Terms Used In Louisiana Revised Statutes > Title 17 > Chapter 2 - Teachers and Employees

• Accepted claim: means either of the following:

  (a)  A nonelectronic claim on a HCFA 1500 form or Uniform Billing Form 92 (UB92), properly completed according to Medicare guidelines. See Louisiana Revised Statutes 22:1831

• Accident: means an unexpected or unforeseen actual, identifiable, precipitous event happening suddenly or violently, with or without human fault, and directly producing at the time objective findings of an injury which is more than simply a gradual deterioration or progressive degeneration. See Louisiana Revised Statutes 23:1021
• Activity statement: means any written communication from a health care provider that advises an enrollee or insured of covered health care services that have been billed to a health insurance issuer. See Louisiana Revised Statutes 22:1872
• Actuarial certification: means a written statement by a member of the American Academy of Actuaries that a health insurance issuer is in compliance with the provisions of this Subpart, based upon the actuary's examination, including a review of the appropriate records and of the actuarial assumptions and methods utilized by the health insurance issuer in establishing rates for applicable health benefit plans. See Louisiana Revised Statutes 22:1091
• Actuarial equivalent: means a benefit of equivalent value to the accumulated contributions, annuity or benefits and regular interest, as the case may be, computed on the basis of such mortality and interest tables as shall be adopted by the board of trustees in accordance with the provisions of Louisiana Revised Statutes 11:1402
• Adjourn: A motion to adjourn a legislative chamber or a committee, if passed, ends that day's session.
• 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 products: shall include aquacultural, horticultural, viticultural, forestry, dairy, livestock, poultry, bee, and farm and range products, and furbearing animals raised or produced on a defined acreage. See Louisiana Revised Statutes 3:4712
• Allegation: something that someone says happened.
• 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.
• 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.
• Appellate: About appeals; an appellate court has the power to review the judgement of another lower court or tribunal.
• Appraisal: A determination of property value.
• Arrest: Taking physical custody of a person by lawful authority.
• Articles: means the original articles of incorporation and all amendments thereto including those contained in merger agreements or, if restated, the latest restatement thereof except in those instances in which the context refers expressly to the original articles of incorporation only. See Louisiana Revised Statutes 6:201
• Attachment: A procedure by which a person's property is seized to pay judgments levied by the court.
• Attorney-in-fact: A person who, acting as an agent, is given written authorization by another person to transact business for him (her) out of court.
• Authorized prescriber: means a person licensed, registered, or otherwise authorized by the appropriate licensing board to prescribe prescription drugs in the course of professional practice. See Louisiana Revised Statutes 22:1060.1
• 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.
• Base health care facility: means a facility or institution providing health care services, including but not limited to a hospital or other licensed inpatient center, ambulatory surgical or treatment center, skilled nursing facility, inpatient hospice facility, residential treatment center, diagnostic, laboratory, or imaging center, or rehabilitation or other therapeutic health setting that has entered into a contract or agreement with a facility-based physician. See Louisiana Revised Statutes 22:1872
• Bequest: Property gifted by will.
• Bill: means any written or electronic communication that sets forth the amount owed by an enrollee or insured. See Louisiana Revised Statutes 22:1872
• Board: means the board of trustees of the Assessors' Retirement Fund. See Louisiana Revised Statutes 11:1402
• Board: means the Board of Supervisors of Community and Technical Colleges. See Louisiana Revised Statutes 17:540
• Board of supervisors: means the Board of Supervisors of Louisiana State University and Agricultural and Mechanical College. See Louisiana Revised Statutes 11:952.1
• booting: means the act of placing on a parked motor vehicle a mechanical device that is designed to be attached to the wheel or tire or other part of such vehicle so as to prohibit its usual manner of movement. See Louisiana Revised Statutes 32:1741
• Capital: means the sum of capital stock, surplus, and undivided profits or, as to mutual state banks, as defined by Louisiana Revised Statutes 6:201
