ObamaCare Glossary & Terms

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ObamaCare Glossary

These are the definitions, terms, and acronyms associated with ObamaCare.

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A

Accountable Care Organization
A group of health care providers who give coordinated care, chronic disease management, and thereby improve the quality of care patients get. The organization’s payment is tied to achieving health care quality goals and outcomes that result in cost savings.
Actuarial value
Percentage of what your health plan will pay of your expenses up to out-of-pocket limit set by the Affordable Care Act.
Affordable Care Act
The comprehensive health care reform law enacted in March 2010. The law was enacted in two parts: The Patient Protection and Affordable Care Act was signed into law on March 23, 2010 and was amended by the Health Care and Education Reconciliation Act on March 30, 2010. The name “Affordable Care Act” is used to refer to the final, amended version of the law.
Allowed amount
Maximum amount on which payment is based for covered health care services. This may be called “eligible expense,” “payment allowance” or “negotiated rate.” If your provider charges more than the allowed amount, you may have to pay the difference.
Annual Limit
A cap on the benefits your insurance company will pay in a year while you’re enrolled in a particular health insurance plan. These caps are sometimes placed on particular services such as prescriptions or hospitalizations. Annual limits may be placed on the dollar amount of covered services or on the number of visits that will be covered for a particular service. After an annual limit is reached, you must pay all associated health care costs for the rest of the year.

B

Benefits
The health care items or services covered under a health insurance plan. Covered benefits and excluded services are defined in the health insurance plan’s coverage documents. In Medicaid or CHIP, covered benefits and excluded services are defined in state program rules.
Behavioral healthcare
The provision of mental health and chemical dependency (or substance abuse) services.
Brand-name drug
A prescription drug that is marketed and sold under a specific name given by the company that manufactures it and usually costing more than its generic counterpart.

C

Care Coordination
The organization of your treatment across several health care providers. Medical homes and Accountable Care Organizations are two common ways to coordinate care.
Carrier
The insurance company or HMO that is insuring the health plan to an individual, family or organization.
Catastrophic Plan
Currently, some insurers describe these plans as those that only cover certain types of expensive care, like hospitalizations. Other times insurers mean plans that have a high deductible, so that your plan begins to pay only after you’ve first paid up to a certain amount for covered services.
Children’s Health Insurance Program
A state and federal partnership program that works closely with Medicaid. It provides low-cost health insurance coverage for children in families who earn too much income to qualify for Medicaid coverage but can’t afford to purchase private health insurance.
Chronic Disease Management
An integrated care approach to managing illness which includes screenings, check-ups, monitoring and coordinating treatment, and patient education. It can improve your quality of life while reducing your health care costs if you have a chronic disease by preventing or minimizing the effects of a disease.
Claim
An itemized statement of healthcare services and their costs provided by a hospital, physician’s office or other provider facility. Claims are submitted to the insurer or managed care plan by either the plan member or the provider for payment of the costs incurred.
COBRA
(Consolidated Omnibus Budget Reconciliation Act) A Federal law that may allow you to temporarily keep health coverage after your employment ends you lose coverage as a dependent of the covered employee, or another qualifying event. If you elect COBRA coverage, you pay 100% of the premiums, including the share the employer used to pay, plus a small administrative fee.
Co-Insurance
Your share of the costs of a covered health care service, calculated as a percent of the allowed amount for the service.
Conversion
The ability, in some states, to switch your job-based coverage to an individual policy when you lose eligibility for job-based coverage. Family members not covered under a job-based policy may also be able to convert to an individual policy if they lose dependent status (for example, after a divorce).
Co-Payment
A fixed amount you pay for a covered health care service (i.e. Doctor visit). Amount may vary depending on the service.
Cost Sharing
The share of costs covered by your insurance that you pay out of your own pocket. This term generally includes deductibles, coinsurance and copayments, or similar charges, but it doesn’t include premiums, balance billing amounts for non-network providers, or the cost of non-covered services. Cost sharing in Medicaid and CHIP also includes premiums.
Cost-sharing subsidies
For individuals and families with household incomes at or below 250% of the federal poverty level, the ACA limits the amount they have to spend of their own money (“out of pocket”) on their health care, when they enroll in a silver level plan through an exchange. In 2013, 250% of the federal poverty level is approximately $28,725 for an individual and approximately $58,875 for a family of four.

