Exam Flashcards
(24 cards)
Healthcare problems in the US
Preventable medical care, high costs, lack of insurance coverage, etc.
Deductible
The amount you pay for covered health care services before your insurance plan starts to pay.
Family Deductible
The maximum amount that a family needs to meet for coinsurance to kick in for everyone in the family.
Coinsurance
The percentage of costs of a covered health care service you pay (20%, for example) after you’ve paid your deductible.
Managed Care
Used to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care.
Cafeteria Plans
An employer-sponsored benefit that lets employees pay certain qualified medical expenses, such as, health insurance premiums for medical, dental, and vision coverage on a pre-tax basis.
Coordination of Benefits
The transmission from any entity to a health plan for the purpose of determining the relative payment responsibilities of a health plan for health care claims or payment information.
Eligibility Period
Conditions that must be met in order for an individual or group to be considered eligible for insurance coverage.
Flexible Spending Accounts
An arrangement through your employer that lets you pay for many out-of-pocket medical expenses with tax-free dollars. Allowed expenses include insurance copayments and deductibles, qualified prescription drugs, insulin, and medical devices.
Health Savings Accounts
A type of savings account that lets you set aside money on a pre-tax basis to pay for qualified medical expenses.
Pre-Existing Conditions
A health problem, like asthma, diabetes, or cancer, you had before the date that new health coverage starts. Insurance companies can’t refuse to cover treatment for your pre-existing condition or charge you more.
Major Medical
A specific type of health insurance plan that will help cover your medical expenses. It often covers preventive care services, urgent care visits, emergency room visits, prescription medications, and other routine medical expenses.
Long Term Care Insurance
Provides coverage for the costs of long-term care associated with the activities of daily living, such as eating, bathing, dressing, and other needs.
Disability Insurance
Replaces a portion of your income when you can’t work.
The Nature of Group Insurance
Provide coverage to a group of members, usually comprised of company employees or members of an organization.
Self Insurance
A type of plan in which an employer takes on most or all of the cost of benefit claims. The insurance company manages the payments, but the employer is the one who pays the claims.
Employee Retirement Income Security Act (ERISA)
Protects retirement savings from mismanagement and abuse, and clarifies that those in charge of those savings be held to a high standard
Pension Benefit Guarantee Corporation
Insures and guarantees private sector workers’ pensions.
Qualified Plans
A retirement plan established by an employer that is designed to provide retirement income to designated employees and their beneficiaries
Defined Benefit Plans
Provide a fixed, pre-established benefit for employees at retirement.
Defined Contribution Plans
A retirement plan in which the employee and/or the employer contribute to the employee’s individual account under the plan.
401K
An employer-sponsored retirement savings plan that offers significant tax benefits while helping you plan for the future. With a 401(k), an employee sets a percentage of their income to be automatically taken out of each paycheck and invested in their account.
403B
A retirement plan for certain employees of public schools, employees of certain Code Section 501(c)(3) tax-exempt organizations and certain ministers. A 403(b) plan allows employees to contribute some of their salary to the plan.
Simplified Employee Pension
Provides business owners with a simplified method to contribute toward their employees’ retirement as well as their own retirement savings.
