The charge(s) for a particular service/treatment by a health care provider

A mathematician working for a health insurance company responsible for determining what premiums the company needs to charge based in large part on claims paid verses amounts of premium generated. Their job is to make sure a block of business is priced to be profitable.

The right granted to a doctor to admit patients to a particular hospital.

Any activity done to help a person or group to get something the person or group needs or wants.

Licensed salespersons who represent one or more health insurance companies and presents their products to consumers.

The maximum amount a health insurer will pay for a service or procedure.

Some medical techniques once considered outside the boundaries of standard practice have become more accepted in recent years and may now be eligible for coverage. Acupuncture, midwives, and osteopathic treatments are examples of formerly excluded treatments that are now covered under many health insurance policies.

Are maximums on the dollar amounts the plan will pay for any given year

The dollar amount on which your insurer bases its payments and your co-payments.

The legal transfer of one person's interest in an insurance policy to another person.

The insured allows a hospital or doctor to collect your health insurance benefits directly from your insurance company.

Fully insured plans issued to employee groups, including those formed by labor unions, nonprofit membership corporations, etc.

A group. Often, associations can offer individual health insurance plans specially designed for their members.

The recipient of the benefits of the policy

Amount payable by the insurance company to a claimant, assignee, or beneficiary when the insured suffers a loss