COBRA
INSURANCE TERMS
Laws and Acts
Programs CCAs Use
Specialists
100

The amount of time members have to accept COBRA once the packet is created? 

What is 60 days

100

The monthly or regular payment you make to keep your insurance active

What is a Premium.

100

A Federal law that lets you temporarily keep your employer-sponsored health insurance after a job loss or other qualifying life event

What is the Consolidated Omnibus Budget Reconciliation Act (COBRA)

100

CCAs use this for making inbound and outbound calls.

What is CXONE/AGENT

100

This is a holistic doctor.

What is a Naturopath.

200

The standard length of time COBRA is offered to a person who was laid off from their job?

What is 18 months.

200

Amount that has to be met before the plan begins paying benefits.

What is a Deductible.

200

It is a U.S. federal law that sets minimum standards for most voluntarily established retirement and health benefit plans in private industry

What is the Employee Retirement Income Security Act of 1974 or ERISA.

200

CCAs use this to log their cases for inbound calls and to see member profiles.

What is CRM.

200

This type of doctor specializes in surgeries in the mouth.

What is an oral and maxillofacial surgeon.

300

The length of time a member has to make a payment after COBRA has been elected?

What is 45 Days.

300

A flat, fixed fee you pay out-of-pocket each time you receive a medical service.

What is a copay.

300

A federal law that requires health plans to apply in-network cost-sharing terms and prohibits certain types of out-of-network providers, facilities, or providers of air ambulance services from billing individuals more than these in-network cost-sharing limits in three main scenarios: Emergency Services,  Certain services at an in-network hospital or outpatient surgical facility  and Air ambulances.

What is the No Suprises Act (NSA).

300

CCAs use this program to access copies of the EOB's, EPPs and see check and payment information.

What is Echo Health. 

300

This type of doctor specializes in hormonal disorders and diseases. 

What is an Endocrinologist.

400

The length of time member on COBRA has to notify us of a second qualifying event?

What is 60 Days.
400

This person is the primary account holder who owns and manages the insurance policy

What is an Employee/Subscriber/Policy holder

400

Washington state law that protects consumers from surprise or balance billing if they receive emergency care at any medical facility or when you're treated at an in-network hospital or outpatient surgical facility by an out-of-network provider. Groups Must 'OPT IN"

What is WA 1065.

400

CCAs use this program to help members see a Fair Price comparison in their area for medical services. 

What is the Valenz tool.

400

This type of doctor specializes in treatment and disorders of the kidneys

What is a nephrologist.

500

Length of COBRA when a dependent child ages out of the plan.

What is 36 months.

500

The highest amount you will pay for covered, in-network medical services in a plan year before your health insurance starts paying 100% of your costs

What is Maximum out of pocket.

500

The federal regulation requires health insurance companies to provide a patient-facing online tool (and phone support upon request) allowing members to get real-time estimates of their personal cost-sharing liability for medical items and services. 

What is the Transparency in Coverage rule. 

500

CCA use these portals to look at Claims that have went through our Fraud, Waste and Abuse partner vendor.

What is Optum Case tracker/Optum Insight and Review portals. 

500

A type of therapist that focuses on behavioral issues of individuals who have autism.

What is an Applied Behavior Analysis (ABA) therapist or a Board Certified Behavior Analyst (BCBA)

M
e
n
u