Terms Used In New York Laws > Insurance > Article 47 - Municipal Cooperative Health Benefit Plans

• 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.
• 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.
• 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.
• 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.
• Community rating: means a rating methodology in which the premium equivalent rate for all persons covered under a municipal cooperative health benefit plan is the same, based upon the experience of the entire pool of risks covered under the plan, without regard to age, sex, health status or occupation and such that refunds, rebates, credits or dividends based upon age, sex, health status or occupation are not permitted. See N.Y. Insurance Law 4702
• Contract: A legal written agreement that becomes binding when signed.
• contribution: means the amount contributed by participating municipal corporations to cover expected claims and expenses thereon, required reserves, surplus, stop-loss insurance, and other expenses associated with the operations of the municipal cooperative health benefit plan. See N.Y. Insurance Law 4702
• 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.
• Deed: The legal instrument used to transfer title in real property from one person to another.
• delinquent tax: include any unpaid tax or other charge against lands owned by the state. See N.Y. Real Property Tax Law 1102
• Enforcing officer: means any elected or appointed officer of any tax district empowered or charged by law to enforce the collection of tax liens on real property; provided, however, that (a) where no law provides otherwise, the enforcing officer shall be (i) in a county which is a tax district, the county treasurer or commissioner of finance, (ii) in a city which is a tax district, the official so empowered or charged by the city charter, (iii) in a village which is a tax district, the village treasurer, and (iv) in a town which is a tax district, the town supervisor; and (b) when the duties and powers of an "enforcing officer" are vested in two or more elected or appointed officials, the governing body of the tax district shall designate which of such officials shall act as enforcing officer for the purposes set forth in this article. See N.Y. Real Property Tax Law 1102
• 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.
• 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.
• 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}
• Fraud: Intentional deception resulting in injury to another.
• Fully-insured: means that all benefits payable pursuant to a municipal cooperative health benefit plan are guaranteed under a contract or policy of insurance delivered in this state and issued by an insurance company authorized to do accident and health insurance business in this state, an article forty-three corporation, or a health maintenance organization. See N.Y. Insurance Law 4702
• Governing board: means the group of persons, designated in the municipal cooperation agreement establishing the municipal cooperative health benefit plan, to be responsible for administering the plan. See N.Y. Insurance Law 4702
• Injunction: An order of the court prohibiting (or compelling) the performance of a specific act to prevent irreparable damage or injury.
• legal charges: means :
  
  (a) the cost of the mailing or service of notices required or authorized by this article;
  
  (b) the cost of publication of notices required or authorized by this title;
  
  (c) the amount of any interest and penalties imposed by law;
  
  (d) the cost of recording or filing legal documents required or authorized by this article; and
  
  (e) the reasonable and necessary cost of any search of the public record required or authorized to satisfy the notice requirements of this article, and the reasonable and necessary expenses for legal services of a tax district in connection with a proceeding to foreclose a tax lien; provided, that: (i) a charge of up to one hundred fifty dollars per parcel shall be deemed reasonable and necessary to cover the combined costs of such searches and legal expenses, and such an amount may be charged without substantiation, even if salaried employees of the tax district performed the search or legal services; and (ii) a tax district may charge a greater amount with respect to one or more parcels upon demonstration to the satisfaction of the court having jurisdiction that such greater amount was reasonable and necessary. See N.Y. Real Property Tax Law 1102
• Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
• Lien: A claim against real or personal property in satisfaction of a debt.
• Mortgage: The written agreement pledging property to a creditor as collateral for a loan.
• Municipal cooperation agreement: means an appropriate cooperative agreement authorized by Article 5-G of the general municipal law. See N.Y. Insurance Law 4702
• Municipal corporation: means within the state of New York, a city with a population of less than one million or a county outside the city of New York, town, village, board of cooperative educational services, school district, a public library, as defined in § 253 of the education law, or district, as defined in § 119-n of the general municipal law. See N.Y. Insurance Law 4702
• 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.
• Person: means an individual, a corporation (including a foreign corporation and a municipal corporation), a joint stock association, a partnership, the state, and any other organization, state, government or county which may lawfully own property in the state. See N.Y. Real Property Tax Law 1102
• Personal property: All property that is not real property.
• plan: means any plan established or maintained by two or more municipal corporations pursuant to a municipal cooperation agreement for the purpose of providing medical, surgical or hospital services to employees or retirees of such municipal corporations and to the dependents of such employees or retirees. See N.Y. Insurance Law 4702
• Plan document: means the group contract issued by the municipal cooperative health benefit plan to participating municipal corporations describing the terms and conditions of coverage. See N.Y. Insurance Law 4702
• 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.
• Qualified actuary: means an actuary who is a member in good standing of the American Academy of Actuaries or Society of Actuaries, with experience in establishing rates for self-insured trusts providing health benefits or other similar experience. See N.Y. Insurance Law 4702
• Real property: Land, and all immovable fixtures erected on, growing on, or affixed to the land.
• Summary plan description: means the certificate of coverage or booklet delivered to employees or retirees enrolled in the plan, summarizing the essential terms and conditions of coverage for employees or retirees and their dependents. See N.Y. Insurance Law 4702
• Summons: Another word for subpoena used by the criminal justice system.
• Tax district: means : (a) a county, other than (i) a county for which the cities and towns enforce delinquent taxes pursuant to the county administrative code, or (ii) a county wholly contained within a city;
  
  (b) a city, other than a city for which the county enforces delinquent taxes pursuant to the city charter;
  
  (c) a village, other than a village for which the county enforces delinquent taxes pursuant to section fourteen hundred forty-two of this chapter; or
  
  (d) a town in a county in which towns enforce delinquent taxes pursuant to the county administrative code. See N.Y. Real Property Tax Law 1102
• Writ: A formal written command, issued from the court, requiring the performance of a specific act.