INSURANCE TERMS & DEFINITIONS

Accident Insurance - Accident insurance helps you seek the treatment needed to be on the mend from accidents such as bumps, bruises, burns and breaks.

Copayment - Is a predetermined fee that an individual pays for health care services in addition to what the insurance covers.

Deductible - The amount that an individual must pay for health care services before insurance covers any of the costs. 

Disability Insurance - Can help replace lost income and help ensure finances are not depleted when faced with a period of unexpected sickness or off-the-job injury.

Guaranteed Issue - Means an insurance company must issue an insurance policy to the individual regardless of any health conditions. 

Life Insurance - Provides cash benefits to keep loved ones or businesses afloat if an unexpected death occurs.

 

 

 

 

Premiums - The amount you pay for your health insurance or other benefits every month.

Voluntary Benefits - Benefits offered by the employer or organization that are solely paid for by the employees or members. 

Coinsurance - Refers to money that an individual is required to pay for services after a deductible has been paid.

Critical Illness/Cancer Insurance - Provides financial support if you are diagnosed with a covered critical illness so they can focus on getting better. Ex: Heart attack, stroke, cancer, etc.

Dental / Vision Insurance - Helps to pay for out of pocket costs related to dental or vision services. 

Fully-Funded Plans - Traditional health plans employers offer where the full premium paid to the insurance company can be comprised of 100% employer funds or a split of employer/employee funds.

Hospital Indemnity - Provides cash benefits for hospital confinements, payable directly to the insured party.  

MEC Plan - Minimum Essential Coverage insurance that meet the standards under the Affordable Care Act to provide affordable health insurance that covers the ACA mandated preventive services for adults, including pregnant women, and children. 

Self-Funded Plans - A unique way of funding an employer sponsored health plan by allotting a portion of the premium to administrative costs, to stop-loss insurance and to the claims account where at the end of the year, a portion or all of the remaining premium left in the claims account.