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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

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
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

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New Hampshire Insurance Department
21 South Fruit St, Suite 14
Concord, NH 03301
(603) 271-2261 or 1-800-852-3416

This website was developed by the New Hampshire Insurance Department and the University of New Hampshire Mobile Development team and is maintained by the Department in cooperation with Human Services Research Institute.

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