Annual plan-year maximum
The most benefit in terms of dollar amount that you will receive (the dental insurance company will pay out toward your claims) in the policy year of your policy.
A group of securities that have similar financial characteristics, behave similarly in the marketplace, and are subject to the same laws and regulations.
Typically those types of treatments and procedures that are relatively straightforward in nature and don't involve a significant laboratory expense for the dentist.
A person who derives advantage from a trust, will, or life insurance policy.
Blood pressure is measured in millimeters of mercury (mmHg). High blood pressure, or hypertension, is defined in an adult as a systolic pressure of 140 mmHg or higher and/or a diastolic pressure of 90 mmHg or higher. Normal blood pressure is defined as a systolic pressure of less than 120 mmHg and a diastolic pressure of less than 80 mmHg. High blood pressure can occur in children or adults. People with high cholesterol, diabetes mellitus, gout or kidney disease have hypertension more often. It's particularly prevalent in African Americans, middle-aged and elderly people, and people who are obese, smoke or are heavy drinkers. Why it matters: High blood pressure can strain your heart by making it beat harder to pass the blood through your arteries. High blood pressure directly increases the risk of coronary heart disease, which leads to heart attack and stroke, especially among those with other risk factors. High blood pressure usually has no symptoms. It's truly a "silent killer." But a simple, quick, painless test can detect it. (Source: American Heart Association) Healthy target to earn the bonus credit: <130/90 mmHg
Body Mass Index (BMI)
BMI is calculated from your height and weight and is used to help determine if you are at a healthy weight. In general, a healthy range is between 18.5 and 25, though there are exceptions. For example, very muscular people can have a higher BMI, but still be at an optimal weight and body fat percentage. Why it matters: High BMI is linked to heart disease, stroke, type 2 diabetes and certain types of cancer. Low BMI can indicate you are underweight, which may have its own set of health concerns. (Source: WebMD) You can lower your BMI by exercising daily and eating fewer calories and healthier food. Cutting back on foods high in fat and sugar can also be helpful. Healthy target to earn the bonus credit: <30
The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events.
Your share of a covered health care service, calculated as a percentage of the total allowed amount. For example, the plan may pay 90% of the cost of a service and you would pay the remaining 10%. Coinsurance does not include deductibles or copays.
Copayment (or copay)
A fixed amount you pay when you receive covered health care services. Amounts vary depending on your plan and the type of provider you use or service you receive.
A flat dollar amount you pay each year before the plan begins paying benefits. The deductible varies based on the number of individuals for whom you are providing coverage and generally does not apply for those services subject to a copayment.
Employment development department (EDD)
A California government agency that processes both State Disability Insurance (SDI) and California Paid Family Leave (CPFL) claims. If you apply for SDI benefits and are approved to receive payments, your payment will come directly from the EDD.
Evidence of insurability (EOI)
This is sometimes called “proof of good health” and is used to qualify for certain amounts of life insurance coverage. This process can involve urine and blood tests, along with a physical exam, to be scheduled at your work or at home by a physician.
The line of the fee table in the prospectus that represents the total of all of a mutual fund's annual fund operating expenses, expressed as a percentage of the fund's average net assets.
A blood glucose test measures the amount of a type of sugar, called glucose, in your blood. Glucose comes from carbohydrate foods like fruit, sweets, bread, rice and cereals and is the main source of energy used by the body. Insulin is a hormone that helps your body's cells use the glucose. Why it matters: Millions of people have diabetes and do not know it. Diabetes without proper treatment can cause hypoglycemia, diabetic coma, cardiovascular disease, chronic renal failure or retinal damage. However, with early detection and treatment, the more likely it is that the serious health consequences of diabetes can be prevented or delayed. (Source: U.S. Department of Health & Human Services) Healthy target to earn the bonus credit: <100 mg/dL
To be an employee in “good standing,” you must not be on a performance improvement plan (or written warning), or have been on one within the previous 90 days.
The adding of a value to employee compensation to properly withhold taxes from wages. For example, if you cover a domestic partner who is not a legal spouse as defined by the Internal Revenue Service (IRS) on your health benefits, Intuit must calculate the estimated fair market value (FMV) of those health benefits and credit that amount to you as “imputed income.” This amount is then added as part of your taxable income and removed as an after-tax deduction.
A provider that has contracted with a health plan and agreed to certain rates. In most cases, you pay less and receive a higher benefit when you use in-network providers. Check with your plan—some plans provide no coverage for out-of-network providers, except in case of an emergency.
Typically includes procedures and treatments that are relatively more complex in nature and often involve a dental laboratory expense. These services tend to be more costly than those found in the Basic category.
Treatment for the correction of irregularly aligned teeth, usually involving braces and sometimes oral surgery.
Orthodontia lifetime maximum
The cumulative dollar amount that a plan will pay for dental care incurred by an individual enrollee or family (under a family plan) for the life of the enrollee or the plan.
A provider that has not contracted with a health plan and agreed to certain rates. Some plans provide no coverage for out-of-network providers, except in case of an emergency.
The maximum amount you need to pay toward your health care for the plan year. Once you reach your out-of-pocket maximum, the plan pays at 100 percent for eligible expenses. Depending on the plan you choose, deductibles and copayments may or may not be included in the out-of-pocket maximum.
Measures taken for disease prevention, as opposed to disease treatment.
Qualified family status change
A significant event in your life, like getting married/divorced or having a baby, that allows you to make changes to your benefits plans. In the absence of such an event, you can only make changes to your plans during the annual enrollment period.
A type of retirement savings plan that’s a unique combination of features of the Roth IRA and a traditional 401(k) plan. Under the Roth 401(k), employees may contribute funds on a post-tax elective deferral basis, in addition to, or instead of, pre-tax elective deferrals under their traditional 401(k) plans.
Triglyceride is the most common type of fat in the body. Excess calories, alcohol or sugar in the body are converted into triglyceride and stored in fat cells throughout the body. Many people who have heart disease or diabetes have high triglyceride levels. Normal triglyceride levels are typically less than 150 mg/dL and can vary by age and gender. Why it matters: A high triglyceride level combined with low HDL cholesterol or high LDL cholesterol seems to speed up atherosclerosis (the buildup of fatty deposits in artery walls). Atherosclerosis increases the risk for heart attack and stroke. (Source: Mayo Clinic and American Heart Association) Healthy target to earn the bonus credit: <150 mg/dL
Usual, customary, and reasonable charge (UCR)
The commonly charged or prevailing fees for health care services within a geographic area. A fee is considered to be reasonable if it falls within the parameters of the average or commonly charged fee for the particular service within that specific community. Health plans determine the UCR rates for all services offered and do not pay benefits or charges that exceed the UCR level.