• Capital stock: means the sum of the par value of the shares outstanding plus any amounts in excess of par value transferred from surplus to capital stock in respect of such shares less any part of such amounts transferred from capital stock to surplus as permitted by this Chapter. See Louisiana Revised Statutes 6:201
• Chambers: A judge's office.
• Charity: An agency, institution, or organization in existence and operating for the benefit of an indefinite number of persons and conducted for educational, religious, scientific, medical, or other beneficent purposes.
• Claim: means a request by a health care provider for payment from a health insurance issuer. See Louisiana Revised Statutes 22:1831
• Claim: means a request by a pharmacist for payment by a health insurance issuer. See Louisiana Revised Statutes 22:1852
• Clean claim: means an accepted claim that has no defect or impropriety including any lack of required substantiating documentation or other particular circumstance requiring special treatment that prevents timely payment from being made on the claim under this Subpart. See Louisiana Revised Statutes 22:1831
• clinician: means a physician, physician assistant providing healthcare services in accordance with Louisiana Revised Statutes 17:500
• clinician: means a licensed physician, a physician assistant providing healthcare services in accordance with Louisiana Revised Statutes 17:1200
• Commission: means the Louisiana Workforce Commission. See Louisiana Revised Statutes 23:1
• Commission: means the Commission of Weights and Measures. See Louisiana Revised Statutes 3:4602
• Commissioner: means the commissioner of the Department of Agriculture and Forestry, or his duly authorized representatives acting at his discretion. See Louisiana Revised Statutes 3:4602
• Commissioner: means the commissioner of insurance. See Louisiana Revised Statutes 22:1132
• Commissioner: means the commissioner of insurance. See Louisiana Revised Statutes 22:1831
• Commissioner: means the commissioner of insurance. See Louisiana Revised Statutes 22:1852
• Commissioner: means the commissioner of insurance. See Louisiana Revised Statutes 22:1872
• Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
• Consumer: means a natural person who is a resident of this state and whose nonpublic information is in a licensee's possession, custody, or control. See Louisiana Revised Statutes 22:2503
• Continuance: Putting off of a hearing ot trial until a later time.
• Contracted health care provider: means a health care provider that has entered into a contract or agreement directly with a health insurance issuer or with a health insurance issuer through a network of providers for the provision of covered health care services. See Louisiana Revised Statutes 22:1872
• Contracted reimbursement rate: means the aggregate maximum amount that a contracted health care provider has agreed to accept from all sources for provision of covered health care services under the health insurance coverage applicable to the enrollee or insured. See Louisiana Revised Statutes 22:1872
• Conviction: A judgement of guilt against a criminal defendant.
• Correct claims address: means the address appearing on an enrollee's or insured's current identification card issued by the health insurance issuer as the current address at which claims are received, or, if no address appears on the identification card, the current address for receipt of claims provided by the health insurance issuer to the department. See Louisiana Revised Statutes 22:1831
• Court reporter: A person who makes a word-for-word record of what is said in court and produces a transcript of the proceedings upon request.
• coverage: means benefits consisting of health care services provided directly, through insurance or reimbursement, or otherwise and including items and services paid for as health care services under any hospital or medical service policy or certificate, hospital or medical service plan contract, preferred provider organization agreement, or health maintenance organization contract offered by a health insurance issuer. See Louisiana Revised Statutes 22:1831
• Covered health care services: means services, items, supplies, or drugs for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease that are either covered and payable under the terms of health insurance coverage or required by law to be covered. See Louisiana Revised Statutes 22:1872
• Cybersecurity event: means an event resulting in unauthorized access to or disruption or misuse of an information system or nonpublic information stored on an information system. See Louisiana Revised Statutes 22:2503
• Deed: The legal instrument used to transfer title in real property from one person to another.
• Delivered by electronic means: means either of the following:

