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Glossary
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
A
ACA Insurer Tax
Accountable Care Organization (ACO)
Actuarial Value
Administrative Services Only (ASO)
Affordable Care Act
Alternative Funding Arrangements
Appeal
B
Balance Billing
Balanced or Level-Funding
Behavioral Health Services
Benefit Buy-Down
Broker
Bundled Payment
C
Carrier Profitability
Carrier Solvency
Catastrophic Loss
Claim
Co-Insurance
Co-Payment
Consolidated Omnibus Budget Reconciliation Act (COBRA)
Consumer Assessment of Healthcare Providers and Systems (CAHPS)
Consumer-Driven Health Care
Contingent Premium
D
Deductible
Disease Management Programs
Dividend-Eligible Funding
Downside Risk Contract
E
Eligibility
Evidence-Based Guidelines
Excluded Services
Explanation of Benefits (EOB)
F
Fee For Service
Fee For Service
Fee For Service
Financial Ratings Organizations
Fixed Costs
Flexible Spending Account (FSA)
Formulary
Fully-Insured (FI)
H
Health Care Provider
Health Maintenance Organization (HMO)
Health Reimbursement Account (HRA)
Health Savings Account (HSA)
High deductible health plan (HDHP)
I
In-Network
Incurred Claims
Indemnity Plan
Inpatient Care
L
Loss Ratio
M
Medical Case Management
Medical Cost Drivers
Medically Necessary
Member Contribution
Metal Levels
Minimum Essential Coverage (MEC)
Minimum Value Standards
N
National Association of Insurance Commissioners (NAIC)
Network Adequacy
New Hampshire Insurance Department
New Hampshire's Federally Facilitated Health Insurance Marketplace
New Hampshire's State Continuation Law
O
Open Enrollment
Out-of-Network
Out-of-Pocket Costs
Out-of-Pocket Maximum
Outpatient Care
P
Patient Centered Medical Home
Pay-For-Performance
Preauthorization
Preferred Provider Organization (PPO)
Premium
Premium Tax
Premium Tax Credit
Preventive Services
Price Transparency
Primary Care Provider (PCP)
Provider Discounts
Provider Network
Q
Qualifying Life Event
R
Referral
Risk Charge
Risk Contracts
S
Self-Insurance (SI)
Self-insured (SI) Plan
Small Group
Special Enrollment Period
Specialist
State Benefit Mandates
Stop-Loss Attachment Point
Stop-Loss Insurance
Substance Use Disorder
Summary of Benefits and Coverage Document
Summary Plan Description
T
Third Party Administrator (TPA)
Triple Aim
U
Underwriting Gain
Underwriting Loss
Upside Risk Contract
V
Value-Based Payment (VBP)
W
Wellness Services