Page 32 - Enrollment Guide
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Glossary
Annual Deductible—the money paid by you for eligible medical services
(not including copays). This amount must be satisied once each plan year,
and does not apply to your preventive beneits.
Beneit—the portion of the plan that is paid for by EnTrans. For
example, EnTrans pays 80 percent of your healthcare services for in-
network non-preventive care; that 80 percent is your beneit.
Coinsurance—coinsurance is a form of cost sharing, where you (the
member) pay a percentage of the cost of services not paid by the plan.
Copay—the ixed dollar amount you pay at the time of a physician’s
ofice visit or to get a prescription illed in the low deductible plan. A
copay is often due for each ofice visit and prescription.
Dependent—a family member of an employee. For example, a spouse
to whom you are legally married and eligible to ile a federal and/or state
tax return jointly; your children, stepchildren, legally adopted children,
who do not exceed the beneit age limit. It may also include children who
exceed the beneit age limit who are disabled with a mental or physical
handicap.
Dependent Care Flexible Spending Account (DCFSA)—this account
allows participants to allocate pretax dollars to pay for eligible dependent
care expenses such as nursery or child care. See IRS Publication 503 at
www.irs.gov for more information.
Employee Assistance Program (EAP)—a conidential service that
employees and dependents may use to ind support for personal problems
such as emotional health, inancial dificulties, parenting, elder care,
substance abuse, and many others.
Glossary
Annual Deductible—the money paid by you for eligible medical services
(not including copays). This amount must be satisied once each plan year,
and does not apply to your preventive beneits.
Beneit—the portion of the plan that is paid for by EnTrans. For
example, EnTrans pays 80 percent of your healthcare services for in-
network non-preventive care; that 80 percent is your beneit.
Coinsurance—coinsurance is a form of cost sharing, where you (the
member) pay a percentage of the cost of services not paid by the plan.
Copay—the ixed dollar amount you pay at the time of a physician’s
ofice visit or to get a prescription illed in the low deductible plan. A
copay is often due for each ofice visit and prescription.
Dependent—a family member of an employee. For example, a spouse
to whom you are legally married and eligible to ile a federal and/or state
tax return jointly; your children, stepchildren, legally adopted children,
who do not exceed the beneit age limit. It may also include children who
exceed the beneit age limit who are disabled with a mental or physical
handicap.
Dependent Care Flexible Spending Account (DCFSA)—this account
allows participants to allocate pretax dollars to pay for eligible dependent
care expenses such as nursery or child care. See IRS Publication 503 at
www.irs.gov for more information.
Employee Assistance Program (EAP)—a conidential service that
employees and dependents may use to ind support for personal problems
such as emotional health, inancial dificulties, parenting, elder care,
substance abuse, and many others.
