Glossary ABCDEFGHIJKLMNOPQRSTUVWXYZ A actuarial valueadjusted gross incomeadvance premium tax creditAffordable Care Actagentancillary benefitsannual maximumappealassociation health plan B benchmark planbeneficiarybenefitsbrand name drugsbrokerbronze (metal level) health plan C carrierCatastrophic health plancertificate of creditable coveragecertificate of insurancecertified application counselorChildren's Health Insurance ProgramclaimCOBRAcoinsurancecommunity ratingcopaycost sharingcost-sharing reductioncovered expenses D deductibledependentdrug formulary E effective dateemployer shared responsibility paymentemployer-sponsored health insuranceessential health benefitsexchangeexclusionsexclusive provider organization planexemptionexplanation of benefits F Family and Medical Leave Actfederal poverty levelfirst-dollar coveragefixed benefit (fixed indemnity)flexible spending account G generic drugsgold (metal level) health plangrace periodgrandfathered health plangroup health insuranceguaranteed issueguaranteed renewal H hardship exemptionhealth maintenance organizationhealth reimbursement accounthealth savings accounthigh-deductible health planhospitalizationhousehold I indemnity planindividual health insuranceindividual mandateindividual shared responsibility paymentinpatientinsurer L lifetime maximumlump sum benefit M managed care plansMarketplaceMedicaidmedical underwritingmedically necessaryMedicaremetal levelsminimum essential coveragemodified adjusted gross income N narrow network (health plans)navigatornetworknon-preferred provider O Obamacareopen enrollmentout-of-network careout-of-pocket costsout-of-pocket maximumoutpatient P platium (metal level) health planpoint of service planpolicypolicyholderpre-existing conditionpreauthorizationpreferred provider organizationspremiumpremium tax creditsprescription drug coverageprescription drugspreventive careprimary care providerproducer Q qualified health planqualifying health coveragequalifying life event R rate reviewrescissionrider (exclusionary rider) S schedule of benefitsself-insured plansilver (metal level) health planspecial enrollment periodspecialty drugsstate high risk poolsubsidy T third-party administratorTRICARE U usual customary and reasonable rate W waiting period × Please use either the Chrome or Firefox web browser for an optimal experience viewing this website. Download Chrome Download Firefox Call Center Hours (CST) × Sunday: ClosedMonday: ClosedTuesday: ClosedWednesday: ClosedThursday: 7:30 AM - 7:00 PMFriday: 7:30 AM - 7:00 PMSaturday: Closed Location (address, city, state and/or ZIP) Distance - optional within 10 miles within 20 miles within 30 miles within 50 miles within 100 miles Locate an Agent Terms of Use - Personal Safety