Page 3 - Benefits Guide TeleSign 2020

Understanding Insurance Terms

Your health insurance plan is important to you and your family. Sometimes some terms may get confusing and get in the way of
your planning. We have listed below a list of commonly used terms .

• Deductible: If your plan includes a deductible, you are required to pay for services out-of-pocket before the insurance carrier
starts paying. You only pay up to the fixed deductible amount before your insurance benefits kick in and you start sharing in
the cost of services.
• Copay: This is the flat dollar amount a covered individual is required to pay for medical expenses, such as office visits or for
prescription drugs.
• Coinsurance: This is the amount you pay to share in the cost of covered services with your plan. Your plan pays a percentage
of the cost, and you pay the remaining percentage. If your plan includes a deductible, coinsurance will kick in after your
deductible has been met.
• Out-of-Pocket Maximum: This is the cap that protects you financially from significant medical claims. All of the money you pay
towards your plan's deductible, copays, and coinsurance is applied to your out-of-pocket maximum. Once the out-of-pocket
maximum has been reached, your plan will pay 100% of the allowed amount for covered health benefits for the rest of the
plan year.
• In-Network: Providers or facilities who have agreed to discounted fees with insurance carriers to participate within their
networks are considered in-network.
• Non-Anthem Providers: Providers or facilities who have not agreed to discounted fees with the carriers are considered out-of-
network. When you seek care from an out-of-network provider, the insurance carrier will pay the claim based on the
maximum allowable amount for a given service or procedure. You will pay your deductible and then coinsurance plus any
charge over the maximum allowable amount. Non-network providers have not agreed to accept certain fees for their services
so they can charge any amount for their services. Please be aware that amounts paid to providers over the maximum
allowable charge do not count towards your annual deductible or out-of-pocket maximum.
• Summary of Benefits and Coverage (SBC): Health insurance issuers and group health plans are required to provide you with a
Summary of Benefits and Coverage (SBC). This guide is designed to help you understand the healthcare options offered to you
by TeleSign. Please refer to the official SBC and carrier contracts each year for additional plan details.

Annual Notices

Various state and federal laws require that employers provide disclosures and annual notices to their plan participants. TeleSign
has posted the following federally-required annual notices and disclosures on UltiPro for you to download and read at your con-
venience.

• Medicare Part D Notice of Creditable Coverage
• Women's Health and Cancer Rights Act (WHCRA)
• Newborns’ and Mothers’ Health Protection Act
• Special Enrollment Rights
• Medicaid & Children’s Health Insurance Program
• HIPAA Notice of Privacy Practices
• Summary of Benefits and Coverage (SBC)

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