Plan
Basics
Basics
Preferred Provider Organization
PPO acronym
Affordable Care Act (ACA)
What federal law requires employers with 50+ employees to offer affordable coverage?
HMO
Which plan type usually requires a referral to see a specialist?
What does ERISA stand for?
Employee Retirement Income Security Act
Self-funded
What funding model involves the employer paying claims directly?
Deductible
What is the amount a member pays before insurance starts covering costs?
HIPAA
Which act protects employees from losing coverage due to pre-existing conditions?
Defined contribution
What is the term for a fixed monthly employer contribution model?
Coinsurance
What term describes the percentage the member pays after meeting the deductible?
Form 1095-C
What IRS form reports employer-provided health coverage?
ICHRA
What strategy allows employers to reimburse employees for individual plans tax-free?
Out-of-pocket maximum
What is the maximum amount a member pays in a year for covered services?
COBRA
What law governs continuation of coverage after job loss?
PEO or Association Health Plan
What model pools multiple small employers into one large plan?