Terms
The fixed dollar amount you pay for a covered healthcare service at the time the service is rendered.
What is copay?
This type of insurance has an annual benefit maximum and categorizes services as preventative, basic, or major.
What is dental?
Under this account, employees are reimbursed for many types of healthcare costs, including insurance premiums.
What is an HRA?
Under this program, you receive a percentage of your projected income capped at a fixed amount per month for a limited period of time before transitioning to a different program.
What is STD?
To generate a benefits presentation deck, navigate to TotalSolutions > Benefits _ _ _
What is B.O.B.?
The maximum amount you pay for covered healthcare services before the carrier pays 100 percent of the remaining covered costs in the calendar year.
What is Out-of-Pocket Maximum?
Federal law dictates that you must be enrolled in this type of medical plan to contribute to an HSA.
What is an HDHP?
This account is portable, but contributions are restricted to periods when an employee is insured under a particular type of medical plan.
What is an HSA?
Under the employer-sponsored version, premiums for coverage exceeding this payout amount are taxable to the employee.
What is $50,000?
Employees have this number of days to submit a Qualifying Life Event.
What is 60?
A percentage of the total billed amount you pay when receiving covered healthcare services.
What is coinsurance?
This type of medical plan provides for out-of-network coverage.
What is PPO?
SEIs are eligible for this type of use-it-or-lose-it spending account, but not the other.
What is dependent-care FSA?
This voluntary plan has three coverage levels (value, classic, and deluxe) and is not marketed as an insurance policy.
What is Wagmo Pet Wellness?
Sending member IDs to a client practitioner on behalf of an employee is a violation of this federal law.
What is HIPAA?
This amount transfers automatically between TotalSource medical plans in June, but some carriers do not allow it in Q4 of the calendar year.
What is a deductible?
Also acceptable: OOPM
Coverage for this type of service has a lifetime maximum and does not reset annually.
What is orthodontia?
Primary subscribers are sent two copies of this after enrolling in an account.
What is the Optum Mastercard?
In the 2025-26 plan year, VSP provides subscribers an allowance of this dollar amount per year for retail frames.
What is $225?
MyLife Advisors are reachable Monday through Friday during these hours.
What is 8am - 11:30pm EST?
(7 - 10:30)
(6 - 9:30)
(5 - 8:30)
This provision governs when and how two separate carriers pay for covered services for someone insured under both policies.
What is Coordination of Care?
On January 1st, a primary subscriber of AETNA-OA EPO 3000-90% will pay this dollar amount for a $20,000 hospital bill (OOPM = $5,000).
What is $4,700?
This contribution, required to be reported on the W-2, is never displayed on the benefits invoice.
What is employer contribution to HSA?
Under these policies, payments to employees are taxable to the employer for FUTA and SUI and may offset payments under public plans.
What are STD and LTD/disability benefits?
This carrier only offers three coverage tiers for all of its medical plans, where tier classification depends on the number of children enrolled.
What is Blue Cross?