Member Benefits/Insurance

Question 1

You will often see U&C or UC when looking at member benefit pages.

Answer 1

Usual & Customary. In other words, what would be the full retail price for that item for someone without insurance. You cannot have different mark-ups for insurance customers and cash paying customers.

Question 2

The employer and/or employees actually contribute (fund) money to the plan. These plans will show a dollar amount towards materials and/or services. ‘ ‘ are the “good plans.”

Answer 2

Funded Plan

Question 3

WFA35

Answer 3

Customer Wholesale Frame Allowance. If the frame they chose wholesales for that amount or less, then the frame is covered in full by their insurance plan, REGARDLESS OF THE RETAIL COST. The retail amount has no impact on this calculation.

Question 4

The insurance company has negotiated with providers to offer materials and/or services at a discount. This may be 10%, 20%, 30% etc. These plans vary and the patient usually ends up paying more out of pocket than if they have a funded plan.

Answer 4

Discount Plans

Question 5

IOF

Answer 5

In Office Finishing

Question 6

EOB

Answer 6

Explanation Of Benefits

Question 7

PCP

Answer 7

Primary care physician

Question 8

POP

Answer 8

point of purchase, to be updated regularly

Question 9

AR

Answer 9

Anti-Reflective