ENROLLMENT
SYSTEM ACCESS
RIDERS
TERMINOLOGY
PRODUCTS
100
Any change in in personal circumstances which enables enrollment into an IBC plan outside of the open enrollment period.
LIFE EVENT CHANGE
100
Document Imaging System
AIS WEB
100
Serves as the liason between the dental provider and the member
UCCI
100
What is the employee of a company who subscribes to a health insurance plan?
SUBSCRIBER
100
Select a PCP but can access most health care services in or out of network without a referral
POINT OF SERVICE
200
The subsciber or dependent for whom the appropriate forms or premiun payments have been received by IBC
MEMBER
200
Processes Pharmacy Claims
ARGUS/IPNS
200
TYPES OF RIDERS
VISION, DENTAL AND PRESCRIPTION
200
What is a health insurance company?
INSURER
200
No claims forms when using an in network provider
Preferred Provider Organization
300
A medical service that is removed from the scope of services covered by the basic capitation payment and is reimbursed as a separate payment
CARVE OUT
300
Internet portal for members to access their information
IBXpress
300
What are the two types of riders offered by the HMO product?
BASIC AND PEDIATRIC DENTAL
300
to register the group or member with the health plan
ENROLL
300
Medically Underwritten Plans
KHPE (HMO) PC (PPO)
400
Stand alone plan offering limited prescription,vision and hearing aid coveraage
Blue Extra
400
Provides membership, group,account, provider, authorization, claims and benefit information
SLIQ
400
Two types of vision programs offered by IBC
HMO/POS RIDERS AND FREESTANDING PROGRAM
400
Type of cost- sharing where the covered person pays a flat dollar amount each time a covered service is provided
COPAYMENT
400
Belief that consumers want more control over their health care decsiions and how their health care dollars are spent
Consumer Driven Health Care (CDHP)
500
The applicans have the ability to apply online or submit an application by mail
IBC Medically Underwritten HMO/PPO applicants
500
System capable of supporting other systems simultaneously
TPX/MAINFRAME
500
IBC prescription benefits Pharmacy Benefits Manager
FUTURE SCRIPTS
500
The process of sending a patient from one provider to another for health care services
REFERRAL
500
Covers anyone regardless of health history and are more expensive
Guaranteed Issue Plans
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