The Affordable Care Act (ACA) mandates guidelines for qualifying events, special enrollment periods, and aims to ensure accessible, continuous health insurance coverage in the United States.
A comprehensive outline of benefit plans, detailing the variety of benefits provided to employees including health insurance, retirement savings, and others.
A percentage of costs that the insured must pay after the deductible has been met. Co-insurance is a fundamental concept in health insurance that distributes healthcare expenses between the insurer and the insured.
A comprehensive overview of co-payment, a type of cost-sharing arrangement in insurance where the policyholder pays a portion of the healthcare costs, with historical context, categories, key events, and detailed explanations.
COBRA is a federal law that allows employees to continue their ESI coverage for a limited period after leaving employment.
Community Rating is a system where insurance premiums are the same for all insured parties within a group, irrespective of individual loss experiences.
A copayment is a specific dollar amount paid for a covered healthcare service at the time of service. It is a fixed amount paid by the insured for specific healthcare services.
A fixed fee paid by the insured for certain services, such as a visit to a therapist, often after the deductible has been met.
An in-depth exploration of Critical Illness Insurance, covering historical context, types, key events, detailed explanations, importance, applicability, and more.
An in-depth exploration of domestic health insurance, its categories, key events, importance, and applicability within a single country.
A comprehensive look at Employer-Sponsored Insurance (ESI), including historical context, types, key events, explanations, models, importance, examples, considerations, related terms, and more.
Detailed explanation of Employer-Sponsored Insurance, types, benefits, examples, historical context, and relevant FAQs.
Health insurance provided by an employer, including historical context, types, key events, detailed explanations, formulas, charts, importance, applicability, examples, considerations, related terms, comparisons, facts, stories, quotes, FAQs, and references.
An in-depth look at the timeframe during which pre-existing conditions are not covered in insurance policies.
An in-depth exploration of Expat Health Insurance, covering its significance, types, key elements, and practical considerations for expatriates seeking comprehensive medical coverage abroad.
Expat Insurance provides specialized insurance coverage for individuals living outside their home country, often including worldwide coverage for health, life, and other insurance needs.
Comprehensive Overview of Group Insurance: Definition, Examples, Applicability, and More
Guaranteed Issue policies must be offered regardless of health status. These policies ensure individuals can secure insurance without being declined based on medical history.
A comprehensive exploration of guaranteed issue insurance, a type of policy that is issued without medical underwriting, guaranteeing coverage but often at higher premium costs.
A comprehensive overview of High-Deductible Health Plans (HDHP), including their historical context, types, key events, mathematical models, importance, examples, and related terms. Essential for understanding HSA eligibility.
Health insurance provides coverage against medical expenses and loss of earnings due to accident or illness. It can be compulsory or voluntary, with premiums varying based on several risk factors.
An essential service assisting individuals in choosing and enrolling in affordable health insurance plans, known as the exchange.
Comprehensive insight into Health Insurance Marketplaces, their historical context, types, key events, detailed explanations, and more.
HIPAA: Legislation ensuring the portability of health insurance coverage and protection against discrimination based on health status.
A former ACA requirement that required all Americans to have health insurance or pay a penalty, which has since been eliminated.
An in-depth look at Insurance Companies, their historical context, types, key events, importance, applicability, examples, and more.
Medicaid Expansion is a provision under the Affordable Care Act (ACA) that allows U.S. states to increase Medicaid eligibility to encompass more low-income individuals, thereby expanding access to healthcare.
An in-depth look at Medicare, a federal health insurance program primarily for individuals aged 65 and older in the United States. Includes historical context, types, key events, detailed explanations, and more.
A comprehensive exploration of Medicare Advantage (Part C), which provides private plan options that combine Parts A (hospital insurance) and B (medical insurance) of Medicare.
Medicare Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care services.
Medicare Part B, a component of the U.S. Medicare system, provides insurance coverage for outpatient services, medical supplies, and preventive services.
A comprehensive overview of Medicare Part C, also known as Medicare Advantage, which allows beneficiaries to receive their Medicare benefits through private health plans.
Comprehensive coverage for prescription drugs under the Medicare program, encompassing eligibility, benefits, and participation.
Understand the differences between Medicare and Medicaid, two key health insurance programs in the United States, including their eligibility criteria, coverage, and funding sources.