D

Deductible
The amount you owe for health care services before your health insurance plan begins to pay
Dental Health Maintenance Organization
An organization that provides dental services through a network of providers to its members in exchange for some form of prepayment.
Dental Preferred Provider Organization
An organization that provides dental care to its members through a network of dentists who offer discounted fees to the plan members.
Dependent Coverage
Insurance coverage for family members of the policyholder, such as spouses, children, or partners.
Disability
A limit in a range of major life activities. This includes, but not limited to, activities like seeing, hearing, walking and tasks like thinking, working, etc. Because different programs may have different disability standards, please check the program you’re interested in for its disability standards.
Donut Hole, Medicare Prescription Drug
Most plans with Medicare prescription drug coverage (Part D) have a coverage gap (called a “donut hole”). This means that after you and your drug plan have spent a certain amount of money for covered drugs you have to pay all costs out-of-pocket for your prescriptions up to a yearly limit. Once you have spent up to the yearly limit, your coverage gap ends and your drug plan helps pay for covered drugs again.

E

Early Periodic Screening, Diagnostic & Treatment Services
A term used to refer to the comprehensive set of benefits covered for children in Medicaid.
Effective Date
The date requested by an employer for an insurance plan to begin.
Electronic Medical Record
A computerized record of a patient’s clinical, demographic and administrative data. (Also known as a computer-based patient record.)
Emergency Room Services
Evaluation and treatment of an illness, injury, or condition that needs immediate medical attention in an emergency room.
Employer Responsibility
Under the Affordable Care Act starting in 2014, if an employer with at least 50 full-time equivalent employees doesn’t provide affordable health insurance and an employee uses a tax credit to help pay for insurance through an Exchange, the employer must pay a fee to help cover the cost of the tax credits.
Essential Health Benefits
A set of health care service categories that must be covered by certain plans beginning in 2014.
Exchange (Health Insurance Exchange or Marketplace)
A new transparent and competitive insurance marketplace where individuals and small businesses can buy affordable and qualified health benefit plans. Affordable Insurance Exchanges will offer you a choice of health plans that meet certain benefits and cost standards. Starting in 2014, Members of Congress will be getting their health care insurance through Exchanges and you will be able buy your insurance through Exchanges too.
Exclusion
Exclusions are expenses that are not covered under an insurance plan. These will usually be listed in the Certificate Booklet/Policy.
Exclusive Provider Organization Plan
A managed care plan where services are covered only if you go to doctors, specialists, or hospitals in the plan’s network (except in an emergency).
Explanation of Benefits
An insurance carrier’s written response to a claim for benefits.

F

Family and Medical Leave Act
A Federal law that guarantees up to 12 weeks of job protected leave for certain employees when they need to take time off due to serious illness or disability, to have or adopt a child, or to care for another family member. When on leave under FMLA, you can continue coverage under your job-based plan.
Federal Employee Health Benefits Program
A voluntary health insurance program for federal employees, retirees, and their dependents and survivors.
Federally Facilitated Exchange
HHS will establish and operate an Exchange in every state and the District of Columbia
Federally Qualified Health Center
Federally funded nonprofit health centers or clinics that serve medically underserved areas and populations. Federally qualified health centers provide primary care services regardless of your ability to pay. Services are provided on a sliding scale fee based on your ability to pay.
Federal Poverty Level
A measure of income level issued annually by the Department of Health and Human Services
Fee for Service
A method in which doctors and other health care providers are paid for each service performed. Examples of services include tests and office visits.
Flexible Spending Account
Allows members to use pre-tax dollars for certain eligible medical and dependent care expenses. Members fund their FSAs with contributions that come out of their paycheck. (Also known as Flexible Spending Arrangements.)
Formulary
A list of drugs your insurance plan covers. A formulary may include how much you pay for each drug. (If the plan uses “tiers,” the formulary may list which drugs are in which tiers.) Formularies may include both generic drugs and brand-name drugs.

