Page 22 - TruckPro-2022-Benefit Guide-FINAL

Glossary

 Brand preferred drugs – A drug with a patent and  High Deductible Health Plan (HDHP) – A qualified High
trademark name that is considered “preferred” because it Deductible Health Plan (HDHP) is defined by the Internal
is appropriate to use for medical purposes and is usually Revenue Service (IRS) as a plan with a minimum annual
less expensive than other brand-name options. deductible and a maximum out-of-pocket limit. These
 Brand non-preferred drugs – A drug with a patent and minimums and maximums are determined annually and
trademark name. This type of drug is “not preferred” and is are subject to change.
usually more expensive than alternative generic and brand  In-network – A designated list of health care providers
preferred drugs. (doctors, dentists, etc.) with whom the insurance provider
 Calendar Year Maximum – The maximum benefit amount has negotiated special rates. Using in-network providers
paid each year for each family member enrolled in the lowers the cost of services for you and the company.
dental plan.  Inpatient – Services provided to an individual during an
 Coinsurance – The sharing of cost between you and the overnight hospital stay.
plan. For example, 80% coinsurance means the plan covers  Mail Order Pharmacy – Mail order pharmacies generally
80% of the cost of service after a deductible is met. You will provide a 90-day supply of a prescription medication for
be responsible for the remaining 20% of the cost. the same cost as a 60-day supply at a retail pharmacy. Plus,
 Copay – A fixed amount (for example $15) you pay for a mail order pharmacies offer the convenience of shipping
covered health care service, usually when you receive the directly to your door.
service. The amount can vary by the type of covered health  Out-of-network – Providers that are not in the plan’s
care service. network and who have not negotiated discounted rates.
 Deductible – The amount you have to pay for covered The cost of services provided by out-of-network providers
services before your health plan begins to pay. is much higher for you and the company. Higher deductibles
 Elimination Period – The time period between the and coinsurance will apply.
beginning of an injury or illness and receiving benefit  Out-of-pocket maximum – The maximum amount you and
payments from the insurer. your family must pay for eligible expenses each plan year.
 Flexible Spending Accounts (FSA) – FSAs allow you to pay Once your expenses reach the out-of-pocket maximum, the
for eligible health care and dependent care expenses using plan pays benefits at 100% of eligible expenses for the
tax-free dollars. The money in the account is subject to the remainder of the year. Your annual deductible is included
“use it or lose it” rule which means you must spend the in your out-of-pocket maximum.
money in the account before the end of the plan year.  Outpatient – Services provided to an individual at a
 Generic drugs – A drug that offers equivalent uses, doses, hospital facility without an overnight hospital stay.
strength, quality and performance as a brand-name drug,  Primary Care Provider (PCP) – A doctor (generally a family
but is not trademarked. practitioner, internist or pediatrician) who provides
 Health Savings Account (HSA) – An HSA is a personal ongoing medical care. A primary care physician treats a
savings account for those enrolled in a High Deductible wide variety of health-related conditions.
Health Plan (HDHP). You may use your HSA to pay for  Reasonable & Customary Charges (R&C) – Prevailing
qualified medical expenses such as doctor’s office visits, market rates for services provided by health care
hospital care, prescription drugs, dental care and vision professionals within a certain area for certain
care. You can use the money in your HSA to pay for procedures. Reasonable and Customary rates may apply
qualified medical expenses now, or in the future, for your to out-of-network charges.
expenses and those of your spouse/domestic partner and  Specialist – A provider who has specialized training in a
dependents, even if they are not covered by the HDHP. particular branch of medicine (e.g., a surgeon, cardiologist
or neurologist).

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