              (a) Delivery to an electronic mail address at which a party has consented to receive notices or documents. See Louisiana Revised Statutes 22:2461

• Department: means the Louisiana Department of Agriculture and Forestry. See Louisiana Revised Statutes 3:4602
• Department: means the Department of Insurance. See Louisiana Revised Statutes 22:1831
• Department: means the Department of Insurance. See Louisiana Revised Statutes 22:1852
• Dependent: A person dependent for support upon another.
• Devise: To gift property by will.
• disability: means unable to or the inability to perform the essential functions of the job the member of the teaching staff or employee was performing at the time of his injury. See Louisiana Revised Statutes 17:1200
• disciplinary action: shall include only suspension without pay, reduction in pay, or involuntary demotion or dismissal. See Louisiana Revised Statutes 17:441
• 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:
• Docket: A log containing brief entries of court proceedings.
• Document: means any written or otherwise tangible material intended to be or actually used as a part of or any evidence of the work history of any school employee including but not limited to any and all reports, comments, reprimands, correspondence, memoranda, evaluations, observations, and grievances relative to a particular school employee. See Louisiana Revised Statutes 17:1233
• Donor: The person who makes a gift.
• drug: means any of the following:

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

• Drug Shortage List: means a list of drug products posted on the United States Food and Drug Administration drug shortage website. See Louisiana Revised Statutes 22:1863
• Electronic claim: means a claim submitted by a health care provider or its agent to a health insurance issuer in compliance with the provisions of the Health Insurance Portability and Accountability Act (42 USC 1302d et seq. See Louisiana Revised Statutes 22:1831
• Electronic claim: means the transmission of data for purposes of payment of covered prescription drugs, other products and supplies, and pharmacist services in an electronic data format specified by a health insurance issuer and approved by the department. See Louisiana Revised Statutes 22:1852
• Electronic funds transfer: The transfer of money between accounts by consumer electronic systems-such as automated teller machines (ATMs) and electronic payment of bills-rather than by check or cash. (Wire transfers, checks, drafts, and paper instruments do not fall into this category.) ^{Source: OCC}
• employee: means any person in the employ of the Iberville Parish School Board who is a member of or is eligible for membership in the State Teachers' Retirement System of Louisiana and who is not covered by the provisions of the State Teachers' Tenure Act. See Louisiana Revised Statutes 17:531
• Employee: means any full-time teacher or instructional personnel of a vocational-technical school. See Louisiana Revised Statutes 17:540
• Encrypted: means the transformation of data into a form that has a low probability of assigning meaning without the use of a protective process or key. See Louisiana Revised Statutes 22:2503
• Enrolled bill: The final copy of a bill or joint resolution which has passed both chambers in identical form. It is printed on parchment paper, signed by appropriate officials, and submitted to the President/Governor for signature.
• Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. ^{Source: U.S. Courts}
• Escrow: Money given to a third party to be held for payment until certain conditions are met.
• Exception report: means an electronic communication related to an electronic claim submission of each electronic claim transaction in that submission that is not deemed an accepted claim. See Louisiana Revised Statutes 22:1831
• Excessive: means the rate charged for the health insurance coverage causes the premium or premiums charged for the health insurance coverage to be unreasonably high in relation to the benefits provided under the particular product. See Louisiana Revised Statutes 22:1091
• Explanation of benefits: means any written communication clearly identified as issued by the health insurance issuer or its agent that contains information regarding coverage, payment, or other information regarding current status of a claim submitted to the health insurance issuer or its agent. See Louisiana Revised Statutes 22:1872
• Facility-based physician: means a physician licensed to practice medicine who is required by the base health facility to provide services in a base health care facility as an anesthesiologist, hospitalist, intensivist, neonatologist, pathologist, radiologist, emergency room physician, or other on-call physician who is required by the base health care to provide covered health care services related to an emergency medical condition as defined in Louisiana Revised Statutes 22:1872
• 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 review threshold: means any rate increase that results in a ten percent or greater rate increase, or such other threshold as required by federal law or regulation or any rate that, when combined with all rate increases and decreases during the previous twelve-month period, would result in an aggregate ten percent or greater rate increase. See Louisiana Revised Statutes 22:1091
• Fiduciary: A trustee, executor, or administrator.
• Foreclosure: A legal process in which property that is collateral or security for a loan may be sold to help repay the loan when the loan is in default. ^{Source: OCC}
• formulary: means a list of prescription drugs which meets any of the following criteria:

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

• Fraud: Intentional deception resulting in injury to another.
• Fund: means the Assessors' Retirement Fund. See Louisiana Revised Statutes 11:1402
• Garnishment: Generally, garnishment is a court proceeding in which a creditor asks a court to order a third party who owes money to the debtor or otherwise holds assets belonging to the debtor to turn over to the creditor any of the debtor
• Gift: A voluntary transfer or conveyance of property without consideration, or for less than full and adequate consideration based on fair market value.
• Governing body: means the board or body in which the bond issuing power of a governmental unit is vested. See Louisiana Revised Statutes 13:5121
• Health care clearinghouse: means a public or private entity that does  either of the following:

  (a)  Processes or facilitates the processing of information from another entity in a nonstandard format or containing nonstandard data content into standard data elements or a standard transaction. See Louisiana Revised Statutes 22:1831

