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A - B - C - D - E - F - G - H - I - J - K - L - M N - O - P - Q - R - S - T - U - V - W - X - Y - Z Additional Insured One who qualifies as "insured" under the terms of a policy even though not named as insured. Officers of a corporation may be included as insureds under the terms of a policy written in the name of the corporation. Agency An insurance company that produces business through an agency network. Applicant Individual that is applying for insurance. Application Fee A charge for the processing of an application. Approved Acceptance of an application for an insurance policy as meeting the underwriting standards of the company. Benefits The money or services that is provided by an insurance policy Billing A bill for the purchase of an insurance policy. Usually the premium due. Brochure A informational guide to the insurance carrier's guidelines of plans and exclusions. Cancer A malignant new growth anywhere in or on the body of a person. Carriers Another term for insurer, or the insurance company that "carries" the risk for the policy owners. Claims A policy owner's request on the insurance company for payment of benefits according to the provisions of a policy. Co-Insurance The percentage of a charge for services that you may have to pay after you pay any plan deductibles. The coinsurance payment is a percentage of the cost of the service . Condition A provision in a contract that has the effect of modifying, suspending, or revoking the principal obligation if a future event happens or fails to happen. " Co-Payment The amount you pay for each medical service, like a doctor visit. A co-payment is usually a set amount you pay for a service. Couple Two people that are married, and are seeking insurance as a pair. Coverage The guarantee against specific losses provided under the terms of an insurance policy. The amount and extent of the insurance provided under an insurance contract. " Crown An enamel cover put on the tooth to protect below the gum line. Death Benefit Policy proceeds to be paid upon the death of the insured. The sum payable as the result of the death of the insured. Declined Rejection of an application for insurance by the insurer or carrier. Deductible The amount you must pay for health care before the plan begins to pay. Dependent A covered person who relies on another person for support or obtains health coverage through a spouse (in CA domestic partner) or parent who is the covered person under a plan. Disability A physical or mental impairment caused by accident or illness that partially or totally limits one's ability to perform everyday activities. Disability Income A disability benefit provided by a specific health insurance contract that pays a regular monthly income if the insured is disabled by sickness or accident. Download Application An application usually available online, that is downloaded from the internet to your computer. The application is usually in what is called a PDF form or adobe acrobat type of file that can only be uploaded in adobe acrobat. Effective Date The date insurance coverage begins. Employee An individual who works for a person or organization having the right to direct and control that individual in the way he or she works, both as to the final results and as to details of when, where and how the work is to be done. It may also be a self-employed person, an owner-employee or a common law employee. " Enrollee A person who is enrolled in an insurance plan. Enrollment Fee A fee or payment for the process of becoming enrolled. Estimates An approximate calculation, close to the exact amount. Exams A medical evaluation of a person. Exclusions A provision in an insurance policy excluding certain risks or otherwise limiting the scope of coverage. Certain causes and conditions, listed in the policy that are not covered. Extraction The pulling of the tooth to be extracted. Family Usually, a male and female couple with one or more children (CA includes domestic partner). Fees A payment for services or the amount of the premium. Fillings The protective filling in a cavity. Group In insurance it is a company or organization that the employees are covered by the employer. Health  The state which your body is in. i.e. good health, poor health. HMO Health maintenance organization- A group of doctors, hospitals, and other health care providers who agree to give health care to beneficiaries for a set amount of money every month. In an HMO, you usually must get all your care from the providers that are part of the plan. Individual  A single person applying for insurance Insurance Protection through specified money compensation or reimbursement for loss, provided by written contract against the happening of specified chance or unexpected events. Insured A person who has obtained health insurance coverage under a health insurance plan. International Outside of the United States. Licenses Certification issued by the appropriate state department of insurance policies, that an individual is qualified to sell insurance for the period stated and renewable upon application without the necessity of the applicant's undergoing the original requirements. Life Insurance The transfer of part of the financial loss due to death of an insured person to an insurance company. The risk insured against is the death of a particular person, the insurance company agrees to pay a stated sum or income to the beneficiary. Limitations Exceptions to coverage and limitations of coverage as contained in an insurance contract. Long Term Insurance policies that cover specified services for a specified period of time. Long-term care policies (and their prices) vary significantly. Max Benefit The maximum or most you can receive in services provided by an insurance company. Medical History Any medical problems or conditions from the past to the present. Member An individual that is insured through an insurance provider. Non Smoker A person who does not smoke. Orthodontics A branch of dentistry that corrects and prevents irregularities in teeth. Out-of-Pocket Maximum The most a member will be required to pay out-of-pocket in a benefit year, coinsurance and deductibles. Out-of-Pocket Cost Health care costs that a patient or member must pay for out of his or her own pocket, including co-payments, coinsurance, deductibles, etc. Pending In insurance it is usually when an application is being processed, and the information is being determined acceptable or not. Plan Details The details of a particular plan through a provider of insurance that includes rates, premiums, deductibles, coinsurance, etc. Policy The written contract or agreement between the insurance company and the policy owner. PPO Preferred Provider Organization-a health care arrangement which offers insured's access to participating providers at reduced costs. PPOs provide insured's lower deductibles and co-payments, to use providers in the network. Network providers agree to negotiated fees in exchange for their preferred provider status. Pre-Enrollment Prior to enrolling, usually the screening of the application before it approved or declined. Pre-existing conditions Any illness or health problem that existed prior to an individual obtaining medical coverage. Premium The periodic  payment required to keep a specific insurance policy in force. It is the rate multiplied by the number of units of insurance purchased. Quote An estimated price for the insurance being purchased. Rates The cost of a given unit of insurance. Representative or Agent This person helps in the placing of risks, delivery of policies, or collection of premiums on behalf of an insurance company. Risk Class The class or group level of risks, or the individual. Search Engine The engine used to search for information. i.e. Google, Yahoo, AOL, Netscape, etc. Short Term An insurance contract in effect for less than one year. Single One, or individual. Not married or with children. Single Parent One parent with one or more children. Smoker A person who uses tobacco. Spouse The partner in marriage (includes domestic partner in CA). Submitting Applications for coverage submitted to the insurance company but not yet acted upon. Subscriber A policy owner of a health plan that is underwritten by a service insurance carrier. Teeth Cleaning Cleaning of the teeth by a dentist. Sometimes a benefit covered by insurance. Temporary Not permanent. Also can be short-term insurance. Term Life Life insurance issued for a specific number of years. Two Party A couple or pair applying for insurance. Underwriting The agency above the broker who provides the quote and accepts the application; the act of reviewing and evaluating prospective insureds for risk assessment and appropriate premium. Workers Compensation Life and health coverage for employees while they are on the job. Premiums are paid by the employer. X-ray A photograph made by means of x-rays.

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