Garner Terms

Question 1

Accumulator

Answer 1

-Tracking & adding up health expenses incurred by member
-Insurance company use: has member met deductible or OOPM
-Garner use: Has member met HSA minimum), how much of Garner HRA they’ve used

Question 2

Actuarial Value (AV)

Answer 2

-Number between 0 and 100 to tell how generous a health plan is, on average
-Ex: AV of 90 = on avg. plan covers 90% of medical expenses for essentials benefits
-Member might have diff. experience from AV

Question 3

Acquired Member

Answer 3

A member who’s created an account with Garner

Question 4

Adjudication

Answer 4

-Process of determining whether a claim should be approved or denied
-For Insurance company: should a provider’s claim be reimbursed
-For Garner: Should a member’s claims be reimbursed

Question 5

Admin Only “AO”

Answer 5

-1 of 2 billings models for HRA clients
-Clients pay us a PEPM fee to administer our HRA to their employees
-Most self-insured groups have AO