Across
- 2. a doctor, pharmacist, or other qualified person that administers health care services
- 4. a fee that a company may deduct on top of insurance premiums to cover a smoker or other user of tobacco products (client specific)
- 5. money taken from a paycheck to pay for certain benefits
- 7. the insurance company or vendor of a policy
- 8. pertaining to the ability to see, and care relating to the preservation or correction of the ability to see
- 9. an amount the company pays for an employee benefit that is subject to income tax, often for basic life insurance over $50,00 or covering domestic partners on health care.
- 15. A percentage paid to the provider in conjunction with the payment sent by the insurance company. Usually (but not always) needs to meet a deductible first
- 16. a type of insurance plan that will cover a participant at the same level regardless of which provider they go to
- 20. relating to teeth and care related to teeth and gums
- 21. ____ status change, or _____ life event. an occurrence in a covered participant's life that allows a mid-year change in coverage
- 23. a fee that a company may deduct on top of an insurance premium to cover an employee's spouse who is eligible for coverage with their own employer (client specific)
- 26. stands for Preferred Provider Organization, covers a greater amount for in-network providers, and will usually cover out-of-network care at a higher cost. A PCP may be elected, but is usually not required
- 27. the cost for the coverage of an insurance plan
- 28. stands for Primary Care Physician. an in-network provider that serves as a primary health care provider for a covered individual or family
- 29. stands for Consolidated Omnibus Budget Reconciliation Act, which allows a covered employee to continue employer group coverage after they leave the company a 102% cost
- 30. data files sent to the health insurance carrier with enrolled participants' data
- 32. A flat dollar amount paid to the provider for services rendered.
- 34. health care providers that give the most financial benefit based on the insurance carrier
- 35. the yearly window during which employees can elect or change benefit coverages for the following plan year
- 36. the recipient of a benefit paid by insurance
- 37. an amount paid for by the employer or other organization that reduces the participant's cost for a benefit.
Down
- 1. stands for Consumer-Driver Health Plan. A health plan that allows for in and out-of-network benefits. Similar to a High Deductible Health Plan but a little cheaper than and HDHP with higher deductibles. With this plan you are also eligible for an HSA.
- 3. the maximum amount that a covered person or family will pay for health care in a plan year
- 5. a person other than the employee that is covered on the employee's benefits
- 6. _____-___ a stand-alone benefit plan that is separate from a customer's medical plan, but included in the premium
- 10. (abbr) A type of savings account used for health care expenses - entire amount of unused funds oll over each year and are usable after an employee leaves the company. Requires a high deductible health plan
- 11. The amount a covered individual or family must pay for health care before the insurance will pay their share
- 12. an alight web-based tool you can use to find information about the benefits and policies a client offers.
- 13. (abbr) A type of spending account that allows a participant to put pre-tax funds aside to pay for dependent day care expenses.
- 14. a benefit that pays an amount to a beneficiary after the insured person passes away
- 17. The most your dental carrier will pay towards your dental expenses in a plan year.
- 18. benefits such as critical illness, identity theft protection, group legal, and pet insurance. varies by client
- 19. Stands for Health Maintenance Organization. A type of insurance that limits the providers to those in-network only. Participants MUST choose a PCP
- 22. stands for Exclusive Provider Organization. A health plan that works similar to an HMO where there are no out-of-network benefits. PCP is required sometimes, however, no referrals needed
- 24. A type of health care or wellness funds account that is funded only by the employer. Certain terms do apply in order to be eligible.
- 25. a branch of dentistry that deals with treatment and correction of irregularities in teeth
- 31. the tool a Customer Service Representative will use to create a research or process ticket request
- 33. (abbr) A type of spending account that allows a participant to put pre-tax funds aside for health care expenses - usually frontloaded, it is possible for unused funds to expire each year (amount is client specific). Does not require a high deductible health plan