• Health care facility: means a facility or institution providing health care services including but not limited to a hospital or other licensed inpatient center, ambulatory surgical or treatment center, skilled nursing facility, inpatient hospice facility, residential treatment center, diagnostic, laboratory, or imaging center, or rehabilitation or other therapeutic health setting. See Louisiana Revised Statutes 22:1872
• Health care professional: means a physician or other health care practitioner licensed, certified, or registered to perform specified health care services consistent with state law. See Louisiana Revised Statutes 22:1872
• Health care services: means services, items, supplies, or prescription drugs for the diagnosis, treatment, cure, or relief of a health condition, illness, injury, or disease. See Louisiana Revised Statutes 22:1060.1
• Health care services: means services, items, supplies, or drugs for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease. See Louisiana Revised Statutes 22:1831
• Health care services: means services, items, supplies, or drugs for the diagnosis, prevention, treatment, cure, or relief of a health condition, illness, injury, or disease. See Louisiana Revised Statutes 22:1872
• Health coverage plan: means any hospital, health, or medical expense insurance policy, hospital or medical service contract, employee welfare benefit plan, contract, or other agreement with a health maintenance organization or a preferred provider organization, health and accident including a group insurance plan or self-insurance plan and the office of group benefits. See Louisiana Revised Statutes 22:1060.12
• health insurance coverage: means services consisting of medical care, provided directly, through insurance or reimbursement, or otherwise, and including items and services paid for as medical care under any hospital or medical service policy or certificate, hospital or medical service plan contract, preferred provider organization, or health maintenance organization contract offered by a health insurance issuer. See Louisiana Revised Statutes 22:1091
• Health insurance coverage: means benefits consisting of prescription drugs, other products and supplies, and pharmacist services provided directly, through insurance or reimbursement, or otherwise and including items and services paid for as prescription drugs, other products and supplies, and pharmacist services under any hospital or medical service policy or certificate, hospital or medical service plan contract, preferred provider organization agreement, or health maintenance organization contract offered by a health insurance issuer. See Louisiana Revised Statutes 22:1852
• Health insurance coverage: means benefits consisting of medical care provided or arranged for directly, through insurance or reimbursement, or otherwise, and includes health care services paid for under any plan, policy, or certificate of insurance. See Louisiana Revised Statutes 22:1872
• Health insurance issuer: means an entity subject to the Louisiana Insurance Code and applicable regulations, or subject to the jurisdiction of the commissioner, that contracts or offers to contract, or enters into an agreement to provide, deliver, arrange for, pay for, or reimburse any of the costs of healthcare services, including a sickness and accident insurance company, a health maintenance organization, a preferred provider organization or any similar entity, or any other entity providing a plan of health insurance or health benefits. See Louisiana Revised Statutes 22:1060.12
• Health insurance issuer: means any entity that offers health insurance coverage through a policy, certificate of insurance, or subscriber agreement subject to state law that regulates the business of insurance. See Louisiana Revised Statutes 22:1091
• Health insurance issuer: means an insurance company, including a health maintenance organization as defined and licensed pursuant to Subpart I of Part I of Chapter 2 of this Title, unless preempted as an employee benefit plan under the Employee Retirement Income Security Act of 1974. See Louisiana Revised Statutes 22:1852
• Health insurance issuer: means any entity that offers health insurance coverage through a policy or certificate of insurance subject to state law that regulates the business of insurance. See Louisiana Revised Statutes 22:1872
• Health insurance issuer liability: means the contractual liability of a health insurance issuer for covered health care services pursuant to the plan or policy provisions between the enrollee or insured and the health insurance issuer. See Louisiana Revised Statutes 22:1831
• Health insurance issuer liability: means the contractual liability of a health insurance issuer for covered health care services pursuant to the plan or policy provisions between the enrollee or insured and the health insurance issuer. See Louisiana Revised Statutes 22:1872
• Hydrocarbon gas: means a combustible organic gas containing only one carbon and hydrogen. See Louisiana Revised Statutes 32:1601
• Inadequate: means rates for a particular product are clearly insufficient to sustain projected losses and expenses, or the use of such rates. See Louisiana Revised Statutes 22:1091
• 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 contractor: means any person who renders service, other than manual labor, for a specified recompense for a specified result either as a unit or as a whole, under the control of his principal as to results of his work only, and not as to the means by which such result is accomplished, and are expressly excluded from the provisions of this Chapter unless a substantial part of the work time of an independent contractor is spent in manual labor by him in carrying out the terms of the contract, in which case the independent contractor is expressly covered by the provisions of this Chapter. See Louisiana Revised Statutes 23:1021
