Glossary of terms:
Additional Health Insurance terms:
Explanation of Benefits (EOB) – Notification that is sent to members for each claim incurred. The EOB explains how the services were covered.
Common Eligibility – A Trust Policy that states a company must have matching enrollment of all enrolled employees/dependents on all lines of coverage offered through the MBA Trust.
Coordination of Benefits (COB) – A provision designed to avoid duplicate payments or payments in excess of charges for benefits covered under more than one individual or group contract.
Portability of Coverage – Washington State law requires health plans to credit waiting periods for pre-existing conditions if the individual was continuously covered by a comparable health plan immediately prior to the effective date under the new health plan.
Pre-existing Condition – In group health insurance, this is a condition for which an individual received medical care during the three months immediately prior to the effective date of coverage.
Employee Assistance Program (EAP) – An employer-sponsored service designed to promote wellness and assist employees and their families in preventing or resolving problems affecting productivity and morale. The EAP also includes limited legal consultation services.
Types of Medical Plans:
Medical Preferred Plans (PPO) – Preferred plans usually cover a percentage of the cost of services once a deductible is met. Members may see any contracted Preferred (PPO) provider. Preferred Plans have a variety of coverage choices such as deductible, copay and coinsurance.
Medical HSA Plans – Health Savings Accounts are a new form of consumer driven health plans designed to assist employers in controlling health care costs. These plans allow employees to pay for certain health expenses with funds from their Health Savings Account.