General Terms

Question 1

Amendment

Answer 1

A legal document changing the provisions of the policy that is signed jointly by the insurance company and an authorized representative of the policyholder.

Question 2

Anniversary

Answer 2

The date on which the policy becomes effective and twelve month intervals following the original effective date. May be a time of the year in which several things may happen to a group. Rates may change, age brackets may change, Guaranteed Increase Benefits are effective, or employees may be effective. What happens depends on the coverages and benefits elected by the Group.

Question 3

Application Subscription Agreement

(SubApp)

Answer 3

This is an abbreviate term for the application/subscription agreement. A formal request from a potential client outlining benefits, schedule and rates they are wishing to purchase. An application is used when applying for a true group product where the employer is the master policyholder. If accepted the application is made part of the group’s master policy. A subscription agreement is used when the employer is applying for a trust product. In this case the trust holds the master policy.

Question 4

Bill Method

(Bill type)

Answer 4

The Bill Method is the type of billing a Policyholder has. OneAmerica has several different Bill Methods, and they are: GAIN List Billed, Summary Billed, iBill Home Office Administered, iBill Policyholder Administered – Self Billed, iBill Policyholder Administered – AUL Billed, or Desktop.

Question 5

Branch

Answer 5

The branch is the four numbers that follow the group number of any policyholder number. The reason for branches can be for multiple reasons, primarily due to multiple locations or product lines. All policyholder numbers have a branch included in their number. If the policyholder only has one branch the four numbers will be 0000.

Question 6

Certificate Number

Answer 6

Used to identify an employee attached to a Policyholder on GAIN – typically synonymous with the employee’s Social Security Number.

Question 7

Class

Answer 7

A segment of the group that has been separated according to specific criteria in order to determine amounts of coverage that each segment is eligible for. Classes need to be well defined from one another. Examples of defining elements: occupation, salary, length of service, etc.

Question 8

Closed Class or Plan

Answer 8

This usually means that we grandfathered employees enrolled in the prior carrier under their original plan design. They can keep what they had but if they wish to make changes or if they are a rehire, they must take the AUL plan.

Question 9

Contributory

Answer 9

An employee pays all or some of the premium for the coverages elected by them. It also means that they must request coverage by filling out an Enrollment form.

Question 10

dba

(doing business as)

Answer 10

The operating name of a company, as opposed to the legal name of the company. For example, Old Navy is the operating name for the company with the legal name Gap, Inc.

Question 11

Deduction Amount

Answer 11

The amount of premium charged based on a certain time period. Examples include: weekly, bi-weekly, semi-monthly, or monthly.

Question 12

Employer Contribution

Answer 12

The percentage of premium that will be paid by the employer.

Question 13

Enrollment Form

Answer 13

A form that has to be filled out when requesting coverage for Employee Paid coverages. This form can be used for Employer Paid coverages but isn’t necessary for us to process the request.

Question 14

Grandfathered

Answer 14

There are two types of Grandfathering. The first is when OneAmerica takes another carrier’s plan design and keep all existing enrolled employees in that plan – all new employees would be in our plan design. The other is when we keep existing coverage amounts for employees currently enrolled in the prior carrier’s plan. These employees may be over our Guaranteed issue amount but they won’t need to provide Evidence of Insurability.

Question 15

Home Office

(HO)

Answer 15

The team of associates working in EB’s main location in Indianapolis. This team includes all associates not working in a Regional Group Office (RGO).

Question 16

Initial Enrollment Period

Answer 16

Time period when initial employee’s enrolled for coverage and during which new employees have to enroll for coverage without Evidence of Insurability.

Question 17

Insured

Answer 17

A person covered under a group insurance contract.

Question 18

Non-Contributory

Answer 18

An Employer pays all of the premium for the coverage.

Question 19

Paid-Thru Date

Answer 19

The date through which a policyholder’s premium has been paid.

Question 20

Participating Unit

Answer 20

The term used to describe a Trust Policyholder in their certificate.

Question 21

Plan Type

Answer 21

The 3-digit character that indicates the type of coverage.

Question 22

Policy

Answer 22

An insurance policy, or Contract, is a legal agreement between the Employer (also known as the Policyholder or Group) and the insurance company which outlines what coverage will be extended to eligible employees and under what conditions.

Question 23

Policyholder

(PH)

Answer 23

The employer of the insured with whom OneAmerica has entered into an insurance contract.

Question 24

Policyholder Number

(Group Number)

Answer 24

This is the number used to identify a customer.

Question 25

Premium

Answer 25

The amount paid for insurance coverage for a predetermined period of time.

Question 26

Provision

Answer 26

Insurance contractual provisions bestow certain rights and privileges, and impose duties on the policy owner and the beneficiary.

Question 27

Statement of Insurability

(SOI)

Answer 27

A form that must be completed when Evidence of Insurability (EOI) is required. EOI and SOI are sometimes used interchangeably to describe this form. The form contains questions about a person’s current and previous medical history and health.

Question 28

Subscription Agreement

Answer 28

The name of the document used by a new client to select the benefits they desire for their Trust Product.

Question 29

Summary Billed

Answer 29

A billing type were a Policyholder reports number of lives per coverage, volume, and premium due on a monthly basis.

Question 30

Turnaround Time

(TAT)

Answer 30

The expected time for a process to be complete.

Question 31

Trust Product

Answer 31

Whether or not a product is Trust depends on how each state files the contract. If a product is Trust, we will only issue a certificate for each product and class/plan.