§ 21-5-407 - Definitions. - Arkansas Statutes

21-5-407. Definitions.

As used in this subchapter:

(1) "Aggregate performance information" means a report or other means of communication about the measurement of accomplishment of the execution of certain tasks, achievement of certain results, or occurrence of certain events related to all patients or to a class or group of patients identifiable by certain criteria;

(2) (A) "Alternate retirement plan retiree" means a retiree in an alternate retirement plan as defined in 24-7-801 of a certain institution whose employer does not contribute to the State or Public School Health Insurance Plan during his or her active employment.

(B) Further, an "alternate retirement plan", for the purposes of this section, is a defined contribution plan allowed under the Internal Revenue Service regulations and allowed but not created by Arkansas state law;

(3) "Dependent" means any member of an employee's or retiree's family who meets the eligibility for coverage under the health benefit plans approved by the State and Public School Life and Health Insurance Board;

(4) "Dual eligibility" means simultaneous participation as an employee, dependent, or retiree in the multiple programs offered by the Employee Benefits Division;

(5) "Eligible inactive retiree" means a former member of the General Assembly or a state-elected constitutional officer who has served a sufficient number of years of credited service to be eligible for retirement benefits but who has not yet reached retirement age. Eligible inactive retirees who enroll in the plan must pay the entire premium cost as set by the board;

(6) "Employee" means a state employee or a public school district employee;

(7) "Health insurance representative" means an individual appointed by a participating entity to act as an agent for the Employee Benefits Division;

(8) "Ineligible inactive retiree" means a terminated employee who has worked a sufficient number of years to be considered vested but who has not yet reached the age to qualify to receive a retirement benefit;

(9) "Internal Revenue Service" means the United States Government agency responsible for tax collection and tax law enforcement;

(10) "Member" means any enrolled state or public school employee, retiree, or covered dependent;

(11) "Participating entity" means an organization authorized to participate in a plan offered under this subchapter;

(12) "Participating institution" means any two-year or four-year college that is participating in a plan offered under this subchapter;

(13) "Prepayment" means collection of medical or life insurance premiums or both medical and life insurance premiums from the employee and employer one (1) month in advance;

(14) "Qualifying event" means a change in an employee's personal life that may impact his or her eligibility or a dependent's eligibility for benefits, as defined by Internal Revenue Service guidelines;

(15) "Quality-of-care information" means the contents of medical records, member claims, patient surveys, pharmacy data, lab data, and other records of or reports about systems, networks, hospitals, and clinical providers to be gathered for assessment of the quality and costs of health care provided by systems, networks, hospitals, and clinical providers;

(16) "Quality performance indicator" means a specific inquiry or standard that, when applied to quality-of-care information, reveals a quantifiable measure of success or failure in system, network, hospital, or clinical provider care;

(17) "Retiree" means a retired employee who is eligible under the provisions of 21-5-411;

(18) "State" means the State of Arkansas; and

(19) "Vendor" means:

(A) A corporation, partnership, or other organization licensed to do business and in good standing with the State of Arkansas; and

(B) A corporation, partnership, or other organization licensed to do business and in good standing with the State of Arkansas that is lawfully engaged in administering employer- or employee-funded benefit plans for employer groups in consideration of an administration fee payable to the vendor.