A law providing that group health plans must offer continued health coverage to employees or to qualified dependents whose health insurance coverage terminated upon the occurrence of certain qualifying events.
Deductible
The initial amount that must be paid by the employee or covered dependent before an insurance plan pays a benefit.
Late Application
The process by which the insurance carrier determines whether it will allow coverage that was not selected during the normal eligibility period.
Major Medical Coverage
Type of coverage that usually pays only a portion of the expense for all covered services (generally involving major illness and injuries) and specifies a deductible that the insured must first pay.
Preferred Provider Organization (PPO)
A network of doctors and hospitals that make an agreement with an insurance company to discount their fees in exchange for an increased volume of patients.
Usual, Customary & Reasonable (UCR)
The fee for providing a health care service which is consistent with the charge in a certain geo-graphical area for identical or similar services.
Waiting Period
The time an employee must wait before benefits for pre-existing conditions are covered by a health plan.
Cobra