Chapter 19 Flashcards
The employer, the government, and the individual each would provide equal contributions to the individual’s economic security
Tripod of economic security
Anything of value received by an employee other than wages
Employee benefits
Federal legislation designed to guarantee certain aspects of pension plans of private employers
ERISA
Straight forward, detailing what employees must do to receive tax benefits
Qualification rules
Using guidelines and formulas, the government tries to ensure that employee benefits do not discriminate in favor of the highly compensated group and against lower-paid workers
Non discrimination rules
When an insurer provides coverage for many people under one master contract
Group insurance
Explanation of the benefits provided
Certificate if participation
This contract provides a death benefit for a specified period, typically one year
Group term life insurance
People participating in this health insurance plan receive treatment from the medical provides who are part of the groups network. They use an unchanging rate for 6mths to a year.
HMO
Point of service plans control costs through the use of a network, but do not restrict coverage to non-network providers. Non-network transactions are subject to deductibles and co-insurance provisions
MCO
They do not provide prepaid benefits, but they bill the employee at prearranged discount prices when service is rendered. Employers use disincentives when people use providers outside of the network
PPOs
Health insurance arrangements that provide employees financial incentives to minimize moral hazard by becoming more actively involved in the decision to consume medical services
Consumer driven health care CDHC
Rules that require employers to allow workers leaving the group, spouses if deceased employers, children who are no longer dependent, and divorced spices go continue group health insurance coverage for up to 36 months after a qualifying event
COBRA
Assures that employees will be permitted to leave their jobs temporarily to tend to urgent family situations, such as the care of a child, spouse, or a parent with a serious health condition, or to care for a personal serious health condition without pay
FMLA
Prohibits employers from excluding newly hired workers from their health insurance plans due to oreexisting conditions
HIPPA