G

Generic Drug
The chemical equivalent of a “brand name drug.” A generic drug provides the same results as its brand-name counterpart but will cost less. It will typically have a lower co-pay as well.
Grandfathered Health Plan
As used in connection with the Affordable Care Act: A group health plan that was created—or an individual health insurance policy that was purchased—on or before March 23, 2010. Grandfathered plans are exempted from many changes required under the Affordable Care Act. Plans or policies may lose their “grandfathered” status if they make certain significant changes that reduce benefits or increase costs to consumers. A health plan must disclose in its plan materials whether it considers itself to be a grandfathered plan and must also advise consumers how to contact the U.S. Department of Labor or the U.S. Department of Health and Human Services with questions. (Note: If you are in a group health plan, the date you joined may not reflect the date the plan was created. New employees and new family members may be added to grandfathered group plans after March 23, 2010).
Group Insurance
A type of insurance contract made with an employer or other entity that covers two or more individuals in that group.
Group Model HMO
An HMO that contracts with a multi-specialty group of physicians who are employees of the group practice. (Also known as a group practice model HMO.)
Guaranteed Coverage
A requirement that health plans must permit you to enroll regardless of health status, age, gender, or other factors that might predict the use of health services. Guaranteed coverage doesn’t limit how much you can be charged if you enroll in most states.
Guaranteed Renewal
A requirement that your health insurance issuer must offer to renew your policy as long as you continue to pay premiums. Except in some states, guaranteed renewal doesn’t limit how much you can be charged if you renew your coverage.

H

U.S. Department of Health and Human Services
Federal agency responsible for implementing the requirements of the ACA
Health Insurance Portability and Accountability Act (HIPAA)
A federal law that outlines the requirements that employer-sponsored group insurance plans, insurance companies, and managed care organizations must satisfy in order to provide health insurance coverage in the individual and group healthcare markets.
Health Maintenance Organization
A health care system that assumes or shares both the financial risks and the delivery risks associated with providing comprehensive medical services to a voluntarily enrolled population in a particular geographic area, usually in return for a fixed, prepaid fee.
Health Reimbursement Arrangements
Accounts that employers can establish for employees to reimburse a portion of their eligible family members’ out-of-pocket medical expenses, such as deductibles, coinsurance and pharmacy expenses.
Health Savings Account
A medical savings account available to those who are enrolled in a High Deductible Health Plan
Health Status
Refers to your medical conditions (both physical and mental health), claims experience, receipt of health care, medical history, genetic information, evidence of insurability, and disability.
High-Cost Excise Tax
Under the Affordable Care Act starting in 2018, a tax on insurance companies that provide high-cost plans. This tax encourages streamlining of health plans to make premiums more affordable.
High Deductible Health Plan
A plan that features higher deductibles than traditional insurance plans. HDHPs can be combined with a health savings account or a health reimbursement arrangement to allow you to pay for qualified out-of-pocket medical expenses on a pre-tax basis.
Home Health Care
Health care services and supplies a doctor decides you may get in your home under a plan of care established by your doctor.
Hospice Care/Service
A set of specialized healthcare services that provide support to terminally ill patients and their families.
Hospitalization
Care in a hospital that requires admission as an inpatient. Hospitalization usually requires an overnight stay.

I

Individual Health Insurance Policy
Policies for people (Individual or Family) that aren’t connected to job-based coverage. Individual health insurance policies are regulated under state law.
Individual Mandate / Responsibility
Under the Affordable Care Act, starting in 2014, you must be enrolled in a health insurance plan that meets basic minimum standards. If you aren’t, you may be required to pay a penalty. You won’t have to pay a penalty if you have very low income and coverage is unaffordable to you, or for other reasons including your religious beliefs. You can also apply for a waiver asking not to pay an assessment if you don’t qualify automatically.
In-Network
A provider or health care facility which is part of a health plan’s network.

J

No terms.

K

No terms.

L

Lifetime Limit
A cap on the total lifetime benefits you may get from your insurance company. An insurance company may impose a total lifetime dollar limit on benefits (like a $1 million lifetime cap) or limits on specific benefits (like a $200,000 lifetime cap on organ transplants or one gastric bypass per lifetime) or a combination of the two. After a lifetime limit is reached, the insurance plan will no longer pay for covered services.
Long-Term Care
Services that include medical and non-medical care provided to people who are unable to perform basic activities of daily living such as dressing or bathing. Long-term supports and services can be provided at home, in the community, in assisted living or in nursing homes. Individuals may need long-term supports and services at any age. Medicare and most health insurance plans don’t pay for long-term care.
Long-Term Disability
A type of insurance which pays employees a percentage of monthly earnings in the event of disability.

