Navigating the insurance world can be confusing, so here are some definitions of terms and types of insurance products to help make sense of it all.
A.M. Best: Reports the financial condition (ratings and analysis) of insurance companies.
All-risk property protection: Covers your building and its contents.
Assignment of Benefits: An arrangement by which a patient requests their benefit payment be made directly to a designated person or facility, such as a doctor or hospital.
Balance billing: When subscribers are billed for the difference between what the insurer pays and the fee that the provider charges.
Capitation: Fees paid to providers based on the number of patients they serve on behalf of the benefits plan.
Claims-made coverage: A form of insurance in which coverage is limited to liability only for those claims that arise from incidents or events that both happen and are reported to the insurance company while the policy is in force. As premiums for claims-made insurance reflect ongoing claims experience, they can be readily adjusted up or down as experience changes. When a claims-made policy is terminated, future claims arising from incidents that occurred during the policy period are not covered.
Group insurance: Cancelable, age-banded and a level premium is not guaranteed.
Individual insurance: Non-cancelable and there is a guaranteed level premium.
Involuntary deductible: Imposed by the insurance company due to the adverse risk of characteristics of an insured; does not include a premium deduction.
Long-term care: Therapeutic, rehabilitative maintenance or personal care services, delivered in a setting other than a hospital for people needing assistance with the activities of daily living because of functional or cognitive impairments.
Mutual Insurance Company: Has no formal stockholders or capital stock. All participants share the losses and profits of the business.
Insurance Info
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