or damage of eligible property. See Hawaii Revised Statutes 431P-1
• Prosecute: To charge someone with a crime. A prosecutor tries a criminal case on behalf of the government.
• Prospective review: means utilization review conducted prior to an admission or a course of treatment. See Hawaii Revised Statutes 432E-1
• Protected health information: means health information as defined in the federal Health Insurance Portability and Accountability Act and related federal rules. See Hawaii Revised Statutes 432E-1
• Provider: means any person licensed to practice dentistry as defined in section 448-1. See Hawaii Revised Statutes 432G-1
• provider: means a health care professional. See Hawaii Revised Statutes 432E-1
• Public highways: has the meaning defined by § 264-1, including both state and county highways, but operation upon rails shall not be deemed transportation on public highways. See Hawaii Revised Statutes 269-1
• Public law: A public bill or joint resolution that has passed both chambers and been enacted into law. Public laws have general applicability nationwide.
• Quorum: The number of legislators that must be present to do business.
• Real property: Land, and all immovable fixtures erected on, growing on, or affixed to the land.
• reclaimed water: means treated wastewater that by design is intended or used for a beneficial purpose; and
  (v) The facility is not engaged, either directly or indirectly, in the processing of food wastes;
  (K) Any person who owns, controls, operates, or manages any seawater air conditioning district cooling project; provided that at least fifty per cent of the energy required for the seawater air conditioning district cooling system is provided by a renewable energy resource, such as cold, deep seawater;
  (L) Any person who owns, controls, operates, or manages plants or facilities primarily used to charge or discharge a vehicle battery that provides power for vehicle propulsion;
  (M) Any person who:

  (i) Owns, controls, operates, or manages a renewable energy system that is located on a customer's property; and

  (ii) Provides, sells, or transmits the power generated from that renewable energy system to an electric utility or to the customer on whose property the renewable energy system is located; provided that, for purposes of this subparagraph, a customer's property shall include all contiguous property owned or leased by the customer without regard to interruptions in contiguity caused by easements, public thoroughfares, transportation rights-of-way, and utility rights-of-way; and
  (N) Any person who owns, controls, operates, or manages a renewable energy system that is located on such person's property and provides, sells, or transmits the power generated from that renewable energy system to an electric utility or to lessees or tenants on the person's property where the renewable energy system is located; provided that:

  (i) An interconnection, as defined in § 269-141, is maintained with an electric public utility to preserve the lessees' or tenants' ability to be served by an electric utility;

  (ii) Such person does not use an electric public utility's transmission or distribution lines to provide, sell, or transmit electricity to lessees or tenants;

  (iii) At the time that the lease agreement is signed, the rate charged to the lessee or tenant for the power generated by the renewable energy system shall be no greater than the effective rate charged per kilowatt hour from the applicable electric utility schedule filed with the public utilities commission;

  (iv) The rate schedule or formula shall be established for the duration of the lease, and the lease agreement entered into by the lessee or tenant shall reflect such rate schedule or formula;

  (v) The lease agreement shall not abrogate any terms or conditions of applicable tariffs for termination of services for nonpayment of electric utility services or rules regarding health, safety, and welfare;

  (vi) The lease agreement shall disclose:

  (1) the rate schedule or formula for the duration of the lease agreement;

  (2) that, at the time that the lease agreement is signed, the rate charged to the lessee or tenant for the power generated by the renewable energy system shall be no greater than the effective rate charged per kilowatt hour from the applicable electric utility schedule filed with the public utilities commission;

  (3) that the lease agreement shall not abrogate any terms or conditions of applicable tariffs for termination of services for nonpayment of electric utility services or rules regarding health, safety, and welfare; and

  (4) whether the lease is contingent upon the purchase of electricity from the renewable energy system; provided further that any disputes concerning the requirements of this provision shall be resolved pursuant to the provisions of the lease agreement or chapter 521, if applicable; and

