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administrative services only (ASO)

A group health self-insurance program for large employers wherein the employer assumes responsibility for all the risk, purchasing only administrative services from the insurer. Such administrative services include such activities as the preparation of an administration manual, communication with employees, determination and payment of benefits, preparation of government reports, preparation of summary plan descriptions, and accounting. Most employers would also purchase stop loss insurance to protect against catastrophic losses.


National Association of Insurance Commissioners (NAIC)

An organization of all state insurance commissioners that meets periodically to discuss insurance industry problems and issues that might require legislation or regulation. It also addresses the need to make the various state laws more uniform for insurance companies and other parties.


Consolidated Omnibus Budget Reconciliation Act (COBRA)

A federal law giving workers and their families who lose their health insurance benefits after leaving a job, the right to continue receiving those benefits. COBRA requires that group health insurance plans sponsored by employers with 20 or more employees in the prior year, offer employees and their families an opportunity for a temporary, 18-month extension of health coverage, when such coverage would normally end. Qualified individuals must pay the entire premium for what would otherwise be paid by the employer, plus a 2 percent administrative fee. Generally, only about 10 percent of workers eligible for COBRA benefits elect them, usually because they are unable to afford the cost, following the loss of a job.


commissioners standard ordinary 1958 mortality table

The mortality table approved by the National Association of Insurance Commissioners (NAIC) as a standard for evaluation and computation of nonforfeiture values for whole life insurance policies.


Exclusive Provider Organization (EPO)

An Exclusive Provider Organization (EPO) is a network of individual medical care providers, or groups of medical care providers, who have entered into written agreements with an insurer to provide health insurance to subscribers. In EPO, medical care providers enter a mutually beneficial relationship with an insurer. The insurer reimburses an insured subscriber only if the medical expenses are derived from the designated network of medical care providers. The established network of medical care providers in turn provide subscribed patients medical services at significantly lower rates than what would have been under normal circumstances. In exchange for reduced rates of medical services, medical care providers get a steady stream of business. An EPO earns additional money by charging an access fee to the insurer for use of the network. It also negotiates with the medical care providers of the organization in order to set fee schedules and help resolve altercations between the insurer and medical care providers. Sometimes EPOs even contract with one another to strengthen their businesses and positions in a certain geographic area. The beneficial relationship between medical care providers and the insurer often rubs off of the insured subscriber because lower rates of medical services means lower rates of increase in monthly premiums. Although a good deal, the downside of EPO is that it can be quite restrictive. As a member of an EPO, you can use the doctors and hospitals within the EPO network, but cannot go outside of the network for care. Suppose you go to a hospital outside of the network in the case of an emergency, you may have to pay you medical bills partially or completely out of the pocket.


Federal Insurance Contribution Act (FICA)

Establishes a payroll tax to assist in the funding of social security benefits.
The Florida Comprehensive Health Association (FCHA) was established by the Florida Legislature in 1982 to provide health insurance coverage to persons who could not get insurance through the commercial market because of pre-existing medical conditions. The Association’s operating costs and losses are covered by annual assessments on health insurance companies that sell individual and small group coverage in Florida.   Because of rapidly rising health care costs, FCHA has been closed to new enrollees since 1991, but continues to serve existing members.


health maintenance organization (HMO)

An organization that offers, provides, or arranges for coverage of designated health services needed by plan members under a prepaid per capita or prepaid aggregate fixed-sum basis. Services are provided through contracts and other arrangements into which the HMO enters with healthcare providers. With limited exceptions, persons enrolled in an HMO must receive healthcare benefits through these contract providers or no insurance benefit is provided.
Minimum premium plan (MPP) – A plan where the employer and the insurer agree that
the employer will be responsible for paying all claims up to an agreed-upon aggregate
level, with the insurer responsible for the excess. The insurer usually is also responsible
for processing claims and administrative services.
National Association of Health Underwriters NAHU is an organization of healt insurance agents that is dedicated to supporting the health insurance industry and to advancing the quality of service provided by insurance professionals
National Association of Insurance and Financial Advisors NAIFA is an organization of life insurance agents that is dedicated to supporting the life insurance industry and to advancing the quality of service provided by insurance professionals
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