We want to help take the confusion out of
health insurance. Here are important terms
you should know.

Agent
A salesperson licensed to represent insurance companies and negotiate, sell and service products on those companies' behalf.
Benefit
The amount of money that is payable by an insurance company to a claimant, assignee, or beneficiary based on the terms of the health plan.
Claim
A payment request submitted to an insurance company by an individual or provider for services obtained by the individual from a health care professional.
Co-Payment
A predetermined (typically flat) fee paid by an individual for health care services that is over and above what the insurance plan covers. For example, a health plan requires a $10 "co-payment" for each office visit, no matter what services are provided during the visit.
Deductible
The amount of money an individual must pay for health care expenses before the individual's plan starts to cover costs. Insurance plans are typically based on yearly deductible amounts.
Exclusions
Medical or other services that an individual's insurance plan doesn't cover, as specified by the plan's terms and conditions.
Limitations
A specific coverage limit on the amount of benefits paid out for a particular expense based on the terms and conditions of an individual's plan.
Premium
A pre-determined amount an individual or group pays over a period of time (typically monthly) for health insurance coverage. Premiums may be adjusted annually based on a number of factors.
Provider
Health professionals who provide health care services. The term may refer to physicians or health care professionals and organizations – hospitals, nurse practitioners, chiropractors, physical therapists, and others offering specialized health care services.
Rider
A change made to an insurance plan regarding the clauses and provisions of the policy (usually adding or excluding coverage).
Risk
The chance of loss, the degree of probability of loss or the amount of possible loss to the insuring company. May also refer to individual health care probabilities such as the likelihood of surgical complications, side effects from medications, the chance of suffering a medical problem because of a lifestyle or other choice, and other factors.
Underwriter
An insurance company that assumes responsibility for risk, issues, insurance policies, and receives premiums.