Glossary

The most a plan (e.g., Dental) will pay for allowable charges for each covered person throughout the plan year.

“Basic services” are dental procedures such as simple extractions, fillings, periapical X-rays, and periodontics.

A “beneficiary” is any person, trust, or organization you designate to receive your benefit if you die. For certain benefits, like 401(k), if you’re married, your spouse is your beneficiary unless you designate a non-spousal beneficiary with your spouse’s notarized written consent.

“Catch-up contributions” are additional contributions to the Savings Plan that employees age 50 or older are allowed to make to their account so that retirement savings catch up with retirement needs. Catch-up contributions are deducted from your paycheck before federal, state, and local (if applicable) income taxes have been deducted.

Your share of the costs of a covered health care service. You pay coinsurance plus any deductibles you owe. The health insurance or plan pays the rest of the allowed amount once the deductible is met.

A Consumer-Directed Health Plan (CDHP) covers 100% of preventive care, and requires you to pay 100% of all non-preventive care and prescription costs up to the deductible. After reaching the deductible, you pay and the plan pays until you reach your out-of-pocket maximum. Once you hit your out-of-pocket maximum, the plan pays for all additional care through the end of the plan year.

A fixed amount you pay for a covered medical, dental, or vision care service, usually when you receive the service. The amount can vary by the type of covered health care service.

The amount you owe for health care services covered by your health insurance or plan before your health insurance or plan begins to pay. The deductible may not apply to all services.

“Evidence of insurability” means a statement of your or your dependent’s medical history—that is, proof of good health—which the insurance company or plan administrator will use to determine whether your application for coverage will be approved. If EOI is required, the plan administrator will reach out to you.

Through the federal Family and Medical Leave Act (FMLA), you may be eligible to take up to 12 weeks of unpaid leave. Qualifying situations include:

• Your own serious health condition that makes you unable to perform the functions of your job (runs concurrently with short-term disability (STD) or approved leave).
• A serious health condition of your child, spouse, or parent that requires you to care for that family member.
• The birth of a child that requires you to take time off to care for the child (six or eight weeks depending on natural or Cesarean childbirth; will run concurrently with STD).
• The placement of a child with you for adoption or foster care.
• Covered military family leave.

A Health Maintenance Organization (HMO) provides coverage for in-network care only, which is coordinated by your primary care physician (PCP). You and your covered dependents must each select a PCP. With an HMO, your PCP must provide a referral in order for you to see a specialist.

A “lump-sum payment” is a one-time cash payment.

A “network provider” is a licensed doctor, nurse, therapist, hospital, lab, or other health care facility, as well as a licensed mental health and chemical dependency provider, such as a licensed psychiatrist or psychologist, who:

• Was selected by the claims administrator;
• Participates in the claims administrator’s network; and
• Agrees to accept discounted payments for services provided.

A “non-network provider” is classified as a licensed doctor, nurse, therapist, hospital, lab, or other health care facility, as well as a licensed mental health and chemical dependency provider such as a licensed psychiatrist or psychologist, who doesn’t participate in the network. When you use a provider who doesn’t participate in the network, you receive a lower level of benefit and your out-of-pocket expenses are higher.

The most you pay during a policy period (usually a year) before your health insurance or plan begins to pay 100% of the allowed amount. This limit never includes your premium, balance-billed charges, or health care your health insurance or plan doesn’t cover.

A “PPO” is a group of health care professionals and/or hospitals, labs, and other health care facilities that contract with an employer or insurance company to provide medical care to a specified group of patients at discounted rates.

“Rollover contributions” occur when you transfer funds to the Savings Plan from a former employer’s tax-qualified plan or from an individual retirement account (IRA) consisting only of funds from a former employer’s tax-qualified plan.