| No. | Item | Definition |
|---|---|---|
| 1. | 401(k) | workplace retirement savings plan |
| 2. | 403(b) | retirement plan for nonprofits |
| 3. | 457(b) | deferred compensation retirement plan |
| 4. | ACA | federal health reform law |
| 5. | adjudication | claim payment decision process |
| 6. | administration | management of benefits programs |
| 7. | amendment | official change to a plan |
| 8. | appeal | request to reconsider denial |
| 9. | audit | formal review of records |
| 10. | beneficiary | person receiving plan proceeds |
| 11. | benefits | employee-provided compensation extras |
| 12. | billing | charging for services |
| 13. | broker | intermediary selling insurance plans |
| 14. | carrier | insurance company |
| 15. | claim | request for payment |
| 16. | COBRA | temporary continuation of coverage |
| 17. | coinsurance | shared percentage of costs |
| 18. | contribution | amount paid toward benefits |
| 19. | copay | fixed amount per service |
| 20. | coverage | what a plan pays for |
| 21. | deductible | amount paid before insurance |
| 22. | denial | refusal of coverage or payment |
| 23. | dependent | covered family member |
| 24. | disability | condition limiting work ability |
| 25. | disclosure | sharing required information |
| 26. | domestic partner | eligible unmarried partner |
| 27. | EAP | employee assistance program |
| 28. | effective date | coverage start date |
| 29. | eligibility | qualification to receive coverage |
| 30. | enrollment | signing up for a plan |
| 31. | EOB | explanation of benefits statement |
| 32. | EPO | exclusive provider network plan |
| 33. | ERISA | federal benefits regulation law |
| 34. | exclusion | service not covered |
| 35. | fiduciary | person acting in others’ interests |
| 36. | FMLA | job-protected unpaid leave law |
| 37. | formulary | covered drug list |
| 38. | FSA | pretax account for expenses |
| 39. | generic | nonbrand prescription drug |
| 40. | grievance | formal complaint about service |
| 41. | HDHP | high-deductible health plan |
| 42. | HIPAA | health privacy and portability law |
| 43. | HMO | managed care network plan |
| 44. | hospitalization | admission to a hospital |
| 45. | HRA | employer-funded reimbursement account |
| 46. | HSA | tax-advantaged medical savings account |
| 47. | ID card | member insurance identification card |
| 48. | in-network | within participating provider group |
| 49. | inpatient | care with hospital stay |
| 50. | insurer | company assuming risk |
| 51. | leave | approved time away from work |
| 52. | limitation | restriction on benefits |
| 53. | long-term disability | extended income replacement benefit |
| 54. | match | employer retirement contribution |
| 55. | maternity | benefits related to childbirth |
| 56. | member | person enrolled in plan |
| 57. | mental health | emotional and psychological care |
| 58. | network | participating doctors and facilities |
| 59. | nondiscrimination | equal treatment under benefits rules |
| 60. | notice | formal written communication |
| 61. | open enrollment | annual plan selection period |
| 62. | out-of-network | outside participating provider group |
| 63. | out-of-pocket | paid directly by member |
| 64. | outpatient | care without overnight stay |
| 65. | pension | employer-funded retirement income |
| 66. | policy | formal insurance contract |
| 67. | POS | plan combining HMO and PPO |
| 68. | PPO | plan with broader network |
| 69. | precertification | advance approval requirement |
| 70. | premium | regular cost for insurance |
| 71. | prior authorization | advance approval for treatment |
| 72. | provider | doctor or healthcare facility |
| 73. | qualifying event | life change allowing enrollment |
| 74. | recertification | renewed proof of eligibility |
| 75. | recordkeeping | maintaining plan information |
| 76. | referral | provider recommendation for specialist |
| 77. | reimbursement | repayment for covered expense |
| 78. | renewal | continuation for another term |
| 79. | rollover | moving retirement funds |
| 80. | short-term disability | temporary income replacement benefit |
| 81. | SPD | summary plan description |
| 82. | specialist | doctor with focused expertise |
| 83. | specialty drug | high-cost complex medication |
| 84. | step therapy | required treatment sequence |
| 85. | subscriber | primary covered person |
| 86. | taxable | subject to tax |
| 87. | telehealth | remote medical care service |
| 88. | termination | ending coverage or employment |
| 89. | tier | level of cost or coverage |
| 90. | trustee | person managing plan assets |
| 91. | underwriting | evaluating insurance risk |
| 92. | urgent care | walk-in immediate medical service |
| 93. | utilization review | assessment of service necessity |
| 94. | vacation | paid leave for rest |
| 95. | vesting | gaining ownership over benefits |
| 96. | waiting period | delay before coverage starts |
| 97. | waiver | formal refusal of coverage |
| 98. | wellness | health improvement program |
| 99. | withholding | money kept from wages |
| 100. | workers’ compensation | job injury benefit system |