A comprehensive guide on the differences between Medicare and Social Security Benefits, covering historical context, types, key events, detailed explanations, and their applicability.
A comprehensive overview of the Patient Protection and Affordable Care Act (ACA), commonly known as Obamacare, its history, features, impact, and ongoing debates.
Open Enrollment is the designated yearly period when employees can enroll in, or make changes to, their health insurance plans. It is a critical time for individuals to review and adjust their health coverage.
A comprehensive look at the Open Enrollment Period, its historical context, significance, and impact on health insurance.
POS (Point of Service) combines features of HMO and PPO health insurance plans, offering flexibility with in-network requirements and subsidized out-of-network care.
A detailed exploration of premium subsidies, including their historical context, types, key events, and applicability in health insurance coverage.
A credit designed to help eligible individuals and families afford health insurance purchased through the Health Insurance Marketplace.
Primary Insurance is the health insurance policy that pays first when an individual is covered by multiple health insurance policies.
Detailed exploration of qualifying events that trigger eligibility for COBRA coverage, including definitions, historical context, types, key events, importance, examples, related terms, and more.
A Qualifying Life Event (QLE) is a change in an employee’s situation that makes them eligible to enroll in or modify their health insurance plan outside the open enrollment period.
Qualifying Life Events (QLEs) are significant life changes like marriage, birth of a child, or job loss that make individuals eligible for a Special Enrollment Period (SEP) to obtain or modify their health insurance coverage outside the standard enrollment windows.
Secondary Insurance is a type of health insurance policy that activates after the primary insurance has paid its share, covering the remaining eligible costs.
A comprehensive overview of Sickness Benefit, a financial aid for workers unable to work due to illness. It includes historical context, types, key events, detailed explanations, charts, importance, applicability, examples, and more.
Special Enrollment allows changes to health insurance plans outside the open enrollment period, triggered by qualifying life events such as marriage, childbirth, or loss of other coverage.
Special Enrollment Periods (SEPs) allow individuals to enroll in health insurance plans outside the open enrollment periods due to certain qualifying life events such as marriage, childbirth, or losing other health coverage.
An in-depth look at state-specific health insurance laws that supplement the federal Uniform Individual Accident and Sickness Policy Provisions Act, providing enhanced consumer protections.
A comprehensive guide to understanding accident and health benefits, their implications for employers and employees, and tax considerations.
An insurance coverage designed to maintain business operations as closely to normal as possible in the event of a loss of a key person, owner, or partner.
An in-depth look at the Consolidated Omnibus Budget Reconciliation Act (COBRA), its provisions, applications, and implications for health coverage continuation.
Comprehensive health insurance offers full coverage for hospital and physician charges, subject to deductibles and coinsurance, combining basic medical expense policies and major medical policies.
An overview of COBRA, a federal legislation that requires group health plans sponsored by employers with 20 or more employees to offer continuation of health coverage to former employees and their dependents.
Consumer-Driven Healthcare encompasses health insurance plans designed to provide protection while promoting cost-conscious decisions in healthcare.
An overview of dependent coverage in life and health insurance policies, including definitions, types, special considerations, examples, and applicability.
Disability Income Insurance is a type of health insurance that provides income payments to insured wage earners when their income is interrupted or terminated due to illness, sickness, or accident. It serves as a financial safety net, ensuring that individuals can maintain their standard of living despite unexpected health setbacks.
Duplication of Benefits in health insurance involves coverage for the same insured loss by two or more policies, where each policy either shares the loss proportionally or establishes a primary and secondary policy dynamic.
An in-depth guide to the Health Insurance Credit: Understanding its role in the Earned Income Credit, eligibility criteria, benefits, and related FAQs.
A detailed definition and explanation of Health Maintenance Organizations (HMOs) as a prepaid group health insurance plan that emphasizes preventive medicine and provides members with access to participating physicians, hospitals, and clinics.
Hospitalization Insurance is a form of health insurance that covers hospital stays and related medical costs, including medicine and physicians' services. Coverage varies depending on specific policies provided by various organizations, often including employer contributions.
A comprehensive exploration of insurability, the circumstances under which an insurance company can issue life or health insurance to an applicant based on the company's standards.
Key Person Insurance provides financial protection to businesses if a key individual suffers from death, disability, sickness, resignation, incarceration, or retirement.