  (vii) Nothing in this section shall be construed to permit wheeling. See Hawaii Revised Statutes 269-1
• 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}
• 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.
• Renewable energy system: means any identifiable facility, equipment, apparatus, or the like that converts renewable energy, as defined in § 269-91, to useful thermal or electrical energy for heating, cooling, or reducing the use of other types of energy that are dependent on fossil fuel for their generation. See Hawaii Revised Statutes 269-1
• 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.
• Reserves: means reserves required or permitted in the covenants in the resolution or resolutions of the board authorizing the obtaining of loans or issuance of revenue bonds under this part. See Hawaii Revised Statutes 10-21
• Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.
• Retail community pharmacy: means a pharmacy, permitted by the board of pharmacy pursuant to § 461-14, that is open to the public, dispenses prescription drugs to the general public, and makes available face-to-face consultations between licensed pharmacists and the general public to whom prescription drugs are dispensed. See Hawaii Revised Statutes 431R-1
• Retrospective review: means a review of medical necessity conducted after services that have been provided to a patient, but does not include the review of a claim that is limited to an evaluation of reimbursement levels, veracity of documentation, accuracy of coding, or adjudication for payment. See Hawaii Revised Statutes 432E-1
• Revenue bonds: means revenue bonds, interim certificates, notes, debentures, or other evidence of indebtedness of the board authorized by or issued under this part. See Hawaii Revised Statutes 10-21
• Reviewer: means an independent reviewer with clinical expertise either employed by or contracted by an independent review organization to perform external reviews. See Hawaii Revised Statutes 432E-1
• Second opinion: means an opportunity or requirement to obtain a clinical evaluation by a provider other than the one originally making a recommendation for a proposed health care service to assess the clinical necessity and appropriateness of the initial proposed health care service. See Hawaii Revised Statutes 432E-1
• Service of process: The service of writs or summonses to the appropriate party.
• Servicing facility: means any insurer engaged in writing direct property insurance in this State and licensed in this State, and any other party authorized to act in like capacity on behalf of the fund. See Hawaii Revised Statutes 431P-1
• 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.
• significant: means twenty per cent or more of the assets of the nonprofit entity or an amount where the for-profit entity gains control or majority ownership of total assets of the nonprofit entity. See Hawaii Revised Statutes 432C-1
• Single-line: means a single-party line or a one-party line. See Hawaii Revised Statutes 269-1
• Specifically excluded: means that the coverage provisions of the health care plan, when read together, clearly and specifically exclude coverage for a health care service. See Hawaii Revised Statutes 432E-1
• Statute: A law passed by a legislature.
• Statute of limitations: A law that sets the time within which parties must take action to enforce their rights.
• Subpoena: A command to a witness to appear and give testimony.
• Subscriber: means an individual whose employment or other status, except family dependency, is the basis for eligibility for enrollment in the dental insurer, or in the case of an individual contract, the person in whose name the contract is issued. See Hawaii Revised Statutes 432G-1
• Taxicab: means and includes:
  (1) Any motor vehicle used in the movement of passengers on the public highways under the following circumstances, namely, the passenger hires the vehicle on call or at a fixed stand, with or without baggage for transportation, and controls the vehicle to the passenger's destination; and
  (2) Any motor vehicle having seating accommodations for eight or less passengers used in the movement of passengers on the public highways between a terminal, i. See Hawaii Revised Statutes 269-1
• telecommunications: means the offering of transmission between or among points specified by a user, of information of the user's choosing, including voice, data, image, graphics, and video without change in the form or content of the information, as sent and received, by means of electromagnetic transmission, or other similarly capable means of transmission, with or without benefit of any closed transmission medium, and does not include cable service as defined in § 440G-3. See Hawaii Revised Statutes 269-1
• telecommunications common carrier: means any person that owns, operates, manages, or controls any facility used to furnish telecommunications services for profit to the public, or to classes of users as to be effectively available to the public, engaged in the provision of services, such as voice, data, image, graphics, and video services, that make use of all or part of their transmission facilities, switches, broadcast equipment, signalling, or control devices. See Hawaii Revised Statutes 269-1
• Testify: Answer questions in court.
• Testimony: Evidence presented orally by witnesses during trials or before grand juries.
• Touch-tone dialing: means dual-tone multi-frequency, as opposed to dial-pulse signaling. See Hawaii Revised Statutes 269-1
• Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.
• Trust account: A general term that covers all types of accounts in a trust department, such as estates, guardianships, and agencies. ^{Source: OCC}
• Trustee: A person or institution holding and administering property in trust.
• Uncovered expenditures: means the costs to the dental insurer for dental care services that are the obligation of the dental insurer, for which an enrollee may also be liable in the event of the dental insurer's insolvency, and for which no alternative arrangements have been made that are acceptable to the commissioner. See Hawaii Revised Statutes 432G-1
• Uniform Commercial Code: A set of statutes enacted by the various states to provide consistency among the states' commercial laws. It includes negotiable instruments, sales, stock transfers, trust and warehouse receipts, and bills of lading. ^{Source: OCC}
• Uphold: The decision of an appellate court not to reverse a lower court decision.
• Utilization review: means a set of formal techniques designed to monitor the use of, or evaluate the clinical necessity, appropriateness, efficacy, or efficiency of, health care services, procedures, or settings. See Hawaii Revised Statutes 432E-1
• Utilization review organization: means an entity that conducts utilization review other than a health carrier performing a review for its own health benefit plans. See Hawaii Revised Statutes 432E-1
• Variable Rate: Having a "variable" rate means that the APR changes from time to time based on fluctuations in an external rate, normally the Prime Rate. This external rate is known as the "index." If the index changes, the variable rate normally changes. Also see Fixed Rate.
• Voting system: means the use of paper ballots, electronic transmission, voting machines, elections by mail pursuant to part VIIA, absentee voting pursuant to chapter 15, or any system by which votes are cast and counted. See Hawaii Revised Statutes 11-1
• Waters: means the area extending seaward two miles from the shoreline. See Hawaii Revised Statutes 6K-2