• Index rate: means the average rate resulting from the estimated combined claims experience for all Essential Health Benefits, pursuant to Louisiana Revised Statutes 22:1091
• Indictment: The formal charge issued by a grand jury stating that there is enough evidence that the defendant committed the crime to justify having a trial; it is used primarily for felonies.
• Individual market: means the market for health insurance coverage offered to individuals other than in connection with a group health plan. See Louisiana Revised Statutes 22:1091
• Information security program: means the administrative, technical, and physical safeguards that a licensee uses to access, collect, distribute, process, protect, store, use, transmit, dispose of, or otherwise handle nonpublic information. See Louisiana Revised Statutes 22:2503
• Information system: means a discrete set of electronic information resources organized for the collection, processing, maintenance, use, sharing, dissemination, or disposition of electronic nonpublic information. See Louisiana Revised Statutes 22:2503
• Injunction: An order of the court prohibiting (or compelling) the performance of a specific act to prevent irreparable damage or injury.
• insured: means an individual who is enrolled or insured by a health insurance issuer under a health benefit plan. See Louisiana Revised Statutes 22:1060.1
• Insured: includes any policyholder, including a dependent, enrollee, subscriber, or member, who is covered through any policy or subscriber agreement offered by a health insurance issuer. See Louisiana Revised Statutes 22:1091
• insured: means an individual who is enrolled or insured by a health insurance issuer for health insurance coverage. See Louisiana Revised Statutes 22:1831
• insured: means an individual who is enrolled or insured by a health insurance issuer for health insurance coverage. See Louisiana Revised Statutes 22:1852
• insured: means a person who is enrolled in or insured by a health insurance issuer for health insurance coverage. See Louisiana Revised Statutes 22:1872
• 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}
• Intestate: Dying without leaving a will.
• Issued shares: means outstanding shares. See Louisiana Revised Statutes 6:201
• issuer: means any entity that offers a health benefit plan through a policy, contract, or certificate of insurance subject to state law that regulates the business of insurance. See Louisiana Revised Statutes 22:1060.1
• issuer: means any entity that offers health insurance coverage through a policy, contract,  or certificate of insurance subject to state law that regulates the business of insurance. See Louisiana Revised Statutes 22:1831
• Juror: A person who is on the jury.
• large employer: means , in connection with a group health plan with respect to a calendar year and a plan year, an employer who employed an average of at least fifty-one employees on business days during the preceding calendar year and who employs at least two employees on the first day of the plan year. See Louisiana Revised Statutes 22:1091
• 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}
• Licensee: means any person licensed, authorized to operate, or registered or required to be licensed, authorized, or registered pursuant to the insurance laws of this state. See Louisiana Revised Statutes 22:2503
• 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.
• Maximum Allowable Cost List: means a listing of the National Drug Code used by a pharmacy benefit manager setting the maximum allowable cost on which reimbursement to a pharmacy or pharmacist may be based. See Louisiana Revised Statutes 22:1863
• Medical loss ratio: means the ratio of expected incurred benefits to expected earned premium over the time period of coverage, subject to the requirements of federal law, regulation, or rule. See Louisiana Revised Statutes 22:1091
• Mortgagor: The person who pledges property to a creditor as collateral for a loan and who receives the money.
• Motor vehicle: means every vehicle which is self-propelled, excluding a motorized bicycle. See Louisiana Revised Statutes 32:1601
• National Bank: A bank that is subject to the supervision of the Comptroller of the Currency. The Office of the Comptroller of the Currency is a bureau of the U.S. Treasury Department. A national bank can be recognized because it must have "national" or "national association" in its name. ^{Source: OCC}
• Nationally recognized clinical practice guidelines: means evidence-based clinical guidelines developed by independent organizations or medical professional societies, including but not limited to the National Comprehensive Cancer Network, the American Society of Clinical Oncology, and the American Society of Hematology, utilizing a transparent methodology and reporting structure and having policies against conflicts of interest. See Louisiana Revised Statutes 22:1060.12
• NDC: means the National Drug Code, a numerical identifier assigned to all prescription drugs. See Louisiana Revised Statutes 22:1863
• network: means an entity, including but not limited to a preferred provider organization as defined in Louisiana Revised Statutes 22:1831
• network: means an entity other than a health insurance issuer that, through contracts with health care providers, provides or arranges for access by groups of enrollees or insureds to health care services by health care providers who are not otherwise or individually contracted directly with a health insurance issuer. See Louisiana Revised Statutes 22:1872
• 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.
• Nonelectronic claim: means a claim submitted by a health care provider or its agent to a health insurance issuer or its agent using a HCFA 1500 form or a Uniform Billing Form 92 (UB92), as appropriate, or a successor to either of these forms adopted by the National Uniform Billing Committee or its successor. See Louisiana Revised Statutes 22:1831
• Nonpublic information: means electronic information that is not publicly available information and is any of the following:

