Page 48 - 2022 Insurity OE Guide FINAL

Glossary

Brand Name Drugs: Drugs sold under a specific name or FSA Grace Period: An extended period of coverage at the
trademark that are protected by a patent. Brand name drugs are end of every FSA plan year, that allows you extra time to incur
generally the most expensive choice. expenses to use your remaining FSA balance after the close of
the plan year. The grace period is 2 ½ months (through March
Coinsurance: The percentage of a covered charge paid by
15th of the following year).
the plan.
Copayment (Copay): A flat dollar amount you pay for medical FSA Run Out: Also referred to as filing limit – the amount of time
or prescription drug services, regardless of the actual amount for an HDHP/HSA member has to submit a claim toward prior
charged by your doctor or health care provider. year funds. Members have until March 31st of the following year
to submit claims for the prior year. This includes requests to use
Deductible: The annual amount you and your family must pay
grace period dollars that carried over.
each year before the plan pays benefits.
Generic Drugs: Generic drugs are less expensive versions of
Embedded and Non-Embedded Deductible
brand name drugs that have the same intended use, dosage,
O Embedded Deductible – Each family member has an effects, risks, safety and strength. The strength and purity of
individual deductible in addition to the overall family generic medications are strictly regulated by the Federal Food
deductible. Meaning if an individual in the family reaches his and Drug Administration.
or her deductible before the family deductible is reached,
Guaranteed Issue: Eligibility member and/or dependent able
his or her services will be paid by the insurance company. to enroll up to a voluntary benefit amount without requiring
O Non-Embedded Deductible – There is no individual
evidence of insurability.
deductible. So the overall family deductible must be
Health Savings Account (HSA): A type of savings account
reached, either by an individual or by the family, in order for
that allows you to set aside money on a pre-tax basis to pay for
the insurance company to pay for services.
qualified medical expenses. HSAs can only be established in
Flexible Spending Account (FSA): An employer sponsored
conjunction with a High Deductible Health Plan (HDHP).
health care benefit that allows employees to set aside monies,
up to the IRS annual allowed amount (on a pre-tax basis) to cover High Deductible Health Plan (HDHP): A plan with a higher
the cost of qualified medical expenses not covered by insurance. deductible than a traditional insurance plan. A High Deductible
Health Plan (HDHP) can be combined with a Health Savings
Account (HSA), allowing you to pay for certain medical expenses
with pre-tax dollars.

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