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| actuary | A professional, with advanced training in mathematics(particularly probability and statistics) who calculates risks based on loss percentages and determines insurance rates and premiums. |
| agent | An authorized representative of an insurance company who sells and services insurance contracts. Must be licensed by the state. |
| beneficiary | The person named in a life insurance policy as the recipient of the insurance money in the event of the insured's death. With health insurance, it is the subscriber or dependent who is eligible for service under a health plan. |
| benefits | The amount of money the insurance company agrees to pay a claimant or beneficiary under the specific policy terms. |
| bonds | Loans to companies or governments. The company or government borrows your money and promises to pay you back with interest by a specific date. |
| broker | An insurance salesperson who represents the insurance buyer and sells insurance offered by a variety of companies. A broker must be licensed by the state. |
| cash surrender value | The amount available in cash upon the policy owner's termination of a permanent life policy before it matures or becomes payable by death. |
| claim | The demand by an individual to recover losses covered under an insurance policy. |
| claimant | The person who files the claim with the insurance company. |
| coinsurance | The portion of health care costs for which the covered person is responsible, usually based on a fixed percentage. |
| copayment | A cost-sharing arrangement in which a person pays a specific charge for a specific medical service, e.g. $10 for an office visit. |
| coverage | The amount and type of protection provided under an insurance contract. |
| death benefit | The sum of money paid to a beneficiary in a life insurance policy. |
| deductible | The amount of charges the insured must first pay on any loss before the insurance company begins to pay benefits. |
| disability | The inability, due to illness or accident, to perform all or some portion of one's occupation, resulting in a loss of income. |
| short term disablity | From three to six months |
| long term disability | Six months to life |
| elimination period | A specified number of days a person must be disable before benefit payments begin. |
| exclusions | Special conditions (e.g., preexisting conditions) or circumstances in a health or disability income plan that are not covered. |
| fee-for-service | A type of health plan whereby the insured can choose any physician and is paid a specific benefit after any deductible. |
| fee schedule | A listing of accepted fess or an established allowance for specified medical procedures |
| grace period | A period of one month following the premium due date during which a policy remains in effect. |
| group insurance | An insurance plan that insures a group of people under one policy. The policy can be issued through an employer, union, or association with which the group has an affiliation. |
| hazard | An act or condition that will increase the risk or severity of a loss. (Driving under the influence of alcohol will increase the likelihood of getting into an automobile accident. |
| HMO --Health Maintenance Organization | An organization that provides comprehensive health care benefits for a fixed annual fee. |
| Insured | The person covered by an insurance policy. |
| Insurer | The company or organization that provides insurance. |
| law of large numbers | The principle that the larger the number of events analyzed, the more accurately the results can be predicted. |
| managed care | A type of health care plan whereby the insured pays lower premiums by visiting providers within a network. |
| money market | A low-risk investment account that often offers some check-writing privileges. |
| mutual funds | A type of investment that reduces risk by pooling together money from a large group of people to invest in many different stocks or bonds chosen by a fund manager. |
| out-of-pocket maximum | The cap you pay indeductibles and coinsurance for health care services in a year's time. |
| permanent life | Life insurance that provides lifelong protection and accumulate a cash value. |
| policy | The contract or agreement made between the insurer and insured. |
| point of service | POS |
| preexisting condition | A physical or mental condition that existed before an insurance policy was issued. |
| Preferred Provider Organization | PPO |
| premium | The payment to the insurance company for insurance coverage. |
| rate | Factor used to determine the insurance buyer's premium |
| retirement plan | A savings plan to ensure the quality of life for your future retirement years. |
| risk | The chance of loss. |
| risk classifications | A system used by actuaries to group together people with similar characteristics, such as age, gender, and health, and to calculate premiums based on the group's level of risk. |
| risk pooling | An underlying premise in insurance that allows individuals to combine risks and agree to share losses. |
| savings | The total amount of money accumulated through bank savings, investments, retirement savgins plans, and other financail instruments. |
| stocks | Shares sold of a company which allow buyers to beome, in effect, part owners. |
| term life | Life insurance that provides coverage for a specific periof of time. Term policies do not accumulate cash value. |
| underwriter | An insurance company employee who evaluates risk and assigns premiums. |
| universal life | A permanent policy that gives the owner the right to vary premium payments and the death benefit within certain prescribed limits. |
| (UCR)--Usual, customary, and reasonable charges | Set dollar amounts for health care that most fee-for-service health plans will cover. |
| variable life | The owner of this type of policy decides where the cash value is invested. |
| whole life | A permanent life insurance policy that is generally designed to last for life or to an advanced age, typically 100 or 110. Policies accumulate cash value. |
