Beneficiary – Person or Persons who will receive money from your life insurance policy when you die. Make sure that you keep this current. If you divorce and remarry, make sure you change your beneficiary! Try not to leave your money to minor children as it will not be given to them until they are 18. Leave it in trust to someone you know will take care of the children.

Coinsurance – A percentage of health care costs that your benefit plan does not cover and you have to pay (excluding your deductible). Your coinsurance is 80% until you have paid $2,400 an individual or $7,200 per family in-network. $2,400 an individual or $7,200 per family in-network. Your coinsurance for out-of-network is 50% with no limit.

Deductible – the amount of money you are required to pay first before your benefit plan starts paying excepts for office visits.

Co-payment – A set dollar amount of money you must pay for a doctor visit, out patient surgery, ER visit or hospital admission.

Out-of-pocket maximums – The plan will set a total amount you are required to pay for health care costs in one year, at which point your plan will pay 100% of eligible costs. This is for in-network costs only.
In-network – Any health care provider, group of providers, hospital, lab or facility that is part of a preferred provider organization or PPO. These are contracted to provide discounts for their services. By using these providers you receive lower costs for your benefits.

Out- of-network – Any health care provider, group of providers, hospital, lab or facility that is not part of a preferred provider organization or PPO. These providers do not provide discounts. You will receive lower benefits and are responsible for costs that are over reasonable and customary.

Generic – Any drug that is exactly the same chemically as a brand name drug, usually lower in cost.

Preventive care benefit (In-network) – A benefit that allows you to have a physical once a year at 100% payment with no deductible after a $20 co-pay up to $450. Stress tests and Mammograms (once a year) are paid at 100% outside of this benefit.

Accident benefit – With an accident report, this benefit will pay the first $500 of the charges before the deductible is applied.