2010/2011 Medical House Staff Benefits Guide 2010/2011 Medical House Staff Benefits Guide : Page 28

Additional Resources continued Glossary Behavioral Health Care— Treatment of mental health and/or substance abuse disorders. Co-Insurance — The portion of covered expenses which you must pay for care, after first meeting a deductible amount, if any. Co-Payment (Co-Pay) — A charge required under a plan that must be paid by you at the time of the provision of covered services (e.g., a visit to the doctor’s office). Deductible — An amount that you must pay for covered services per specified period in accordance with your plan before benefits will be paid. Dependent — A person other than the enrollee who is eligible to receive care under a plan’s provisions. Examples include a Spouse/SSDP or child. Evidence of Insurability (EOI) — A statement of your medical history used to determine if you will be approved for coverage, also known as medical underwriting. Flexible Spending Accounts (FSA) — Accounts regulated by IRS Section 125. Allows you to reduce your salary and pay on a pre-tax basis for unreimbursed health care expenses for you and your dependent(s) (i.e. deductibles, co-payments, dental and vision expenses) and/or dependent day care expenses (i.e. care for a child, elderly parent or disabled spouse). Formulary — An approved list of prescription drugs and their appropriate dosages felt to be the most useful and cost effective for patient care. Generic Drug — A drug which is exactly the same as a brand-name drug and which is allowed to be produced after the brand-name drug’s patent has expired. Also called a “generic equivalent.” Inpatient — Person who receives medical, dental or other health-related services while lodged in a hospital or other health care institution for at least one night. Life Insurance — Specified amount of money to be paid to the insured’s designated beneficiaries upon death of the insured. Long-Term Disability (LTD) — Provides partial income protection against income loss due to illness or injury. Benefits are payable after three months of disability. Network — A list of physicians, hospitals and other providers who provide health care services to the members of a specific health plan. Out-of-Pocket Maximum — Pre-determined amount of medical expenses you are responsible for before a plan pays 100% of remaining charges. 28 2010-2011 Medical House Staff Benefits Guide 05/10/10

Glossary

Behavioral Health Care — Treatment of mental health and/or substance abuse disorders.<br /> <br /> Co-Insurance — The portion of covered expenses which you must pay for care, after first meeting a deductible amount, if any.<br /> <br /> Co-Payment (Co-Pay) — A charge required under a plan that must be paid by you at the time of the provision of covered services (e.g., a visit to the doctor’s office).<br /> <br /> Deductible — An amount that you must pay for covered services per specified period in accordance with your plan before benefits will be paid.<br /> <br /> Dependent — A person other than the enrollee who is eligible to receive care under a plan’s provisions.<br /> <br /> Examples include a Spouse/SSDP or child.<br /> <br /> Evidence of Insurability (EOI) — A statement of your medical history used to determine if you will be approved for coverage, also known as medical underwriting.<br /> <br /> Flexible Spending Accounts (FSA) — Accounts regulated by IRS Section 125. Allows you to reduce your salary and pay on a pre-tax basis for unreimbursed health care expenses for you and your dependent(s) (i.e. deductibles, co-payments, dental and vision expenses) and/or dependent day care expenses (i.e. care for a child, elderly parent or disabled spouse).<br /> <br /> Formulary — An approved list of prescription drugs and their appropriate dosages felt to be the most useful and cost effective for patient care.<br /> <br /> Generic Drug — A drug which is exactly the same as a brand-name drug and which is allowed to be produced after the brand-name drug’s patent has expired. Also called a “generic equivalent.” Inpatient — Person who receives medical, dental or other health-related services while lodged in a hospital or other health care institution for at least one night.<br /> <br /> Life Insurance — Specified amount of money to be paid to the insured’s designated beneficiaries upon death of the insured.<br /> <br /> Long-Term Disability (LTD) — Provides partial income protection against income loss due to illness or injury.<br /> <br /> Benefits are payable after three months of disability.<br /> <br /> Network — A list of physicians, hospitals and other providers who provide health care services to the members of a specific health plan.<br /> <br /> Out-of-Pocket Maximum — Pre-determined amount of medical expenses you are responsible for before a plan pays 100% of remaining charges.<br /> Outpatient — Person who receives medical, dental or other health-related services in a hospital or other health care institution but who is not lodged there.<br /> <br /> Pre-Existing Condition — A condition for which you received medical treatment, consultation, care or services (including diagnostic measures) or took prescribed drugs or medicines during a given period of time. This applies to Long Term Disability (LTD) at Emory when your disability began in the first 12 months following your effective date of coverage.<br /> <br /> Preventive Care — Health care which emphasizes prevention, early detection and early treatment, thereby reducing the costs of health care in the long run.<br /> <br /> Spouse/SSDP Medical Charge — An additional $50 per month medical charge added to an employee’s medical plan contribution if their covered Spouse/ SSDP has access to medical insurance through an employer other than Emory. Employees will be given the opportunity to certify that their Spouse/SSDP “does” or “does not” have access to a medical plan through an employer other than Emory when selecting coverage through Employee Self Service in PeopleSoft. If Employee plus Spouse/SSDP or Family coverage is selected and the certification is not completed, an additional $50/month will be added to the cost of your medical plan rate.<br /> <br /> Summary Plan Description (SPD) — A legally required summary of the plan to be distributed to employees.<br /> <br /> Urgent Care Center — Facility that provides care and treatment for problems that are not life-threatening, but require attention over the short term.<br /> <br /> Waiting Period — A period of continuous disability which must be satisfied before you are eligible to receive disability benefits.

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