Glossary of Terms
📖 Understand the language, learn the lingo, and make confident decisions.
To better understand your coverage and make confident plan decisions, here’s a comprehensive list of health and benefits terms and acronyms commonly used across this Benefits Website.
A
Accrual Cap
The maximum number of paid hours (vacation or sick leave) you can accumulate before your balance stops growing.
Accrue
Tenpoint’s 401(k) provider, offering an easy-to-use portal for managing contributions, rollovers, and investments.
ADA (Americans with Disabilities Act)
A federal law protecting individuals with disabilities from discrimination in employment and public services.
AD&D (Accidental Death and Dismemberment)
Insurance that pays a benefit if you die or lose a limb, sight, or other function due to an accident.
Accrual Cap
The maximum number of paid hours (vacation or sick leave) you can accumulate before your balance stops growing.
ADA (Americans with Disabilities Act)
A federal law protecting individuals with disabilities from discrimination in employment and public services.
AD&D (Accidental Death and Dismemberment)
Insurance that pays a benefit if you die or lose a limb, sight, or other function due to an accident.
Allowed Amount
The maximum amount a plan pays for covered medical services. If an out-of-network provider charges more, you may be billed the difference.
B
Balance Billing
When a provider bills you for the difference between their charge and the insurer’s allowed amount. In-network providers cannot balance the bill for covered services.
Beneficiary
The person(s) you name to receive benefits from your life insurance or retirement plan if you pass away.
BRC (Benefit Resource Center)
Your first stop for plan help — available by phone or email for claims, eligibility, or coverage questions.
C
CDHP (Consumer Driven High-Deductible Plan)
A medical plan paired with an HSA (Health Savings Account) that offers lower premiums and higher deductibles, giving you more control over spending and saving.
COBRA (Consolidated Omnibus Budget Reconciliation Act)
Allows you and your dependents to continue Medical, Dental, and Vision coverage after employment ends, at your expense.
Coinsurance
Your share of covered service costs, expressed as a percentage (e.g., 20%). You pay until your out-of-pocket maximum is met.
Copay
A flat fee you pay for certain services like doctor visits or prescriptions.
Coverage Effective Date
The date your benefits begin (Medical/Vision on your hire date; Dental on the 1st of the following month).
D
DCAP (Dependent Care Assistance Program)
An employer-sponsored benefit that lets you pay for eligible dependent care expenses with pre-tax dollars.
Deductible
The amount you pay out-of-pocket for covered expenses before your plan starts to share costs.
Dependent
A spouse, domestic partner, or eligible child covered under your plan.
E
EAP (Employee Assistance Program)
A free, confidential resource through Unum for you and your household offering mental health, financial, and legal support.
EOB (Explanation of Benefits)
A document from your insurer showing what was billed, what the plan paid, and what you owe.
EOI (Evidence of Insurability)
Proof of good health sometimes required for certain life or disability coverage amounts.
F
FFS (Fee For Service)
A payment model where providers are paid for each service rather than a flat rate or bundled care.
FICA (Federal Insurance Contributions Act)
Federal payroll taxes that fund Social Security and Medicare.
Flexible Spending Account (FSA)
A pre-tax account used to pay for eligible healthcare or dependent care expenses. Funds must generally be used within the plan year.
Formulary
The approved list of prescription medications covered by your plan, grouped into cost tiers.
G
GTL (Group Term Life Insurance)
Employer-provided life insurance coverage that pays your designated beneficiary if you pass away while covered.
Guaranteed Issue
The maximum amount of life insurance you can get without answering health questions if you enroll when first eligible.
H
HDHP (High-Deductible Health Plan)
A plan with higher deductibles and lower premiums, often paired with an HSA (Health Savings Account) for tax-advantaged savings.
Health FSA (Flexible Spending Account)
An FSA that reimburses qualified healthcare expenses for you and your dependents.
HMO (Health Maintenance Organization)
A plan that provides coverage only within a specific provider network and typically requires referrals from a Primary Care Physician (PCP).
HRA (Health Reimbursement Arrangement)
An employer-funded account used to reimburse employees for qualified healthcare expenses.
HSA (Health Savings Account)
A tax-advantaged account available to employees in a qualifying HDHP. Contributions, earnings, and withdrawals for eligible expenses are tax-free.
HIPAA (Health Insurance Portability and Accountability Act)
Federal law protecting the privacy of your personal health information.
I
In-Network Provider
A doctor or facility contracted with your insurance carrier to provide discounted rates and lower out-of-pocket costs.
