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ID A/H/S – Medical Plans

Concepts, Provisions, and Clauses

Fee-for-Service or Prepaid
Specified Coverage or Comprehensive Coverage
Dependent Coverage
Deductibles
Coinsurance
Stop-Loss Provision
Impairment Rider

Types of Medical Plans

Basic Plans
Major Medical Insurance
Major Medical Insurance—Out of Pocket
Major Medical Insurance—Covered Expenses
Major Medical Insurance—Exclusions
Health Maintenance Organizations (HMOs)
Preferred Provider Organizations (PPOs)
Point-of-Service (POS) Plans

Cost Containment in Health Care Delivery

Cost Containment
Managed Care
Preventive Care
Outpatient Benefits
Utilization Management
Preauthorization
Gatekeeper

Limited Policies

Limited Policies
Accidental Death & Dismemberment (AD&D)
Hospital Indemnity
Critical Illness / Dread Disease
Vision Care / Hearing / Dental

HIPAA

What is HIPAA?
HIPAA Terms
Privacy
Portability
Portability — Losing Group Coverage
Portability — Changing Jobs

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Monday thru Friday

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(801) 518-1956

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(801) 518-5016

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