Page 9 - NYMets_2018_Benefits_Guide
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terms you should know
In the case of family coverage, benefits for any individual
covered family member will not be payable at 100% until
the entire family total maximum out-of-pocket has been decoding benefit acronyms
satisfied. Once the entire family total maximum out-of-pocket
is satisfied, claims will be reimbursed at 100% of the allowance AD&D Accidental Death & Dismemberment
for covered expenses for the family, regardless of whether the EAP Employee Assistance Program
individual deductible, individual out-of-pocket and individual
total maximum out-of-pocket have been satisfied.. EOI Evidence of Insurability
FSA Flexible Spending Account
Primary Care Physician. A health care professional HDHP High Deductible Health Plan
(usually a physician) who is responsible for monitoring and
managing your overall health care needs. Your PCP will refer HSA Health Savings Account
you to more specialized physicians for specialist care, if LTD Long Term Disability
necessary.
PCP Primary Care Physician
While electing a PCP is not required under our plans, it is still
a good idea to have a primary doctor to oversee your care. PPO Preferred Provider Organization
R&C (or UCR) Reasonable & Customary (sometimes
reasonable & Customary (R&C). A term that refers referred to as Usual, Customary & Reasonable)
to commonly charged or prevailing fees for out-of-network
health services within a geographic area. A fee is considered STD Short Term Disability
to be reasonable if it falls within the parameters of the average
or commonly charged fee for that particular service within
your community.
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