If your employer or your spouse’s employer offers a health plan, birth, adoption, and placement for adoption may also trigger a special enrollment opportunity for you, your spouse, and your child, without regard to any open season for enrollment.The Affordable Care Act (ACA) adds important protections related to employment based group health plans that will improve health coverage for you and your family.Aggregate: The maximum amount an insurance company will pay during the policy All Risk Coverage: Property insurance covering loss arising from all causes of loss except those that are specifically excluded Annually Renewable Term: Term insurance that provides coverage for one year and allows the policy owner to renew his or her coverage each year.Application: A form with the information needed for an insurance company to underwrite and rate a specific policy Assignment Assignment: The transfer of ownership of a Life Insurance policy from one person to another. Your attained age is a factors life insurance companies use to determine premiums.It’s important to pay your monthly health insurance premium in full to your insurance company — not the Health Insurance Marketplace — by the due date.Your health insurance company could end your coverage if you fall behind on your monthly premiums.Tom serves as coverage and claims monitoring counsel for directors and officers liability insurers, overseeing securities class action, derivative, and ERISA litigation against insureds.
Accounts Receivable Coverage: Covers loss of sums owed to the insured by its customers that are uncollectible due to damage by an insured peril to accounts receivable records Actual Cash Value (ACV): Cost to repair or replace damaged property with materials of like kind and quality, less depreciation Additional Insured: A person or organization for whom insured status is arranged by endorsement Advertising Injury: General liability coverage that insures against libel, slander, invasion of privacy, copyright infringement and misappropriation of advertising in connection with the insured's advertising of its goods or services Agent: An authorized representative of an insurance company.
Audit: A verification of the financial records, usually payroll or receipts, of an organization to determine exposures and premiums Automobile: A land motor vehicle, trailer or semi-trailer designed for travel on public roads, not including 'mobile equipment' Backdating: Making the effective date of a policy earlier than the date of application. Best Company giving the financial condition of insurance companies Binder: A temporary insurance policy that expires at the end of a specific time period or when a permanent policy is written.
Backdating is often used to make the age of the applicant lower than it actually was at the time of application so that he/she can get a lower premium. Bailee Coverage: Coverage on property left in the care of the insured for storage, repair or servicing Basic Cause of Loss Form: Property coverage for named perils: Fire, Lightening, Explosion, Smoke, Windstorm, Hail, Riot, Civil Commotion, Aircraft, Vehicles, Vandalism, Sprinkler Leakage, Sinkhold Collapse and Volcanic Action Basic Limits: The minimum limits of liability that can be carried by an insured Beneficiary: The designated person set to receive the death benefit if the insured should die. A binder is given to an applicant for insurance during the time it takes the an insurance company to complete the policy paperwork.
Bodily Injury by Accident Limit: The most an insurer will pay under Part Two of a Workers' Compensation Policy for claims arising out of any one accident, regardless of how many employee claims arise out of the accident Bodily Injury by Disease, Each Employee : The most an insurer will pay under Part Two of a Workers' Compensation Policy for damages due to bodily injury by disease to any one employee Bodily Injury by Disease-Policy Limit : The most an insurer will pay under Part Two of a Workers' Compensation Policy employee bodily injury by disease claims during the policy period regardless of the number of employees who make such claims Bodily Injury Liability Limit: The insured is legally liable for damages due to bodily injury, sickness, or disease, including resulting death Boiler & Machinery Insurance: Coverage for loss caused by mechanical or electrical equipment breakdown, including damage to the equipment Bond: A written agreement in which one party, the surety, guarantees the performance or honesty of a second party, the principal (obligor), to the third party (obligee) to whom the performance or debt is owed Brands and Labels Endorsement: Property insurance coverage that allows the insured to remove labels from damaged goods or mark the items as 'salvage,' provided the goods are not damaged in the process Broad Causes of Loss Form: Property coverage for the named perils: Fire, Lightening, Explosion, Smoke, Windstorm, Hail, Riot, Civil Commotion, Aircraft, Vehicles, Vandalism, Sprinkler Leakage, Sinkhole Collapse, Volcanic Action, Breakage of Building Glass, Falling Objects, Weight of Snow, Ice or Sleet, Water Damage (in the form of leakage from appliances) and Collapse from Specified Causes Building Ordinance Coverage: Covers against loss caused by enforcement or ordinances or laws regulating construction and repair of damaged buildings Burglary: Theft of property by forcible entry, which is evidenced by visible signs, in a premises, by a person Business Auto Policy: Auto Policy for businesses that includes auto liability and auto physical damage coverages Business Income Coverage: Insurance covering loss of income by a business when operations are interrupted due to property loss that is a covered cause of loss Business Interruption Coverage: See Business Income Coverage Business Owners Policy (BOP): A policy that combines property and liability coverages for special types of small businesses Cancellation: The termination of an insurance policy usually before its expiration Care, Custody or Control: An exclusion of liability insurance which eliminates coverage for damage to property in the insured's care, custody or control Carrier: The insurance company which provides coverage Cash Benefits: The Money that is paid to the policy holder upon settlement of a covered claim.
Cash Value: The equity amount or "savings" accumulation in a whole life insurance policy.
When Care Source Will NOT Automatically Adjust a Denied COB Claim: If the updated coverage was received after 90 days from the denial for COB, the provider still needs to notify Care Source within 365 days of date of service that the claim is COB.