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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

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