              (a) Any information concerning a consumer which because of name, number, personal mark, or other identifier can be used to identify a consumer, in combination with any one or more of the following data elements:

              (i) Social Security number. See Louisiana Revised Statutes 22:2503

• 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.
• Office: means the office of workers' compensation administration established pursuant to Louisiana Revised Statutes 23:1021
• Oversight: Committee review of the activities of a Federal agency or program.
• Owner operator: means a person who provides trucking transportation services under written contract to a common carrier, contract carrier, or exempt haulers which transportation services include the lease of equipment or a driver to the common carrier, contract carrier, or exempt hauler. See Louisiana Revised Statutes 23:1021
• Package: means any commodity packed or packaged in any manner in advance of sale in units suitable for either wholesale or retail sale. See Louisiana Revised Statutes 3:4602
• Paid: means the transfer by the health insurance issuer or its agent of the amount of the health insurance issuer liability on either of the following dates:

  (a)  The date of mailing of a check via the United States Postal Service or a commercial carrier to the correct address. See Louisiana Revised Statutes 22:1831

• Part-time employee: means an employee who as a condition of his hiring knowingly accepts employment that (a) customarily provides for less than forty hours per work week, and (b) that is classified by the employer as a part-time position. See Louisiana Revised Statutes 23:1021
• Particular product: means a basic insurance policy form, certificate, or subscriber agreement delineating the terms, provisions, and conditions of a specific type of coverage or benefit under a particular type of contract with a discrete set of rating and pricing methodologies that a health insurance issuer offers in the state. See Louisiana Revised Statutes 22:1091
• Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
• Party: means any recipient of any notice or document required as part of an insurance transaction, including but not limited to an applicant, an insured, a policyholder, or an annuity contract holder. See Louisiana Revised Statutes 22:2461
• Person: means any natural person or any nongovernmental juridical person. See Louisiana Revised Statutes 22:2503
• Person: means both plural and singular, as the case demands, and includes individuals, partnerships, corporations, companies, societies, and associations

              (14)(a) Except as provided in Subparagraph (b) of this Paragraph, "petroleum product" means any refined hydrocarbon mixture including motor oil, kerosene, gasoline, gasohol, diesel fuel, aviation fuel, heating kerosene, and any blend of two or more refined hydrocarbon mixtures except liquefied petroleum gas and natural gas. See Louisiana Revised Statutes 3:4602

• Personal property: All property that is not real property.
• Personnel file: means the file or files which contain the cumulative collection of any and all documents maintained by the school system with respect to each individual school employee. See Louisiana Revised Statutes 17:1233
• Personnel file custodian: means those persons employed by the school system charged with the duty of maintaining and preserving the personnel files. See Louisiana Revised Statutes 17:1233
• Persons: means any individual, partnership, corporation, association, firm, or other business entity. See Louisiana Revised Statutes 32:1741
• petroleum product: shall include compressed natural gas, liquefied natural gas, and liquefied petroleum gas as those terms are defined in Louisiana Revised Statutes 3:4602
• pharmacies: means any appropriately licensed place within this state where prescription drugs are dispensed and pharmacist services are provided and any place outside of this state where prescription drugs are dispensed and pharmacist services are provided to residents of this state. See Louisiana Revised Statutes 22:1852
• Pharmacist: means an individual currently licensed as a pharmacist by the Louisiana Board of Pharmacy to engage in the practice of pharmacy in this state. See Louisiana Revised Statutes 22:1852
• Pharmacist: means a licensed pharmacist as defined in Louisiana Revised Statutes 22:1863
• Pharmacist services: means the filling and dispensing of prescription drugs or providing products and supplies, drug therapy, and other patient care services provided by a licensed pharmacist with the intent of achieving outcomes related to the cure, prevention, or management of a disease, elimination or reduction of patient's symptoms, or arresting or slowing of a disease process. See Louisiana Revised Statutes 22:1852
• Pharmacist services: means products, goods, or services provided as a part of the practice of pharmacy as defined in Louisiana Revised Statutes 22:1863
• Pharmacy: means any appropriately licensed place where prescription drugs are dispensed as defined in Louisiana Revised Statutes 22:1863
• Pharmacy benefit manager: means an entity that administers or manages a pharmacy benefits plan or program. See Louisiana Revised Statutes 22:1863
• Physician: means a person licensed by the Louisiana State Board of Medical Examiners. See Louisiana Revised Statutes 22:1060.1
• plan: means an entity which provides benefits through or by a health insurance issuer consisting of health care services provided directly, through insurance or reimbursement, or otherwise and including items and services paid for as health care services under any hospital or medical service policy or certificate, hospital or medical service plan contract, preferred provider organization agreement, or health maintenance organization contract; however, "health benefit plan" shall not include benefits due under Chapter 10 of Title 23 of the Louisiana Revised Statutes of 1950 or limited benefit and supplemental health insurance policies, benefits provided under a separate policy, certificate, or contract of insurance for accidents, disability income, limited scope dental or vision benefits,  benefits for long-term care, nursing home care, home health care, or specific diseases or illnesses, or any other limited benefit policy or contract as defined in Louisiana Revised Statutes 22:1060.1
• Plea: In a criminal case, the defendant's statement pleading "guilty" or "not guilty" in answer to the charges, a declaration made in open court.
• Pleadings: Written statements of the parties in a civil case of their positions. In the federal courts, the principal pleadings are the complaint and the answer.
• Position holder: means the person who holds the inventory position in motor fuel in a terminal as reflected on the records of the terminal operator. See Louisiana Revised Statutes 3:4602
• Positron emission tomography: means an imaging test that uses radioactive substances to visualize and measure metabolic processes in the body to help reveal how tissue and organs are functioning. See Louisiana Revised Statutes 22:1060.12
• Precedent: A court decision in an earlier case with facts and law similar to a dispute currently before a court. Precedent will ordinarily govern the decision of a later similar case, unless a party can show that it was wrongly decided or that it differed in some significant way.
• Prior authorization: means a determination by a health insurance issuer or person contracting with a health insurance issuer that healthcare services ordered by the provider to an individual or an enrollee are medically necessary and appropriate. See Louisiana Revised Statutes 22:1060.12
• Private property: means any privately owned parking facility at any location or any parking lot or street which is privately owned and is located near or contiguous to premises having one or more stores or business establishments which is used for the parking of motor vehicles or for vehicular travel by the owner or customers of such establishments and those having express or implied permission of the owner. See Louisiana Revised Statutes 32:1741
• Probable cause: A reasonable ground for belief that the offender violated a specific law.
• Probation: A sentencing alternative to imprisonment in which the court releases convicted defendants under supervision as long as certain conditions are observed.
• Program: means the Louisiana Guaranteed Benefits Pool. See Louisiana Revised Statutes 22:1132
• Prosecute: To charge someone with a crime. A prosecutor tries a criminal case on behalf of the government.
• provider: means :

