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Urgent Care
Care for an illness, injury or condition serious enough that a reasonable person would seek care right away, but not so severe as to require Read More
UCR (Usual, Customary and Reasonable)
The amount paid for a medical service in a geographic area based on what providers in the area usually charge for the same or similar Read More
Specialist
A physician specialist focuses on a specific area of medicine or a group of patients to diagnose, manage, prevent or treat certain types of symptoms Read More
Reconstructive Surgery
Surgery and follow-up treatment needed to correct or improve a part of the body because of birth defects, accidents, injuries or medical conditions. Back to Read More
Primary Care Provider
A physician (M.D. – Medical Doctor or D.O. – Doctor of Osteopathic Medicine), nurse practitioner, clinical nurse specialist or physician assistant, as allowed under state Read More
Preauthorization
A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary. Sometimes Read More
Out-of-Pocket Limit
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. Read More
Out-of-network Co-insurance
The percent (for example, 40%) you pay of the allowed amount for covered health care services to providers who do not contract with your health Read More
Non-Preferred Provider
A provider who doesn’t have a contract with your health insurer or plan to provide services to you. You’ll pay more to see a non-preferred Read More
Medically Necessary
Health care services or supplies needed to prevent, diagnose or treat an illness, injury, condition, disease or its symptoms and that meet accepted standards of Read More
In-network Co-payment
A fixed amount (for example, $15) you pay for covered health care services to providers who contract with your health insurance or plan. In-network co-payments Read More
In-network Co-insurance
The percent (for example, 20%) you pay of the allowed amount for covered health care services to providers who contract with your health insurance or Read More
Hospital Outpatient Care
Care in a hospital that usually doesn’t require an overnight stay. Back to Glossary Interested in a Free Benefits Consultation? LET’S MEET
Hospitalization
Care in a hospital that requires admission as an inpatient and usually requires an overnight stay. An overnight stay for observation could be outpatient care. Read More
Health Insurance
A contract that requires your health insurer to pay some or all of your health care costs in exchange for a premium. Back to Glossary Read More
Excluded Services
Health care services that your health insurance or plan doesn’t pay for or cover. Back to Glossary Interested in a Free Benefits Consultation? LET’S MEET
Emergency Medical Transportation
Ambulance services for an emergency medical condition. Back to Glossary Interested in a Free Benefits Consultation? LET’S MEET
Emergency Medical Condition
An illness, injury, symptom or condition so serious that a reasonable person would seek care right away to avoid severe harm. Back to Glossary Interested Read More
Deductible
The amount you owe for health care services your health insurance or plan covers before your health insurance or plan begins to pay. For example, Read More
Co-Payment
A fixed amount (for example, $15) you pay for a covered health care service, usually when you receive the service. The amount can vary by Read More
Co-Insurance
Your share of the costs of a covered health care service, calculated as a percent (for example, 20%) of the allowed amount for the service. Read More
Balance Billing
When a provider bills you for the difference between the provider’s charge and the allowed amount. For example, if the provider’s charge is $100 and Read More
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 Read More
ACA Compliance
We help our employers maintain compliance through assistance with 1095’s ( production assistance and payment for production), assistance with PCORI fee filing, and compliance updates.
Wrap Documents
We help our employers maintain compliance through assistance with 1095’s ( production assistance and payment for production), assistance with PCORI fee filing, and compliance updates.
5500 Reporting Compliance
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Open Enrollment Meeting Preparation
We believe in making the Open Enrollment (OE) process fun. We want to encourage your staff to enroll and engage in their health. So, whether Read More
On Call Employee Support for Benefits Questions & Claims Negotiations
At Open Enrollment, our team will give your employees their contact information to be the first line of defense in dealing with insurance carriers. Our Read More
Free HR Technology
As an FH Insurance client, you will have access to a benefits administration at no cost. Our team will help make Open Enrollment as simple Read More