FAQ
Question: How important is it to have a health insurance plan? Answer: It is vital to have health insurance coverage. A health insurance provides insurance coverage against medical costs. When you claim a bill you usually have to pay a deductible and Co-Insurance.
Question: What is a claim? Answer: A request by an individual (or his or her Provider) to the health plan for payment or reimbursement for services obtained from a health care professional.
Question: What is coinsurance? Answer: Coinsurance is the money that an individual is required to pay for service, after a Deductible has been paid. Coinsurance is often specified by a percentage.
Question: What is COBRA? Answer: Cobra (Consolidated Omnibus Budget Reconciliation Act) is federal legislation requiring employers to offer continued health insurance coverage to employees who have had their health insurance coverage terminated.
Question: What is a copay? Answer: The flat fee dollar amount of a charge that a covered person must pay for certain covered services.
Question: What is a covered service? Answer: A covered service is a medical procedure for which the health plan agrees to pay.
Question: What is a deductible? Answer: A deductible is the amount of covered expenses an individual (or family) must pay before benefits become payable by the health plan. It is often determined on a Calendar Year or plan year basis.
Question: What is a calendar year? Answer: The calendar year is from January 1 through December 31 of the same year.
Question: What is an FSA (flexible spending account)? Answer: A flexible spending account is am employee benefit that allows you to have pre-tax dollars withheld from your paycheck to pay for un-reimbursed healthcare, dependent care or transportation/parking expenses. You choose how much money you want to contribute to an FSA at the beginning of each plan year.
Question: What is a high deductible health plan (HDHP)? Answer: An HDHP is a health benefit plan that typically offers lower premiums in exchange for higher annual deductibles when compared to traditional health plans. To be an HAS compatible or “qualified” HDHP, the plan must meet the requirements of the Medicare Prescription Drug, Improvement, and modernization Act of 2003 for minimum deductibles and out-of-pocket maximums. High Deductible plans may offer first-dollar coverage of preventive care and still remain qualified.
Question: What is open enrollment? Answer: Open enrollment is the period of time during which a person is first eligible to enroll under the contract, starting on the date of the person’s initial date of eligibility and ending several weeks later, also used to refer to the annual enrollment period.
Question: What is a plan year? Answer: The plan year is the twelve month period between health plan renewals.
Question: What is a premium? Answer: A premium is the amount paid by the customer on a periodic basis for coverage under the health plan.
Question: What is a waiting period? Answer: The waiting period is the length of time an employee must continuously work for the employer before he is eligible to enroll for coverage under the contract.
Question: What is a health savings account (HSA)? Answer: A health savings account is a tax-favored savings account you can use to pay for healthcare expenses. It is owned by you, is 100% vested, and lets you build up savings for future needs. A requirement for opening an HSA is that it be coupled with a qualified high deductible health plan (HDHP) that covers catastrophic medical expenses after the deductible. Important Note: If you own an HAS and later become ineligible to make deposits, you can still receive distributions from your HSA. All that is limited is your ability to put additional contributions into an HSA.