8 Ill. Adm. Code 755.20
Definitions
Section 755
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.