Terms Used In Rhode Island General Laws > Chapter 27-74 - Discount Medical Plan Organization Act

• Ancillary services: includes , but is not limited to, audiology, dental, vision, mental health, substance abuse, chiropractic, and podiatry services. See Rhode Island General Laws 27-74-3
• Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
• Commissioner: means the health insurance commissioner. See Rhode Island General Laws 27-74-3
• Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
• Contract: A legal written agreement that becomes binding when signed.
• Conviction: A judgement of guilt against a criminal defendant.
• 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.
• Discount medical plan: means a business arrangement or contract in which a person, in exchange for fees, dues, charges, or other consideration, offers access for its members to providers of medical or ancillary services and the right to receive discounts on medical or ancillary services provided under the discount medical plan from those providers. See Rhode Island General Laws 27-74-3
• Discount medical plan organization: means an entity that, in exchange for fees, dues, charges, or other consideration, provides access for discount medical plan members to providers of medical or ancillary services and the right to receive medical or ancillary services from those providers at a discount. See Rhode Island General Laws 27-74-3
• Facility: includes , but is not limited to:

  (A)  A hospital or other licensed inpatient center;

  (B)  An ambulatory surgical or treatment center;

  (C)  A skilled nursing center;

  (D)  A residential treatment center;

  (E)  A rehabilitation center; and

  (F)  A diagnostic, laboratory, or imaging center. See Rhode Island General Laws 27-74-3

• 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.
• Health carrier: means an entity subject to the insurance laws and regulations 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 healthcare services, including a sickness and accident insurance company, a health maintenance organization, a nonprofit hospital and medical service corporation, or any other entity providing a plan of health insurance, health benefits, or medical or ancillary services. See Rhode Island General Laws 27-74-3
• Healthcare professional: means a physician or other healthcare practitioner who is licensed, accredited, or certified to perform specified medical or ancillary services within the scope of his or her license, accreditation, certification, or other appropriate authority and consistent with state law. See Rhode Island General Laws 27-74-3
• in writing: include printing, engraving, lithographing, and photo-lithographing, and all other representations of words in letters of the usual form. See Rhode Island General Laws 43-3-16
• 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.
• Marketer: means a person or entity that markets, promotes, sells, or distributes a discount medical plan, including a private label entity that places its name on and markets or distributes a discount medical plan pursuant to a marketing agreement with a discount medical plan organization. See Rhode Island General Laws 27-74-3
• Member: means any individual who pays fees, dues, charges, or other consideration for the right to receive the benefits of a discount medical plan. See Rhode Island General Laws 27-74-3
• 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, a corporation, a partnership, an association, a joint venture, a joint stock company, a trust, an unincorporated organization, any similar entity, or any combination of the foregoing. See Rhode Island General Laws 27-74-3
• Provider: means any healthcare professional or facility that has contracted, directly or indirectly, with a discount medical plan organization to provide medical or ancillary services to members. See Rhode Island General Laws 27-74-3
• Provider network: means an entity that negotiates directly or indirectly with a discount medical plan organization on behalf of more than one provider to provide medical or ancillary services to members. See Rhode Island General Laws 27-74-3
• 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.
• Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.
• Statute: A law passed by a legislature.
• Trustee: A person or institution holding and administering property in trust.
• under common control with: means the possession, direct or indirect, of the power to direct or cause the direction of the management and policies of a person, whether through the ownership of voting securities, by contract other than a commercial contract for goods or nonmanagement services, or otherwise, unless the power is the result of an official position with or corporate office held by the person. See Rhode Island General Laws 27-74-3