Understanding the Labels
The set dollar amount you pay for certain covered services when you enroll in the EPO or PPO options.
Copay
After you've reached your deductible, you and your plan share some of your medical costs. The portion of covered expenses you are responsible for.
Coinsurance
A flat dollar amount you must pay out of your own pocket before your plan begins to pay for covered services.
Deductible
A receipt that outlines your services and fees, what your insurance is paying for, what you are responsible to pay, and more. Make sure you are checking your EOB for errors and that the billing has been done accurately.
Explanation of Benefits (EOB)
A medical plan with a high deductible and lower monthly premium.
High Deductible Health Plan (HDHP) Health
A tax-advantaged account available to participants who are enrolled in a high-deductible health plan. Funds roll over year to year and are yours to keep.
Savings Account (HSA)
A pre-tax benefit used to pay for eligible dental, vision care and post- deductible medical expenses for participants enrolled in a high- deductible health plan.
Limited Purpose Flexible Spending Account (LFPSA)
Health care providers that are contracted with your insurance company to accept certain negotiated and discounted rates.
In-Network
Health care providers that are contracted with your insurance company to accept certain negotiated and discounted rates.
The most you'll have to pay out-of-pocket in copays and coinsurance for covered expenses during the plan year.
Out-of-Network (OON)
Out-of-Pocket Maximum
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