  (a)  A physician or other health care practitioner licensed, certified, registered, or otherwise authorized to perform specified health care services consistent with state law. See Louisiana Revised Statutes 22:1831

• provider: means a health care professional or a health care facility or the agent or assignee of such professional or facility. See Louisiana Revised Statutes 22:1872
• Public defender: Represent defendants who can't afford an attorney in criminal matters.
• Publicly available information: means any information that a licensee reasonably believes is lawfully made available to the general public when all of the following occur:

              (a) The information is available to the general public from any of the following sources:

              (i) Federal, state, or local government records. See Louisiana Revised Statutes 22:2503

• Rack: means a mechanism for delivering motor fuel from a refinery, terminal, marine vessel, or bulk plant into a transport vehicle, railroad tank car, or other means of transfer that is outside the bulk transfer/terminal system. See Louisiana Revised Statutes 3:4602
• Rate: means the rate initially filed or filed as a result of determination of rates by a health insurance issuer for a particular product. See Louisiana Revised Statutes 22:1091
• rate increase: includes a premium volume-weighted average increase for all insureds for the aggregate rate changes during the twelve-month period preceding the proposed rate increase effective date. See Louisiana Revised Statutes 22:1091
• Real property: Land, and all immovable fixtures erected on, growing on, or affixed to the land.
• receipt: means :

  (a)  For a nonelectronic claim:

  (i)  For a claim mailed via the United States Postal Service for which no return receipt is requested, the physical receipt of the claim by the health insurance issuer or its agent designated for the receipt of claims at the correct claims address, as documented in accordance with claims filing procedures filed by the health insurance issuer with the department. See Louisiana Revised Statutes 22:1831

• Recess: A temporary interruption of the legislative business.
• 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.
• Remittance advice: means a written or electronic communication explaining the issuer's action on each claim adjudicated by the issuer. See Louisiana Revised Statutes 22:1831
• Reporter: Makes a record of court proceedings and prepares a transcript, and also publishes the court's opinions or decisions (in the courts of appeals).
• Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.
• Retirement: means withdrawal from active service with a retirement allowance granted under the provisions of this part. See Louisiana Revised Statutes 11:952.1
• Retirement system: means the Teachers' Retirement System of Louisiana as defined in Louisiana Revised Statutes 11:701
• Risk assessment: means the risk assessment that each licensee is required to conduct pursuant to Louisiana Revised Statutes 22:2503
• Rural hospital: shall mean either:

  (a)  A hospital with sixty or fewer beds located in either:

  (i)  A parish with a population of less than fifty thousand according to the most recent federal decennial census. See Louisiana Revised Statutes 22:1831

• school bus operator: means any employee of any city, parish, or other local public school board whose duty it is to transport students in any board school bus or activity bus to and from any school of suitable grade approved by the state Department of Education or to and from any school-related activity. See Louisiana Revised Statutes 17:491
• School system: means a parish or city school system. See Louisiana Revised Statutes 17:1233
• Secretary: means the secretary of the commission. See Louisiana Revised Statutes 23:1
• 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.
• Shares: means the units into which the stockholders' rights to participate in the control of the state bank, in its profits, or in the distribution of corporate assets are divided. See Louisiana Revised Statutes 6:201
• small employer: means any person, firm, corporation, partnership, trust, or association actively engaged in business which has employed an average of at least one but not more than fifty employees on business days during the preceding calendar year and who employs at least one employee on the first day of the plan year. See Louisiana Revised Statutes 22:1091
• Spread pricing: means any amount a pharmacy benefit manager charges or claims from a health plan provider or managed care organization for payment of a prescription or for pharmacy services that is different than the amount the pharmacy benefit manager paid to the pharmacist or pharmacy who filled the prescription or provided the pharmacy services. See Louisiana Revised Statutes 22:1863
• State: means the state of Louisiana. See Louisiana Revised Statutes 11:952.1
• Statute: A law passed by a legislature.
• Stockholder: means the holder of record of one or more shares. See Louisiana Revised Statutes 6:201
• Surplus: means sums contributed by stockholders in excess of the par value of shares outstanding plus any amounts transferred from undivided profits pursuant to action by the board of directors. See Louisiana Revised Statutes 6:201
• Surviving spouse: means a person who is legally married to a member of the system and living with the member at the time of his death. See Louisiana Revised Statutes 11:1402
• Teacher: means :

