Device that enables the health maintenance organization (HMO) to present a premium quotation to the employer that would encourage the employer to replace the current health carrier. The POS offers three options for the delivery of health care:
traditional gatekeeper (GK) option HMO network provides the care and there is a gatekeeper director.
open access (OA) option HMO network provides the care but there is no gatekeeper director. At the time care is required, the member selects the provider.
out-of-network option (OON) care is permitted outside the HMO network and there is no gatekeeper director. At the time care is required, the member selects the provider.
The member has increasing payments under the OA and OON options as compared with the GK option. For example, the GK option may have a $15 physician CO PAYMENT and provide total hospital benefits. The OA option may have a $30 physician co payment with a 10% COINSURANCE requirement. The OON option may provide for a $500 DEDUCTIBLE, an 80/20 coinsurance requirement until the employee's out-of-pocket medical expenses reach $5000, and then the plan would pay all expenses up to a $750,000 lifetime maximum.
Same as term Cargo Insurance: shipper's policies covering one cargo exposure or all cargo exposures by sea on all risks basis. Exclusions include war, nuclear disaster, wear and tear, ...
Subsidence is a term used in geology, engineering and surveying to denote the motion of a surface (usually, the earth\'s surface) downwards relative to a datum such as sea-level. In ...
Rules stating that, under the tax EQUITY AND RESPONSIBILITY ACTS OF 1982 AND 1983 (TEFRA), a plan can not discriminate in favor of key employees regarding contributions and benefits if ...
Coverage on an all risks basis, subject to exclusions of war, wear and tear, loss resulting from delay, loss of market, infidelity of the insured's employee, loss due to rain, sleet, snow, ...
Risk management control device used to minimize accidents and injuries to employees resulting from an unsafe working environment. For example, potential cumulative trauma disorders losses ...
Same as term Blanket Insurance: single policy on the insured's property for (1) two or more different kinds of property in the same location; (2) same kind of property in two or more ...
Element usually found in industrial life insurance policies under which the insurance company upon the death of the insured under certain conditions is allowed to choose the beneficiary if ...
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