Glossary

• A
• B
• C
• D
• E
• F
• G
• H
• I
• J
• K
• L
• M
• N
• O
• P
• Q
• R
• S
• T
• U
• V
• W
• X
• Y
• Z

A

• Affordable Care Act
• Ambulance services

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B

• Benefit year
• Benefits

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C

• Claim
• Clinical research
• Coinsurance
• Copay
• Cost sharing reduction (CSR)

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D

• Deductible
• Dependent coverage
• Durable medical equipment

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E

• Effective date
• Employer mandate
• Enrollment
• Excluded services
• Expanded bronze plan
• Extra Help

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F

• Flexible Spending Account (FSA)
• Formulary
• Full-time equivalent (FTE)

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G

• Guaranteed issue

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H

• Health care provider
• Health insurance agent
• Health plan categories
• Health Savings Account (HSA)
• HIPAA
• Home health care
• Hospice services

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I

• Individual mandate
• Initial Coverage Election Period (ICEP)
• Inpatient care

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J

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K

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L

• Long-term care
• Low Income Subsidy (LIS)

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M

• Maternity and newborn coverage
• Medical underwriting
• Medically necessary services or supplies
• Mental health services
• Minimum Essential Coverage (MEC)
• Minimum value

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N

• Network

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O

• Open Enrollment Period
• Optional supplemental benefits
• Out-of-pocket costs
• Out-of-pocket maximum

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P

• Pre-existing condition
• Premium
• Preventive services
• Primary care physician
• Private health insurance

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Q

• Qualified Small Employer Health Reimbursement Arrangement (QSEHRA)
• Qualifying life event

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R

• Referral

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S

• Skilled nursing facility care
• Small Business Health Options Program (SHOP)
• Special Enrollment Period (SEP)
• Specialist
• Subsidized coverage
• Summary of Benefits and Coverage (SBC)

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T

• Tiers

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U

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V

• Vision coverage

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W

• Waiting period

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X

• X-ray

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Y

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Z

• Zero cost sharing plan

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