• High Deductible Health Plan (HDHP) – A qualified High Deductible Health Plan (HDHP) is defined by the Internal Revenue Service (IRS) as a plan with a minimum annual deductible and a maximum out - of - pocket limit. These minimums and maximums are determined annually and are subject to change. • In - network – A designated list of health care providers (doctors, dentists, etc.) with whom the insurance provider has negotiated special rates. Using in - network providers lowers the cost of services for you and the company. • Inpatient – Services provided to an individual during an overnight hospital stay. • Mail order pharmacy – Mail order pharmacies generally provide a 90 - day supply of a prescription medication for the same cost as a 60 - day supply at a retail pharmacy. Plus, mail order pharmacies offer the convenience of shipping directly to your door. • Out - of - network – Providers that are not in the plan’s network and who have not negotiated discounted rates. The cost of services provided by out - of - network providers is much higher for you and the company. Higher deductibles and coinsurance will apply. • Out - of - pocket maximum – The maximum amount you and your family must pay for eligible expenses each plan year. Once your expenses reach the out - of - pocket maximum, the plan pays benefits at 100% of eligible expenses for the remainder of the year. Your annual deductible is included in your out - of - pocket maximum. • Outpatient – Services provided to an individual at a hospital facility without an overnight hospital stay. • Pre - existing condition – A health condition that an individual was treated for, or got medical advice from a doctor about, prior to when they applied for health or life insurance. This can also apply if a person had existing symptoms that would cause them to seek treatment. • Primary Care Provider (PCP) – A doctor (generally a family or internal medicine practitioner or pediatrician) who provides ongoing medical care. A primary care physician treats a wide variety of health - related conditions. • Reasonable & Customary Charges (R&C) – Prevailing market rates for services provided by health care professionals within a certain area for certain procedures. Reasonable and Customary rates may apply to out - of - network charges. • Specialist – A provider who has specialized training in a particular branch of medicine (e.g., a surgeon, cardiologist or neurologist). • Specialty drugs – A drug that requires special handling, administration or monitoring. Most can only be filled by a specialty pharmacy and have additional required approvals. • Brand preferred drugs – A drug with a patent and trademark name that is considered “preferred” because it’s safe and effective and usually less expensive than other brand - name options. • Brand non - preferred drugs – A drug with a patent and trademark name that is “not preferred” because it’s usually more expensive than other generic and brand preferred options. • Calendar year maximum – The maximum benefit amount paid each year for each family member enrolled in the dental plan. • Coinsurance – The sharing of cost between you and the plan. For example, 80% coinsurance means the plan covers 80% of the cost of service after a deductible is met. You will be responsible for the remaining 20% of the cost. • Copay – 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 the type of service. • Deductible – The amount you have to pay for covered services each year before your health plan begins to pay. • Elimination period – The time period between the beginning of an injury or illness and receiving benefit payments from the insurer. • Evident of Insurability (EOI) – EOI is documentation or declaration of good health requested by the insurance company in order for the enrollee to obtain coverage. • Flexible Spending Accounts (FSA) – FSAs allow you to pay for eligible health care and dependent care expenses using tax - free dollars. The money in the account is subject to the “use it or lose it” rule which means you must spend the money in the account before the end of the plan year. • Generic drugs – A drug that is equivalent to brand - name drugs in use, dose, strength, quality and performance, but is not trademarked. • Guaranteed issue – Guaranteed issue refers to coverage that is offered to all eligible enrollees regardless of their health status. • Health Savings Account (HSA) – An HSA is a personal savings account for those enrolled in a High Deductible Health Plan (HDHP). You may use your HSA to pay for qualified medical expenses such as doctor’s office visits, hospital care, prescription drugs, dental care and vision care. You can use the money in your HSA to pay for qualified medical expenses now, or in the future, for your expenses and those of your dependents, even if they are not covered by the HDHP. • Health Reimbursement Arrangement (HRA) – A fund you can use to help pay for eligible medical costs not covered by your medical plan. Funds are contributed to the HRA by the company. Benefit acronyms ACA – Affordable Care Act AD&D – Accidental Death & Dismemberment FSA – Flexible Spending Account HDHP – High Deductible Health Plan HMO – Health Maintenance Organization 18 HSA – Health Savings Account LPFSA – Limited Purpose Flexible Spending Account LTD – Long - Term Disability PPO – Preferred Provider Organization STD – Short - Term Disability Helpful Benefit Terms