              (a) Any employee of a local public school board, state special school, or a school or program administered by the special school district who holds a teacher's certificate and whose legal employment requires such teacher's certificate. See Louisiana Revised Statutes 17:441

• teacher: shall include any member of the teaching staff of a public school in the state and any social worker or school psychologist employed by a local school board in the state who holds a valid professional ancillary certificate in school social work or school psychology issued by the state Department of Education. See Louisiana Revised Statutes 17:1211
• teaching staff: shall include any person employed by a city, parish, or other local public school board in the state of Louisiana who holds a valid teaching certificate issued by the state Department of Education and any social worker, school counselor, school nurse, audiologist, educational diagnostician, speech-language pathologist, or school psychologist employed by a city, parish, or other local public school board in the state who holds the appropriate valid professional ancillary certificate issued by the state Department of Education. See Louisiana Revised Statutes 17:1170
• teaching staff: shall include any member of the teaching staff of a public school in the state of Louisiana and any social worker, school counselor, or school psychologist employed by a city, parish, or other local public school board in the state who holds, as applicable, a valid professional ancillary certificate in school social work, school counseling, or school psychology issued by the state Department of Education. See Louisiana Revised Statutes 17:1200
• 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.
• Testate: To die leaving a will.
• Third-party service provider: means a person, not otherwise defined as a licensee, who contracts with a licensee to maintain, process, store, or otherwise have access to nonpublic information through its provision of services to the licensee. See Louisiana Revised Statutes 22:2503
• Tort: A civil wrong or breach of a duty to another person, as outlined by law. A very common tort is negligent operation of a motor vehicle that results in property damage and personal injury in an automobile accident.
• Total voting power: means the entirety of the voting power. See Louisiana Revised Statutes 6:201
• 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.
• Trial jury: A group of citizens who hear the evidence presented by both sides at trial and determine the facts in dispute. Federal criminal juries consist of 12 persons. Federal civil juries consist of six persons.
• Trustee: A person or institution holding and administering property in trust.
• Unfairly discriminatory: means rates that result in premium differences between insureds within similar risk categories that do not reasonably correspond to differences in expected costs. See Louisiana Revised Statutes 22:1091
• Uniform claim form: shall mean a form prescribed by rule by the department pursuant to Louisiana Revised Statutes 22:1852
• University: means all campuses and divisions of the Louisiana State University and Agricultural and Mechanical College. See Louisiana Revised Statutes 11:952.1
• Unjustified: means a rate for which a health insurance issuer has provided data or documentation to the department in connection with rates for a particular product that is incomplete, inadequate, or otherwise does not provide a basis upon which the reasonableness of the rate may be determined or is otherwise inadequate insofar as the rate charged is clearly insufficient to sustain projected losses and expenses. See Louisiana Revised Statutes 22:1091
• Unreasonable: means any rate that contains a provision or provisions that are any of the following:

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

• Utilization review: means a set of formal techniques designed to monitor the use of, or evaluate the clinical necessity, appropriateness, efficacy, or efficiency of, healthcare services, procedures, or settings. See Louisiana Revised Statutes 22:1060.12
• Vehicle tank: means any vehicle tank, tank truck, tank wagon, or any other container in which gasoline, motor fuel, or any other petroleum products are transported in this state. See Louisiana Revised Statutes 3:4602
• Venue: The geographical location in which a case is tried.
• Vocational-technical school: means any vocational-technical school under the jurisdiction of the Board of Supervisors of Community and Technical Colleges. See Louisiana Revised Statutes 17:540
• Voting power: means the right vested by law or by the articles or the bylaws in the stockholder or in one or more classes of stockholder to vote in the determination of any particular question or matter coming before meetings of the stockholders. See Louisiana Revised Statutes 6:201
• Wages: means average weekly wage at the time of the accident. See Louisiana Revised Statutes 23:1021
• Writ: A formal written command, issued from the court, requiring the performance of a specific act.