The amount a member will pay before the health insurance or plan begins to pay 100%.
What is Out of Pocket Limit?
100
A configured item where specific valid values from the product machine have been selected.
What is a Plan?
100
These are ‘target’ plans an insurance company wants to sell. These plans are not actually sold to members.
What is a Base Plan?
100
These Plans are created from Base Plans and may be sold to many groups.
What is a Custom Plan?
100
This is considered the single source of truth.
What is the Product Machine?
200
Medical, Pharmacy, Dental and Health and Wellness are all examples of this.
What is Line of Business?
200
Plans in these two statuses may be Reinstated.
What are Discontinued and Terminated?
200
When a plan is copied, both these IDs are set to new values.
What are the Plan ID and Plan Version ID?
200
On the in Benefit Inventories and in the Plan Configurator application, In-Network and Out-of-Network groups are also known as this.
What are Situation Groups?
200
The meaning of the acronym POC.
What is Proof of Concept?
300
Patient Protection & Affordable Care Act (PPACA) is commonly known by this name.
What is Health Care Reform?
300
There are several fields on the Create Plan screen which filter subsequent fields. This field is the primary driver of the rest of the filter.
What is Effective Date?
300
High-level selections that affect coverage on most or all of a plan's benefits.
What are Plan Options?
300
This date of a Market cycle and a Base plan will always be the same.
What is Effective Date?
300
High-level selections that affect specific benefits on a plan.
What are Benefit Options?
400
This tab in PC allows for the primary configuration of deductibles, coinsurance, and OOP amount.
What is the Plan Options Tab?
400
Healthcare Exchanges must offer these four levels of coverage.
What are Bronze, Silver, Gold and Platinum?
400
During configuration of a Plan, the configured Plan Option values are inherited by every benefit on a plan, with one exception. What is the exception?
What is a PM override?
400
In PC, this tab allows a user to configure visit limitations for a specific benefit.
What is the Benefit Overview Tab?
400
There are currently four fields required to create a new Cycle. Which required field is missing from the list:
Effective date
Funding Arrangement
Line of Business