Glossary

Pastoral professional liability insurance is a type of professional liability insurance that covers both individual pastors and religious leaders and the religious organization. A major exposure covered by pastoral professional liability insurance is counseling by ministers or similar individuals. Pastoral professional liability insurance may combine other coverages as well, such as sexual abuse and molestation coverage and potentially management liability coverage (like directors and officers (D&O) liability and employment practices liability (EPL) coverages).

Patch management is the process of ensuring that cyber updates are routinely applied to correct vulnerabilities in software and firmware. According to the National Institute of Standards and Technology, enterprise patch management is defined as "[t]he process of identifying, prioritizing, acquiring, installing, and verifying the installation of patches, updates, and upgrades throughout an organization." Effective patch management requires a number of steps, the first being the creation of a comprehensive asset inventory. Then, vulnerabilities must be assessed and patches applied once they have been tested. Importantly, patches should be vetted and approved prior to being applied, as unexpected problems can sometimes accompany them. Once deployed, ongoing monitoring is essential to identify new vulnerabilities. Unfortunately, many organizations have gaps within these processes or apply them irregularly.

Patent infringement refers to an encroachment on a right granted by a government to an inventor assuring the sole right to make, use, and sell an invention for a certain time period. Coverage for this exposure is normally not provided by liability policies.

Patient compensation funds are state-operated programs that afford excess insurance coverage for healthcare providers, including doctors, hospitals, dentists, and some allied healthcare professionals. Such programs cap a defendant healthcare provider's per claim exposure at an amount specified in the state's statute. The fund pays any amount of a claim exceeding this threshold. Patient compensation funds are paid for by an annual surcharge against healthcare providers, generally a percentage of the provider's annual liability premium. Participating healthcare providers are required to maintain liability limits in an amount no less than the threshold at which the excess coverage applies.

Patient dumping refers to a statutorily imposed liability that occurs when a hospital capable of providing the necessary medical care transfers a patient to another facility or simply turns the patient away because of the patient's inability to pay for services. Hospitals that knowingly, willfully, or negligently fail to comply with legislation prohibiting this practice are subject to various monetary penalties as well as suspension of their Medicare provider agreements.

The Patient Protection and Affordable Care Act (PPACA) is a 2010 law that enacted the most significant regulatory overhaul of the American healthcare system since passage of Medicare and Medicaid in 1965. Following are the highlights of the PPACA. Health insurance market reforms: These include (1) health insurance policies are barred from having annual or lifetime coverage limits; (2) insurers must cover all applicants, with new minimum policy standards, and offer the same rates regardless of preexisting conditions or gender; (3) those with preexisting conditions cannot be denied coverage; (4) health insurers may not drop insureds who develop a medical condition; (5) parents with children up to the age of 26 can cover them under their own policies. Individual mandate: Everyone in the United States must purchase health insurance or pay a penalty to the Internal Revenue Service (IRS) on their income tax return. Exemptions will be granted for financial hardship, religious objections, American Indians, prison inmates, those without coverage for less than 3 months, undocumented immigrants, people with incomes below certain tax filing thresholds (currently $9,500 for individuals and $19,000 for married couples), and those for whom the lowest cost plan option exceeds 8 percent of household income. Medicaid expansion: As of 2013, every state has different Medicaid eligibility requirements based on income, age, gender, dependents, and other specific requirements. Starting in 2014, states have the option, but not the obligation, to expand Medicaid eligibility levels to 138 percent of the federal poverty level (FPL). The expansion covers the gap for those who earn too much to qualify for Medicaid but not enough to qualify for subsidies available under the individual mandate. Insurance exchanges: Directs states to establish insurance exchanges where individuals and small businesses can compare various insurers' healthcare plans, band together to form larger purchasing groups, and obtain coverage at more affordable rates. In states that choose not to establish such exchanges, the federal government will do so. Premium subsidies: Provides sliding-scale subsidies that reduce the cost of coverage. To be eligible for a premium subsidy, household income must be between 100 percent and 400 percent of the FPL. (Below 100 percent of FPL, the household qualifies for Medicaid. Above 400 percent of FPL, subsidies are no longer available.) Large employer mandate: Requires employers with more than 50 full-time employees to offer "affordable" coverage to their workforce or pay an annual penalty to the IRS. "Full-time" employees are defined as working 30 hours or more per week (which means the law does not apply to part-time workers). The amount of the penalty depends on whether the employer does or does not offer coverage and whether any of the employees receive a premium credit for purchasing individual or family coverage on a state-based exchange. Small employer subsidies: Offers a modest tax credit to small employers to help defray some of the cost of purchasing health insurance for their employees. To be eligible, a small business must meet the following criteria: (1) 25 full-time employees or fewer (meaning tax credit subsidies are unavailable for companies with between 26 and 50 employees); (2) average annual wage less than $50,000; and (3) employer contributes at least 50 percent to the premium cost.

Patient's Bill of Rights legislation refers to laws allowing claimants to sue managed care organizations (MCOs) for malpractice and other treatment-related causes of action. The effect of such legislation is to lift the so-called Employee Retirement Income Security Act (ERISA) preemption, which places substantial legal restrictions on a patient's ability to sue an MCO. Currently, only a few states, most notably Texas, allow lawsuits against MCOs. Interestingly, only a few lawsuits have been filed against MCOs in Texas, thus calling into question some of the insurance industry's high cost estimates in the event that the ERISA preemption against lawsuits is removed, per pending federal legislation.

Patient wearable refers to a wearable device used to monitor medical patients' vital signs. Although once used almost exclusively in hospital intensive care units, wearables have expanded into both standard hospital treatment rooms and are being used extensively with outpatients. Wearables can vastly improve patient monitoring and significantly reduce the risk of death in both noncritical areas of hospitals and for patients in their homes. Furthermore, wearables can lower treatment costs without compromising the quality of medical care. For example, a remote monitoring device has the potential to reduce the number of a patient's visits to either a doctor's office or a hospital for routine checkups. Wearable devices come with risks. For example, use of remote patient monitoring opens up the possibility that the hardware at the hospital or healthcare facility where remote readings are being received suddenly fails in some way or produces faulty readings. In addition, the person(s) charged with monitoring/analyzing remotely received patient data may negligently perform this role. Lastly, wearables expose a patient to the threat of hacking, which poses various privacy risks.

Paul v. Virginia is an 1869 US Supreme Court decision holding that insurance is not commerce and is therefore not subject to regulation by the federal government. The ruling was overturned in 1944 by another US Supreme Court decision, United States v. South-Eastern Underwriters Ass'n, 322 U.S. 533, 64 S. Ct. 1162, 88 L. Ed. 1440 (1944). [75 U.S. 168, 19 L. Ed. 357, 8 Wall. 168 (1869)].

A payer death rider is a life insurance rider that is used when the premium for the policy is being paid by someone other than the insured and provides that, in the event of death of the payer, the policy premiums will be waived for the remainder of the premium paying period.