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GLOSSARY
- COBRA - Consolidated Omnibus Budget Reconciliation Act of 1986. Terminated employees or those who lose coverage because of reduced work hours may be able to buy group coverage for themselves and their families for limited periods of time.
- Co-Insurance-The amount you must pay for medical care in a point-of service plan (POS) or preferred provider organization (PPO) after you have reached your deductible. It is often a percentage of bills charged.
- Co-payment - A charge you pay for medical services. Your health care plan covers the remaining medical charges. As an example, you may pay $30, 40, or 50 for an office visit co-pay or $30-50 for a perscription co-pay.
- CSR (Customer Service Rep) - This is a non-licensed person who is supporting a licensed agent in the process of service. This usually is in the case where a customer shops online and picks or agents site and then proceeds to enter the site. Then site does all the presales and selling, and helps you make an educated decision about products and finding the price for insurance plans. A CSR will give Customer Service support and assistance in the process on behalf of the Agent.
- Exclusions - Specific conditions or circumstances in which the policy will not offer benefits.
- Deductible - The amount of money you must pay each year for coverage to your medical care expenses, before your insurance policy begins to pay.
- Exclusions - Specific conditions or circumstances in which the policy will not offe benefits.
- Fee-for-Service - Payment agreements for health care in which the provider is paid for each service, rather than a pre-negotiated amount for the patient.
- HIPAA - Health Insurance Portability and Accountability Act of 1996. It is designed to protect health insurance coverage for workers and their families when they change or lose their jobs.
- HMO (Health Maintenance Organization) Prepaid health plans for which a premium is due each month. The HMO covers your cost of care to see a doctor within their working network at pre-negotiated rates. You are required to choose a primary care physician who takes care of you and makes referrals to any specialists you may need. If you, as an HMO member, do not use the doctors, hospitals and clinics that do not participate in your planýs network, you may be required to pay the cost of those medical services.
- IPA (Independent Practice Association) An independent group of physicians who unite with an HMO to offer services for the HMO members.
- Lifetime Maximum- The maximum percentage of benefits available to a member during their lifetime, in which, all benefits served are subject to this limit unless stated as unlimited.
- MSA (Medical Savings Account) A tax-advantaged personal savings account used along with a high deductible health policy. You may deposit money into this account on a pre-tax basis to set aside money for medical care and expenses that qualify, including annual deductibles and co-payments.
- Out-Of-Pocket Maximum The highest amount of money you will pay in a year for deductibles and coinsurance plus regular premiums.
- Point-Of-Service (POS) Plan - A certain managed care plan combing features of health maintenance organizations (HMOs) and preferred provider organizations (PPOs). You may choose whether to go to a network provider and pay a flat dollar amount or to an out-of-network provider and pay a deductible and/or coinsurance charge.
- Pre-existing Condition
A health problem that existed or was treated before your insurance became in effect. Most health insurances have a pre-existing condition plan that describes under what conditions they will cover medical expenses that relate to a pre-existing condition.
- PREMIER AGENT - A Premier Agent is one who has risen above the rest of his or her peers and recieves the honored title. With this comes special service from the PROVIDER. This allows the Premier agent often times to give faster and better service. It is usually only a handful of these agents for the tens of thousands of agents in the industry. This agent usually specialize in his or her field giving them a much greater knowledge for the needs of the client.
- PPO (Preferred Provider Organization) - A network of health care providers that offers medical services to health plan members at a discounted cost. PPO members usually make their own decisions about their health care instead of going through a primary care physician like an HMO member. The costs to use physicians within the PPO network are less than using a non-network provider.
- Premium - The amount you must pay in exchange for health insurance coverage.
- Primary Care Physician - Under a health maintenance organization (HMO) or point-of-service (POS) plan, a primary care physician is often the first contact for health care. It is usually a family physician, internist, or pediatrician. A primary care physician makes referrals to specialists if necessary.
- Provider - Any person (doctor or nurse) or institution (hospital, clinic, or laboratory) which is certified, that provides medical care.
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RAPID PROCESSING
This is a feature that allows customers faster response time.
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Well Baby - Health services, which include immunizations provided by the memberýs participating medical group, up to a certain age as specified by the carrier. This benefit is usually provided in HMO plans and/or POS plans. The level of benefit will vary for PPO plans if specified as a benefit
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Affordable Family Health Insurance Agency
Toll Free: 1-800-596-3299 Local: 210-699-3299 Fax: 210-699-1934
2007-2008 All Rights Reserved. Insurance License # 793531
Affordable Family Health Insurance Agency offers group and individual health care coverage including low cost quote and plan rates for maternity, children, private individuals and the self employed. Established in San Antonio, TX in 1988 with the goal of providing unmatched customer service and being your only choice for health insurance. We offer free rate quotes online for short term, supplemental, temporary, student and small business plans. Licensed Providers of medical and healthcare insurance services in Colorado, Florida, Georgia, Kansas, Michigan, Nevada, Ohio, Indiana, Illinois, Oklahoma, Texas and Virginia.
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Affordable Family Health Insurance Agency
Toll Free: 1-800-596-3299 Local: 210-699-3299 Fax: 210-699-1934
2007-2008 All Rights Reserved. Insurance License # 793531 |
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Affordable Family Health Insurance Agency offers group and individual health care coverage including low cost quote and plan rates for maternity, children, private individuals and the self employed. Established in San Antonio, TX in 1988 with the goal of providing unmatched customer service and being your only choice for health insurance. We offer free rate quotes online for short term, supplemental, temporary, student and small business plans. Licensed Providers of medical and healthcare insurance services in Colorado, Florida, Georgia, Kansas, Michigan, Nevada, Ohio, Indiana, Illinois, Oklahoma, Texas and Virginia.
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