M

Medicaid
A joint federal and state program that provides hospital expense and medical expense coverage to the low-income population and certain aged and disabled individuals
Medicare
A federal government program established under Title XVIII of the Social Security Act of 1965 to provide hospital expense and medical expense insurance to elderly and disabled persons.
Medicare Advantage (Medicare Part C)
A type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Medicare Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. If you’re enrolled in a Medicare Advantage Plan, Medicare services are covered through the plan and aren’t paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage.
Medicare Hospital Insurance Tax
A tax under the Federal Insurance Contributions Act (FICA) that is a United States payroll tax imposed by the Federal government on both employees and employers to fund Medicare.
Medicare Part D
A program that helps pay for prescription drugs for people with Medicare who join a plan that includes Medicare prescription drug coverage. There are two ways to get Medicare prescription drug coverage: through a Medicare Prescription Drug Plan or a Medicare Advantage Plan that includes drug coverage. These plans are offered by insurance companies and other private companies approved by Medicare.
Medicare Prescription Drug Donut Hole
Most plans with Medicare prescription drug coverage (Part D) have a coverage gap (called a “donut hole”). This means that after you and your drug plan have spent a certain amount of money for covered drugs you have to pay all costs out-of-pocket for your prescriptions up to a yearly limit. Once you have spent up to the yearly limit, your coverage gap ends and your drug plan helps pay for covered drugs again.
Metallic Plans
Four insurance plan levels (Bronze, Silver, Gold, Platinum) that were developed by ACA requirements. The plans are based on actuarial values
Minimum Essential Coverage
The type of coverage an individual needs to have to meet the individual responsibility requirement under the Affordable Care Act. This includes individual market policies, job-based coverage, Medicare, Medicaid, CHIP, TRICARE and certain other coverage.

N

Navigator
Persons or organizations providing assistance and guidance to consumers about the Insurance Marketplace/Exchange.
Network
A group of doctors, hospitals and other providers contracted to provide services to insured individuals for less than their usual fees. Networks can cover large geographic markets and/or a wide range of health care services. It costs less for an insured individual to use a network provider than using a provider outside the network.

O

Open Enrollment Period
The period of time set up to allow you to choose from available plans, usually once a year. Under the new ACA, open enrollment for consumers through the Insurance Marketplace/Exchange will begin October 1, 2013 for plan year beginning January 1, 2014.
Out-of-Network
A healthcare provider/facility that is not part of a health plan’s network. You will probably pay more for these services than if you used a provider within the network.
Out-of-Pocket Costs
Your expenses for medical care that aren’t reimbursed by insurance. Out-of-pocket costs include deductibles, coinsurance, and copayments for covered services plus all costs for services that aren’t covered.
Out-of-Pocket Limit
The most you pay during a policy period before your insurance plan pays 100% of the allowed amount.
Outpatient Care
Treatment that is provided to a patient who is able to return home after care without an overnight stay in a hospital or other inpatient facility.

