Dental
The total dollar amount that a plan will pay for dental care incurred by an individual enrollee or family during the benefit year.
What is Annual Maximum
How often a patient can receive a particular type of service
What is Frequency?
This type of life insurance is paid for by the employer and may include coverage for dependents.
What is Basic Life?
This type of insurance covers an employee's monthly income.
What is Long-Term Disability Insurance?
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What is Starbursts?
These types of services usually include oral exams, routine cleanings, x-rays, fluoride treatments and sealants. Typically these services are covered at 100% and are not subject to the annual deductible.
What are Preventive Services?
A routine one of these is typically covered once per member every 12 months and is used to review the health of the patient’s eye as well as determine the need for corrective lenses.
What is an Eye Exam?
The person or persons named on an enrollee’s enrollment form that designates who will receive the life insurance benefit in the event of the death of the enrollee.
What is a Beneficiary?
The percent of salary used to calculate the member’s weekly or monthly disability benefit.
What is Benefit Percentage?
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When a dentist bills a member for amounts above the dental insurance approved or allowed amount. This typically occurs when a non-participating dentist is used.
What is Balance Billing?
A lens with two different ‘segments’ for near vision and far vision.
What is a Bifocal Lens?
A carrier form used to determine the health status of an employee, spouse or child applying for life insurance. Each life insurance carrier has their own unique form to be used.
What is Evidence of Insurability?
This type of insurance covers an employee's monthly income.
What is Short-Term Disability?
Weighing around eight pounds, this is the human body's largest organ.
What is The Skin?
The length of time a member needs to be enrolled before certain procedures or services will be covered by the insurance carrier.
What are Waiting Periods?
Surgical procedure using a laser to correct near or far sightedness.
What is LASIK?
This type of life insurance is an optional policy that employees can purchase to add additional life insurance coverage on themselves, spouse, and dependent children. The cost of this coverage is based on the employee’s age and the amount of insurance they choose.
What is Voluntary Life Insurance?
The period an employee must wait between the actual date of disability and the date benefits begin.
What is Waiting Period?
What is Chicago?
The amount paid for a service in a geographic area based on what providers in the area usually charge for the same or similar service.
What is UC&R (Usual Customary & Reasonable)?
Multifocal lenses whose corrective powers change progressively throughout the lens. Each area is blended invisibly into the next, without the lines that traditional bifocals or trifocals have.
What is a Progressive Lens?
The amount of life insurance that a member can enroll in without the need for proof of good health via an Evidence of Insurability (medical questionnaire) or physical.
What is Guarantee Issue?
Any injury or sickness for which a member received medical treatment, advice or consultation, care or services, including diagnostic measures, or had drugs or medicine prescribed or taken within a specified number of months prior to the date they became covered on the policy.
What is a Pre-Existing Condition?
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