The amount you pay for the cost of services after you pay any deductibles.

A bill that your

A large magnitude loss that is significantly higher than expected.  

The ability of a carrier to pay its debts and insurance obligations, particularly in the long-term.

The ability of a carrier to produce a return on investment, often measured by profit margin.

A payment structure alternative to traditional fee-for-service arrangements, bundled payments are used to reimburse health care providers based on the expected costs for a clinically-defined episode of care (e.g., open heart surgery, joint replacement surgery).

An independent agent licensed and regulated by the state, which represents the buyer, rather than the insurance company, and tries to find the buyer the best policy by comparison shopping.  A

A measurement of the reduction in benefits paid by a plan when an insurer or employer (for self-insured plans) increases member cost-sharing requirements to reduce the

Behavioral health services Behavioral health services

A health insurance funding mechanism that allows employers with relatively fewer employees (typically 25 to 250) to self-insure.  It has a level monthly payment based upon total projected costs, provides a credit to the employer if claims are lower than expected, and includes stop-loss protection if claims are higher than anticipated.