P

Patient Protection and Affordable Care Act
See Affordable Care Act
Plan Year
A 12-month period of benefits coverage under a group health plan. This 12-month period may not be the same as the calendar year. To find out when your plan year begins, you can check your plan documents or ask your employer. (Note: For individual health insurance policies this 12-month period is called a “policy year”).
Point-of-Service Plan
A type of plan in which you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network. POS plans also require you to get a referral from your primary care doctor in order to see a specialist.
Policy Year
A 12-month period of benefits coverage under an individual health insurance plan. This 12-month period may not be the same as the calendar year. To find out when your policy year begins, you can check your policy documents or contact your insurer. (Note: In group health plans, this 12-month period is called a “plan year”).
Pre-admission Testing
A utilization management technique that requires plan members who are scheduled for inpatient care to have preliminary tests, such as X-rays and laboratory tests, performed on an outpatient basis prior to admission.
Pre-certification:
A utilization management technique that requires a plan member or the physician in charge of the member’s care to notify the plan, in advance, of plans for a patient to undergo a course of care such as a hospital admission or complex diagnostic test. (Also known as prior authorization.)
Pre-existing Condition:
A condition, disability or illness (physical/mental) that you have before you’re enrolled in a health plan
Preferred Provider Organization
A health plan that contracts with a network of medical providers (doctors, hospitals, pharmacies, etc)
Premium
The amount that must be paid for your health insurance plan on a specified schedule.
Prepaid Care
Healthcare services provided to an HMO member in exchange for a fixed, monthly premium paid in advance of the delivery of medical care.
Prescription Cards
Identification cards issued by a pharmacy benefit management plan to plan members. These cards assist PBMs in processing and tracking pharmaceutical claims. (Also known as drug cards or pharmaceutical cards.)
Prescription Drug Coverage
Health insurance plan that helps pay for prescription drugs and medications.
Prescription Drug
Drugs and medications that require a prescription and are prescribed by healthcare providers.
Preventive Services
Routine health care that includes screenings, check-ups, and patient counseling to prevent illnesses, disease, or other health problems.
Primary Care
General medical care that is provided directly to a patient without referral from another physician. It is focused on preventive care and the treatment of routine injuries and illnesses.
Primary Care Physician
A physician (M.D. – Medical Doctor or D.O. – Doctor of Osteopathic Medicine) who provides or coordinates a range of healthcare services for a patient.
Private Health Insurance Exchange
These private businesses are typically operated by brokers or insurers that sell insurance products to healthcare consumers online. They are designed to help consumers find plans for specific health conditions. They may help you find preferred doctors/hospitals and budget levels. Employers may purchase healthcare insurance plans through a private exchange. Their employees can then choose a health plan from those supplied by participating payers
Provider
This is any person or entity providing health care services, including hospitals, physicians, home health agencies and nursing homes.
Public Health
A field that seeks to improve lives and the health of communities through the prevention and treatment of disease and the promotion of healthy behaviors such as healthy eating and exercise.
Public Health Insurance Exchange
A public health insurance exchange is a marketplace for consumers to compare, purchase and enroll for healthcare coverage. These online marketplaces offer consumers and small employers a wide choice of affordable health plans and are operated by either the state or federal government.

Q

Qualified Health Plan
Beginning in 2014, under the ACA, an insurance plan that is certified by an Exchange that provides essential health benefits. A Qualified Health Plan must include:

Being certified by the state exchange for criteria such as the size of the network, how the plan is marketed, and the how the plan helps improve the member’s health.
Providing a minimum essential health benefits package
Following established limits on cost-sharing (like deductibles, copayments and out of pocket maximums)
Offering at least one silver and one gold plan
Charging the same premium both on and off exchange

R

Referral
A transfer to a specialty physician (i.e., Ear, Nose, & Throat Physician) or specialty care by a primary care physician within a managed care plan
Rider
A modification to a Certificate of Insurance policy regarding clauses and provisions of a policy. A rider usually adds or excludes coverage. This is usually a type of added-on policy that covers additional expenses at an additional cost.
Risk
A term insurance providers use to describe the uncertainty of financial loss that an insurance policy would cover.

S

Short-Term Medical
Temporary health coverage for an individual for a short amount of time, usually 30 days to 6 months.
Skilled Nursing Facility Care
Skilled nursing care and rehabilitation services provided on a continuous, daily basis, in a skilled nursing facility. Examples of skilled nursing facility care include physical therapy or intravenous injections that can only be given by a registered nurse or doctor.
Small Business Health Options Program
A program designed to simplify the process of finding and providing health insurance for small businesses
Small Employer Group
Typically employers with 1 ¬to 99 employees. The definition of small employer group varies between states.
Special Enrollment Period
A time outside of the open enrollment period during which you and your family have a right to sign up for job-based health coverage. Job-based plans must provide a special enrollment period of 30 days following certain life events that involve a change in family status (for example, marriage or birth of a child) or loss of other job-based health coverage.
Specialty Services
Healthcare services that are generally considered outside standard medical-surgical services because of the specialized knowledge required for service delivery and management.
Standard of Care
A diagnostic and treatment process that a clinician should follow for a certain type of patient, illness or clinical circumstance.
State Based Exchange
A new health insurance exchange/marketplace that will be operated by an individual state
State Children’s Health Insurance Program
A program, established by the Balanced Budget Act, designed to provide health assistance to uninsured, low-income children either through separate programs or through expanded eligibility under state Medicaid programs.
Stop-Loss
The dollar amount of claims filed for eligible expenses at which the insurance begins to pay at 100% per insured individual. Stop-loss is reached when an insured individual has paid the deductible and reached the out-of-pocket maximum amount of co-insurance.

T

Tax credits
Individuals and families with household incomes between 133% and 400% of the federal poverty level are eligible for a tax credit (subsidy) when enrolled through an Exchange. In 2013, 400% of the federal poverty level for an individual is approximately $45,000 and approximately $94,000 for a family of four.