L
LTD (Long-Term Disability)
Coverage that replaces a portion of income if you cannot work for more than 90 days due to illness or injury.
Leave of Absence
Approved time away from work for personal, family, or health reasons, managed through Tilt.
M
MSA (Medical Savings Account)
Also called an Archer MSA — a tax-advantaged account for self-employed individuals or small businesses to pay healthcare costs.
MSP Rules (Medicare Secondary Payer Rules)
Federal regulations determining whether Medicare or private insurance pays first when you’re covered by both.
O
OOPM (Out-of-Pocket Maximum)
The most you’ll pay for covered services in a plan year before the plan begins paying 100%.
Out-of-Network Provider
A provider not contracted with your plan. You’ll pay higher out-of-pocket costs and may be billed for the difference.
P
PCE (Preexisting Condition Exclusion)
A limitation that excludes coverage for medical conditions diagnosed or treated before coverage begins.
PHI (Protected Health Information)
Any personal medical information that identifies you and is protected by HIPAA (Health Insurance Portability and Accountability Act) .
PPO (Preferred Provider Organization)
A flexible medical plan that allows in- or out-of-network care, typically with higher coverage in-network.
Preferred Provider
A provider designated for high-quality care at lower negotiated costs.
Preventive Services
Screenings, vaccines, and exams to help prevent illness—covered at 100% in-network.
Primary Care Physician (PCP)
Your main doctor for general medical care and referrals.
Prescription Drug Coverage
Coverage for medications listed on your plan’s formulary, categorized by cost tiers.
S
SMM (Summary of Material Modifications)
An ERISA (Employee Retirement Income Security Act)-required notice describing changes made to a benefits plan.
SPD (Summary Plan Description)
A detailed, legally required summary explaining plan benefits, rights, and responsibilities.
Specialist
A physician focused on a specific area of medicine or condition.
STD (Short-Term Disability)
Coverage that replaces part of your income if you can’t work due to illness, injury, or childbirth recovery (after a short waiting period).
T
Tilt
Tenpoint’s leave management partner providing tech-enabled and human-centered support for company, state, and federal leaves.
TPA (Third-Party Administrator)
An outside organization that manages benefits administration or claims on behalf of an employer.
Travel Assistance
24/7 global support from Unum for medical, legal, or logistical emergencies while traveling.
U
UCR (Usual, Customary & Reasonable Charges)
The standard fee range providers typically charge for a service in a geographic area; used to determine your plan’s payment limits.
Common Health Plan Acronyms
ADA – Americans with Disabilities Act
AD&D – Accidental Death and Dismemberment
CDHP – Consumer Driven High-deductible Plan
COBRA – Consolidated Omnibus Budget Reconciliation Act
DCAP – Dependent Care Assistance Program
EAP – Employee Assistance Program. Provides counseling and other services to employees.
EOB – Explanation of Benefits. Issued by insurance companies to participants to explain what amount of their medical expenses was covered.
EOI – Evidence of Insurability. Sometimes called evidence of good health, often required by insurers before issuing an LTD or GTL policy.
ERISA – Employee Retirement Income Security Act of 1974
FFS – Fee For Service
FICA – Federal Insurance Contribution Act. Refers to Social Security and Medicare taxes.
FSA – Flexible Spending Account
GTL Insurance – Group Term Life Insurance
HDHP – High Deductible Health Plan
Health FSA – A Flexible Spending Account (FSA) under which participants may obtain reimbursement for medical expenses.
HIPAA – Health Insurance Portability and Accountability Act
HMO – Health Maintenance Organization
HRA – Health Reimbursement Arrangement
HSA – Health Savings Account
LTD Plan – Long-Term Disability Plan. A plan that provides a partial income-replacement benefit to an employee unable to work because of a disability.
MSA – Medical Savings Account. Also known as an Archer MSA.
MSP Rules – Medicare Secondary Payer Rules. Laws that require Medicare to be the secondary payer in most situations where a group health plan or private insurance carrier also provides coverage.
OOPM – Out-of-Pocket Maximum
PCE – Preexisting Condition Exclusion
PHI – Protected Health Information
PPO – Preferred Provider Organization
SMM – Summary of Material Modifications. An ERISA-required summary of plan changes that a plan sponsor must distribute to participants and beneficiaries.
SPD – Summary Plan Description. An ERISA-required plan summary that must be furnished to participants and beneficiaries.
STD – Short-Term Disability
TPA – Third-Party Administrator