Ill. Admin. Code tit. 8 § 755.20

Current through Register Vol. 48, No. 36, September 6, 2024
Section 755.20 - Definitions

"Administrator" means the professional third-party claims administrator chosen by the Department based on the criteria set forth in this Part to collect claims information and supporting documentation, and to provide recommendations to the Department.

"Claim" means a request to the Department for payment of outstanding health care costs not previously reimbursed by Mid-Continent.

"Department" means the Illinois Department of Agriculture.

"District" means one of the Soil and Water Conservation Districts of Illinois.

"Eligible Period" means the time period from January 1, 1996 through December 31, 1996.

"Employee" means a person who was employed by a Soil and Water Conservation District during the twelve month period from January 1, 1996 through December 31, 1996.

"Mid-Continent" means Mid-Continent Medical Benefit Trust, the Districts' insurance carrier during the eligible period.

"Outstanding Costs" means those health care costs for which employees were eligible for reimbursement from Mid-Continent, but which were not paid by Mid-Continent.

"Provider" means any person or entity that provided health care services or products to an employee during the eligible period.

"Valid Claim" means a claim that is verified and adjudged by the Department to be eligible for reimbursement.

Ill. Admin. Code tit. 8, § 755.20