Vocabulary, Terms and Acronyms

Beneficiary (in the context of life insurance) is the person designated to receive the cash value of the policy in case of the covered person's death.  (i.e., "Who do you want to get the money if something happens to you?")

• Primary Beneficiary is the person "first in line" to receive the cash value of the life insurance policy.  As long as the primary beneficiary is alive at the time a claim is approved, the insurance company will cut the check to them.
• Contingent Beneficiary is the person "second in line" to receive the cash value of the policy, the "back up" in case the primary beneficiary is no longer alive at the time a claim is approved.

Co-pay is the fixed dollar amount you pay for a covered service.

Deductible is the amount of covered services that you, on your own behalf or on behalf of your covered dependent, are responsible for paying before benefits become payable under the policy.

Co-insurance is the percentage of charges for a covered service paid by the insurer and the member after the deductible is met.

MPA (Maximum Plan Allowance) is the maximum amount on which the insurer will base its reimbursement to physicians and providers. Members are responsible for charges above the MPA for non-participating providers only. Participating providers have agreed they will not bill members for amounts over the MPA.

AD&D—Accidental Death and Dismemberment

C.O.B.—Coordination of Benefits

COPES—Coordinated Outpatient Education and Intervention Services

EAP—Employee Assistance Program

EBO—Employee Benefits Office

EOB—Explanation of Benefits

JBC—Joint Benefits Committee

LTD—Long-Term Disability

PCP—Primary Care Provider or Physician

PPO—Preferred Provider Organization

QSC - Qualified Status Change (a life event allowing a change to plan elections outside of the Open Enrollment period)

TIP—Traditional Indemnity Plan

UCR—Usual Customary and Reasonable