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The covered person is completely unable to engage in any gainful occupation for which he or she is or becomes reasonably fitted by educationn, training, or experience
The covered person is prevented from performing any and every duty pertaining to the employee's occupation.
A combination of the "own occupation" and "any occupation" disability definitions that applies each definition for a specific time period
A disability plan characterized by a schedule of weekly benefits based on earnings categories, but with relatively low maximum benefits, short elimination periods, and short maximum benefit periods.
A disability plan designed to take care of serious, long-term disabilities; characterized by benefits stated as a percentage of earnings, with relatively high maximum monthly benefits and longer elimination periods
Coordination of benefits
Policy provisions that indicate how other disability income benefits will affect the benefits payable under the group plan
The maximum amount of monthly benefit and insurer will provide on any one individual, under disability insurance
The maximum amount of monthly benefits from all sources in which an insurer will participate, under disability insurance
Fee-for-service (indeminity) plan
A medical expense coverage plan that is primarily a reimbursement mechanism that pays for "reasonable and customary" covered health-care care expenses within the plans' limits. It does not attempt to control access to care or use of care.
Managed care plans
A medical expense coverage plan that not only finances healthcare but also organizes the care and to some degree controls access to care
Supplementary medical insurance (SMI)
A voluntary portion of Medicare coverage that pays 80 percent of the reasonable charges for covered medical services after $100 deductible in each calendar year.
Cafeteria compensation (flexible benefits)
An employer-provided employee benefit program organized in a way that allows an employee to choose at least part of a benefits packages from among several types and levels of benefits
Flexible spending account (FSA)
An employer-provided employee benefit program in which an employee may elect to have his or her salary reduced by a certain amount and this amount is then placed , before tax, in a seperate account from which medical expenses that are not otherwise covered by the employer's plan can be paid
Policy provisions that relate to the insured's rights to continue his or her individual coverage from one policy period to another
A policy renewal provision stating that the policy can be nonrenewed for stated reasons only
A policy renewal provision stating that the insured has the right to renew coverage for a specified time period, such as to age 65 or in some cases, for life.
Also a period that the insurer cannot itself make any change in the policy, except that the insurer retains the right to make changes in premium rates for whoel classes of policies
Noncancelable and guaranteed renewable
A policy provision that gives the insured the right to continue the policy in force by the timely payment of premiums as specified in the policy, usually for a specified time period, such as to age 65. The insurer retains no right by itself to make any changes in any policy provision during this period
Expense reimbursement policy
One of two delivery methods by which the daily benefit under a long term care policy can be structured; actual charges incurred are paid, up to the policy's daily benefit amount
Per diem policy
One of two delivery methods by which the daily benefit under a long term care policy can be structured; the policy's daily benefit is paid, regardless of the actual charges incurred
One of the long term care coverage triggers, generally taken to mean the deterioration in or loss of intellectual capacity of the insured that can be measured by clinical evidence and standardized tests
Chronically ill individual
A person who is unable to perform at least two activities of daily living due to loss of functional capacity or a similar level of disability or who requires substantial supervision because of severe cognitive impairment
An arrangement that alllows terminally ill and other life insurance policy owners to sell their policies to viatical settlement companies for a percentage of the policy's face amount
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