Insurance Vocabulary
The amount of money you pay out of pocket for covered medical care before your health plan starts to pay.
What is a deductible?
Which plan design do individuals choose a primary care physician (PCP) who then acts as a gatekeeper for all healthcare services. (In Network Only)
What is an HMO? (Health Maintenence Organization)
After pay, what is the number two reason that employees switch jobs?
What is Benefits?
What are supplemental benefits in the context of employee benefits?
What is additional insurance to enhance their core benefits package?
A federal law that was passed in 1996 to protect sensitive health information
What is HIPAA? (Health Insurance Portability and Accountability Act)
The highest amount of money a person or family pays for covered health care services in a calendar year
What is your Out of pocket maximum?
What plan design allows individuals to see both in-network and out-of-network providers with no referals needed.
What is a PPO? (Preffered Provider Organization)
What are the two types of health plan funding for benefits programs?
What is Fully Insured and Self-Funded?
Aside from Medical Insurance what is the most common supplementary benefit offered to employees?
What is Dental insurance?
A federal law that allows certain employees and their families to temporarily continue their group health insurance after a qualifying event
What is COBRA?
A fixed amount for a covered service, paid by a patient to the provider of service before receiving the service
What is a Co-Pay?
What type of health plan requires you to stay in network but allows for out of network care only in emergencies or special circumstances?
What is an EPO?
How many employees qualifies a group as an Applicably Large Employer (ALE).
What is 50?
What are the advantages of offering supplemental benefits to employees?
What is to help employees fill gaps in coverage and provide additional financial security along with peace of mind?
This is the maximum age that a dependent can be to remain on your insurance.
What is 26?
A personal savings account that allows participants to pay for medical expenses with pre-tax dollars.
What is an HSA?
What plan type offers lower premiums in exchange for higher out-of-pocket costs such as a higher deductible?
What is an HDHP?
With most typical medical plans what is the limit of dependents an employee can have on their major medical plan?
What is no limit?
What are the most common types of supplemental benefits commonly offered to employees? (Name 3)
What is Dental, Vision, Life Insurance, Disability Insurance, Accident Insurance, Critical Illness Insurance and Hospital indemnity Insurance?
This allows for changes to your benefit elections outside of open enrollment.
What is a qualifying life event?
The percentage of costs you agree to pay each benefit year after meeting your plan's deductible.
What is Co-Insurance?
What type of Medical Plan is a combination of an HMO and PPO? Offering lower costs for using in-network providers, but you may need to pay more for out-of-network care.
What is a POS? (Point of service)
What is a way that employers can limit the risk that a self-funded plan can pose for them?
What is Stop Loss Coverage?
How do employees typical pay for supplemental benefits?
What is through payroll deductions?
A law that provides eligible employees with up to 12 weeks of unpaid, job-protected leave per year for certain reasons
What is the Family and Medical Leave Act?(FMLA)