Glossary of Terms

Supplemental medical plan that pays indemnity-based benefits to the member based on treatment received for accidental injuries. Can be structured for 24-Hour or Off-Job coverage.

Supplemental medical plan that pays a lump sum benefit to the member if they meet the diagnosis requirements for a covered condition. Covered conditions typically include: Cancer, Heart Attack, Stroke, Major Organ Transplant/Failure, and End Stage Renal Failure.

Supplemental medical plan that pays indemnity-based benefits to the member if they are confined to the hospital for illness or injury. Optional benefits may also be available for outpatient treatment including: surgery, X-ray, diagnostic tests, and more.

Heaped Commissions pay a high 1st year commission, with a lower flat renewal – for instance, a 60% commission in year 1, with a 10% renewal available thereafter. 

Commission structure that pays a level commission amount year after year, typically 10%, 15%, or 20%.

Data exchange standards created by LIMRA, focused on automating the application and enrollment processes for most insurance product lines; thus creating quicker turnaround times and eliminating the potential for mistakes. 

 The concept of Minimum Essential Coverage (MEC) was established by the Patient Protection and Affordable Care Act (ACA) in 2010. The ACA, also known as Obamacare, was a comprehensive healthcare reform law that aimed to improve access to healthcare and make it more affordable for Americans. The MEC provision of the ACA mandates all health insurance plans to offer essential health benefits, ensuring access to basic healthcare services for all Americans regardless of their income or health status.

The act of proactively notifying or processing claims based on data collected internally or through a 3rd party.

When a Member experiences an event that potentially qualifies for a claim payment, and are then automatically notified that they have a potential claim they can file on their Supplemental Health plan once that claim is processed on another line of coverage (Ex. Health Insurance).

When a Member experiences an event that potentially qualifies for a claim payment, and the claim is automatically submitted on their Supplemental Health plan based on data collected on another line of coverage, and the Member receives a notification.

When a Member experiences an event that potentially qualifies for payment, the claim is automatically processed and paid with minimal human intervention from Member or carrier, based on data the carrier has in-house or through a 3rd party.

Typically refers to individual policies (or an individual contract) sold on a payroll deducted basis as an employee benefit. May be used interchangeably with "Voluntary Benefits". 

Insurance policy that pays the member a weekly or monthly payment when they are unable to work due to sickness or injury.  Benefits are subject to an elimination period and benefit period, and members typically need to submit an Attending Physician's Statement showing the diagnosis and anticipated date of return to work to qualify for benefits.  Can be structured as Short Term Disability (can receive up to 1 year of benefit), or Long Term Disability (can receive benefits up to retirement age).

Life insurance policy that features a level premium (does not increase as you age), is portable, and able to be continued into retirement. It takes several forms including: Whole Life, Univeral Life, or Level Premium Term products. They often feature riders that allow you to customize coverage to your unique needs (Ex Chronic Care, Long Term Care, AD&D, Premium Waiver, Spouse or Child Term Life, and more.

Life insurance that features a fixed death benefit, level premium, but does not grow a cash value. Coverage is for a set period of time - 10, 20, 30 years or to a certain age (Ex. 100).

Permanent Life insurance that features a fixed death benefit, flexible premium, and grows a cash value with interest accruing on a tax deferred basis. Coverage is typically purchased for final expenses, for retirement savings, or as a solution for long term care services.

Permanent Life insurance that features a fixed death benefit, level premium, and grows a cash value with interest accruing on a tax deferred basis. Coverage is typically purchased for final expenses, for retirement savings, or as a solution for long term care services. 

Coverage that pays a monthly benefit if you are receiving long term care services. To qualify for coverage, you typically must be receiving care and unable to complete at least (2) Activities of Daily Living (Ex. bathing, dressing, walking, using the toilet, eating, hygiene).

Term used to describe extras available to employees in the workplace. They can range from discount programs, to assistance with childcare, time-off, and more. 

Commonly offered Voluntary Benefits that resolves identity theft issues for you. They typically also have proactive resources to reduce the likelihood of identity theft and include an insurance policy to assist with costs to resolve the identity theft and stolen funds.

Commonly offered Voluntary Benefits that assist you with legal needs including finding a lawyer and paying for services. Offered as an insurance policy or a discount program.  Covered services range from: creating a Will, POA or Trust - to traffic ticket defense - to family law matters, and more.

Employee perk that allows employees to purchase discounted home and auto insurance through their workplace. Premiums can be offered on a payroll deducted or direct pay basis.

Plan that assists members in paying for veterinary treatment for their pets. Coverage is typically subject to a deductible, coinsurance and annual limit. 

Employee perk that assists employees with managing their student loan debt. Services range from assistance with refinancing or consolidating student loan debt, to expert guidance and advice, to managing contributions to student loan debt.