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Insurance Unit
Insurance Unit
23
Finance
10th Grade
04/06/2011

Additional Finance Flashcards

 


 

Cards

Term
Coverage Limit
Definition
The maximum amount an insurance company will pay if you file a claim.
Term
Deductible
Definition
The amount of a loss you must pay out of your own pocket before the insurance company will step in and pay the rest.
Term
Insurance
Definition
A way to guarantee your financial protection against various risks.
Term
Insurance Policy
Definition
A written contract detailing how much you will pay for insurance coverage and what an insurance company will cover and pay in the event of a loss.
Term
Insurance Premium
Definition
The amount you pay for an insurance policy.
Term
Risk
Definition
The probability that injury, damage, or loss will occur.
Term
Risk Management
Definition
The process of dealing with the chance of a potential personal or financial loss.
Term
Accidental Death Benefit
Definition
An additional benefit in case of death as a result of an accident.
Term
Beneficiary
Definition
The individual(s) named in the policy as the recipient(s) of the life insurance payment upon the insured's death.
Term
Cash Value
Definition
The cash available to the owner of a life insurance policy if the policy is surrendered or "cash in".
Term
Coinsurance
Definition
Typically a fixed percentage of the health care costs that the insured has to pay.  Usually applies after the insured meets the deductible.
Term
Copayment
Definition
A flat fee charged for a specified health care service such as $10 for a doctor's visit.  Usually in addition to any coinsurance and deductible payments.
Term
Convertible Term Insurance
Definition
Term insurance that can be converted to a whole life policy without evidence of insurability.
Term
Dividend
Definition
A return of part of the premium by the insurer based on their investment, mortality and expense experience.
Term
Guaranteed Insurability
Definition
An option for the insured to purchase additional insurance in the future without having to show evidence of insurability.
Term
Waiver of Premium
Definition
A provision which will allow the insurance company to keep the insurance in effect without a premium payment.  Typically available in the event of disability.
Term
Premium
Definition
The amount the policy-holder or his sponsor (e.g. an employer) pays to the health plan to purchase health coverage.
Term
Coverage Limit
Definition
Some health insurance policies only pay for health care up to a certain dollar amount. The insured person may be expected to pay any charges in excess of the health plan's maximum payment for a specific service. In addition, some insurance company schemes have annual or lifetime coverage maximums. In these cases, the health plan will stop payment when they reach the benefit maximum, and the policy-holder must pay all remaining costs.
Term
Out-of-Pocket Maximum
Definition
Similar to coverage limits, except that in this case, the insured person's payment obligation ends when they reach the out-of-pocket maximum, and health insurance pays all further covered costs. Out-of-pocket maximums can be limited to a specific benefit category (such as prescription drugs) or can apply to all coverage provided during a specific benefit year.
Term
In-network Provider
Definition
A health care provider on a list of providers preselected by the insurer. The insurer will offer discounted coinsurance or co-payments, or additional benefits, to a plan member to see an in-network provider. Generally, providers in network are providers who have a contract with the insurer to accept rates further discounted from the "usual and customary" charges the insurer pays to out-of-network providers.
Term
Prior Authorization
Definition
A certification or authorization that an insurer provides prior to medical service occurring. Obtaining an authorization means that the insurer is obligated to pay for the service, assuming it matches what was authorized. Many smaller, routine services do not require authorization.
Term
Explanation of Benefits
Definition
A document that may be sent by an insurer to a patient explaining what was covered for a medical service, and how payment amount and patient responsibility amount were determined.
Term
Prescription Drug Plan
Definition
where the patient pays a copayment and the prescription drug insurance part or all of the balance for drugs covered in the formulary of the plan.
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