A plan typically existing in large businesses where the employer personally takes premium payments from employees who use the employer’s group plan, and becomes responsible for paying the claims of employees and dependents. Employers who participate in self-insured plans can hire insurance professionals to complete tasks such as enrollment, claims processing services, and handling provider networks, or they can manage all of the above themselves.
An illness or injury that prevents an individual from being able to work for a limited time period. Health insurance companies have different interpretations for the length of time a short-term disability leave will be, and what health problems qualify for coverage during this time. The purpose of short-term disability coverage is to help the individual financially during the time they are not working.
Short-Term Health Insurance
A temporary policy created for transitional times such as early retirement, recent college graduation, in-between jobs, or just starting a new job. These plans usually last between 30 days an six months, and have a necessary amount of coverage for a short time period. To learn more about short-term health insurance, read this article.
Small Business Health Care Tax Credits
Tax credits (also called subsidies) provided by the government for businesses with under 25 full time employees have an average annual income of less than $50,000. In 2010, the tax credits given were up to 35% of total health care costs, and as of 2014, they will reach 50%. For more information on subsidies, read this article.
Small Employer Group
Typically a business enrolled in a group health plan with 1-50 employees, though in other areas the definition varies and can be up to 99 employees.
Special Enrollment Period
A time period other than the open enrollment period where an individual and their family has the right to sign up for group coverage under an employer. Employers are required to have a special enrollment period of 30 days after the occurrence of qualified events that change a family status, such as marriage or birth of a child, or loss of another employer’s health plan.
Special Health Care Need
Medical and non-medical needs of children with chronic physical, behavioral, developmental, or emotional conditions.
Prescription medications used in the treatment of complicated, chronic illnesses such as cancer, multiple sclerosis, and rheumatoid arthritis. Specialty drugs are expensive and require regulation by a health care professional.
State Mandated Benefits
The benefits that are required by all health insurance companies in a state according to that state’s health insurance laws.
State Continuation Coverage
Similar to COBRA, but for businesses with under 20 employees, where a state is required to offer to continue the same coverage an individual received with the employer’s health plan. In certain states, the state continuation coverage laws also are applicable to larger companies and can be used in addition to COBRA.
Student Health Insurance
An individual health insurance plan for college students that acts similarly to a short-term plan, but for the length of college enrollment. For more information about student health insurance, read the following article.
Also referred to as individual affordability credits, subsidies are given to individuals by the government to help them afford health insurance. This was a part of the Affordable Care Act implemented to ensure that individuals can participate in the individual mandate, requiring everyone to have a health plan. For further information on subsidies, read the following article.
1. HealthInsurance.org, “Health insurance glossary”. http://www.healthinsurance.org/glossary/
2. HealthCare.gov, “Glossary – S”. http://www.healthcare.gov/glossary/s/index.html