A process where health care providers work together to recommend treatment plans and ensure that proper care is given to individuals who are disabled, ill or injured. This term is commonly used when care is provided in a

The ratio of what an insurance company pays in claims to what it collects in premiums.

Care received that requires admittance to a hospital and an overnight stay.

A “

Claims that have been submitted by providers and reimbursed by the health plan plus an estimate of claims that have been incurred but not reported.  The date of service rather than the date of payment determines when the plan “incurs” the obligation to pay the

The facilities, health care providers and suppliers that your health insurance plan has contracted with to provide services.

A health insurance policy with a higher annual

A savings account that allows you to put money into the account tax-free and can only be used to pay for qualified health care expenses.

An employer-funded, tax-free account that reimburses employees for qualified medical care expenses, which are typically combined with a high

An organization that provides and arranges managed care. With an HMO insurance plan, you pick one primary care provider and all health care goes through that doctor.