Key Person Life and Health Insurance provides financial protection to businesses against the loss of key employees through death or disability, ensuring business continuity and risk management.
An overview of Loss of Income Insurance, a coverage within property and health insurance that compensates for lost wages due to insured perils or disability.
Medicaid is a health insurance program under Title XIX of the 1965 amendments of the Social Security Act, offering assistance to individuals with low income and limited assets.
A comprehensive overview of medical examinations, often required for life and/or health insurance applicants to determine their eligibility and risk classification.
Comprehensive overview of Medicare, the federal health insurance program for seniors, individuals with permanent kidney failure, and those on Social Security disability benefits.
Medigap is a health insurance policy designed to cover the areas of noncoverage under Medicare, such as deductibles, coinsurance amounts, and various medical services. Learn about its types, benefits, and why it is essential for Medicare beneficiaries.
Partnership Life and Health Insurance offers protection to maintain the value of a business in case of death or disability of a partner. It ensures the transfer of the deceased or disabled partner's interest to the surviving partners according to a predetermined formula.
Sick pay is a taxable income paid to employees during periods of illness or personal injury, provided by employers, welfare funds, state funds, associations, or insurance plans.
Discover the ACA Health Insurance Marketplace, a crucial aspect of the Affordable Care Act (ACA), which provides health insurance plans to individuals, families, and small businesses. Learn how it works, its benefits, and its impact on healthcare access.
A comprehensive overview of the Affordable Care Act (ACA), including its key features, impact on the healthcare system, and recent updates.
Learn about the Consolidated Omnibus Budget Reconciliation Act (COBRA), a federal law that allows employees and their families to continue their health insurance coverage after losing their jobs or experiencing other qualifying events.
Detailed explanation of Form 1095-A, its definition, filing requirements, how to obtain it, and its significance in the healthcare marketplace.
Understand the Hardship Exemption, its purpose, how it works, and the criteria for eligibility. Learn how this exemption relieves individuals from paying the federal fee for not having health insurance.
An in-depth look at health insurance, including its definition, how it works, types, examples, historical context, and its importance.
An in-depth look at Health Maintenance Organizations (HMO), their benefits, drawbacks, and how they operate within the healthcare system.
A comprehensive guide to the four categories of health insurance plans based on average expenses paid by the plan. Learn about the differences, benefits, and considerations for each type.
An in-depth look at High-Deductible Health Plans (HDHP), their definition, coverage benefits, and detailed cost analysis, including pros and cons, types, and practical examples.
Explore the Hospital Insurance Trust Fund, a key component of Medicare Part A, which provides health insurance coverage for individuals 65 and older in the United States. Learn how it works, its significance, and its impact on healthcare.
An in-depth exploration of Medicaid, a government-sponsored insurance program for low-income individuals and families, explaining its mechanisms, eligibility criteria, and special conditions.
An in-depth look at the Medical Cost Ratio (MCR), its significance in health insurance, how it works, and practical examples.
An in-depth exploration of Multiple Employer Welfare Arrangements (MEWAs) including definitions, regulations, benefits, historical context, and related terms.
An in-depth exploration of Other Post-Employment Benefits (OPEB), highlighting their definition, various types, examples, historical context, and frequently asked questions.
Learn about the out-of-pocket maximum, its purpose, how it functions within health insurance plans, and why it's important for managing healthcare expenses.
Explore the comprehensive definition, benefits, and key features of a Preferred Provider Organization (PPO), an arrangement with insurance companies that offers a network of medical professionals and facilities providing services at reduced rates.
A qualifying event allows changes to an existing health insurance policy or sign-up for a new one outside the open enrollment periods. Explore its mechanisms, types, and its role in health insurance management.
The Uniform Individual Accident and Sickness Policy Provisions Act is legislation adopted by all U.S. states that mandates specific provisions for individual health insurance policies to be valid.
An in-depth exploration of Uniform Policy Provisions, which are mandatory and optional clauses required by state laws in health insurance policies.
Comprehensive analysis of Universal Healthcare Coverage, its definition, operational mechanisms, diverse types, and significant considerations.
A comprehensive guide to understanding vision insurance, including coverage options, costs, availability, and the advantages and disadvantages of having a vision insurance plan.
An in-depth look at the Voluntary Employees' Beneficiary Association (VEBA), its structure, benefits offered, historical context, and applicability.