U

No terms.

V

No terms.

W

Well-baby and Well-child Visits
Routine doctor visits for comprehensive preventive health services that occur when a baby is young and annual visits until a child reaches age 21. Services include physical exam and measurements, vision and hearing screening, and oral health risk assessments.
Wellness Programs
A program intended to improve and promote health and fitness that’s usually offered through the work place, although insurance plans can offer them directly to their enrollees. The program allows your employer or plan to offer you premium discounts, cash rewards, gym memberships, and other incentives to participate. Some examples of wellness programs include programs to help you stop smoking, diabetes management programs, weight loss programs, and preventative health screenings.
Workers’ Compensation Insurance
Insurance coverage for work-related illness and injury. All states require employers to carry this insurance.

X

No terms.

Y

No terms.

 

Acronyms and Short Terms

Because of the many organizations and terms involved in both the Patient Protection and Affordable Care Act (Pub. L. 111-148) and health insurance industry, we have a list of acronyms and their corresponding terms in alphabetical order below. In no way is this list all inclusive but it will help you in understanding the more common acronyms and terms.

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A

ALJ
Administrative Law Judge
APTC
Advance payments of the premium tax credit
ARF
Allowable rating factor
AV
Actuarial Value

B

No terms.

C

CFR
Code of Federal Regulations
CHIP
Children’s Health Insurance Program
CMP
Civil money penalty
CMS
Centers for Medicare & Medicaid Services

D

DHMO
Dental Health Maintenance Organization
Dental PPO
Dental Preferred Provider Organization
DOI
State Department of Insurance
DOL
U.S. Department of Labor

E

EHB
Essential Health Benefits
EMR
Electronic Medical Record
EOB
Explanation of Benefits
EPO Plan
Exclusive Provider Organization Plan
EPSDT
Early Periodic Screening, Diagnostic & Treatment Services
ERISA
Employee Retirement Income Security Act (29 U.S.C. section 1001, et seq.)

F

FDA
U.S. Food and Drug Administration
FEDVIP
Federal Employees Dental and Vision Insurance Program
FEHBP
Federal Employees Health Benefits Program
FEHB
Federal Employees Health Benefits
FFE
Federally-facilitated Exchange
FFE API
Federally-facilitated Exchange application programming interface
FF-SHOP
Federally-facilitated Small Business Health Options Program
FMLA
Family Medical Leave Act
FPL
Federal Poverty Level
FQHC
Federally Qualified Health Center
FSA
Flexible Spending Account

G

GAAP
Generally-accepted accounting principles
GAAS
Generally accepted auditing standards
GAGAS
Generally accepted governmental auditing standards
GAO
United States Government Accountability Office

H

HEDIS
Healthcare Effectiveness Data and Information Set
HHS
U.S. Department of Health and Human Services
HIOS
Health Insurance Oversight System
HIPAA
Health Insurance Portability and Accountability Act of 1996 (Pub. L. 104-191)
HRA
Health Reimbursement Arrangement
HAS
Health Savings Account
HMO
Health Maintenance Organization

I

IOM
Institute of Medicine
ICR
Information Collection Requirements
IRS
Internal Revenue Service

J

No terms.

K

No terms.

L

LTC
Long-Term Care
LTD
Long-Term Disability

M

MLR
Medical Loss Ratio
MV
Minimum Value

N

NAIC
National Association of Insurance Commissioners
NCQA
National Committee for Quality Assurance

O

OIG
Office of the Inspector General of the U.S. Dept. of Health and Human Services
OMB
Office of Management and Budget
OPM
U.S. Office of Personnel Management

P

PCP
Primary Care Provider
PHS Act
Public Health Service Act
PII
Personally Identifiable Information
PPACA
Patient Protection and Affordable Care Act
PPO
Preferred Provider Organization
PRA
Paperwork Reduction Act

Q

QHP
Qualified Health Plan

R

No terms.

S

SCHIP
State Children’s Health Insurance Program
SHOP
Small Business Health Options Program
SSA
Social Security Administration
SBE
State Based Exchange

T

The Code
Internal Revenue Code of 1986
TIN
Taxpayer Identification Number

U

No terms.

V

No terms.

W

No terms.

X

No terms.

Y

No terms.

Z

No terms.