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Glossary of Terms & Services Available

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  • Accident Only or AD&D

    Policies providing coverage, singly or in combination, for death, dismemberment, disability, or hospital and medical care caused by or necessitated as a result of accident or specified kinds of accidents. Types of coverage include student accident, sports accident, travel accident, blanket accident, specific accident or accidental death and dismemberment (AD&D).

  • Adverse Selection

    is the natural tendency for those who know they are highly vulnerable to loss from a specific risk to be most inclined to acquire and retain insurance to cover related cost.

  • Annual Benefits Compliance Review

    TriBridge will provide an annual review of your benefits compliance and with regards to Acts and Regulations such as ERISA, COBRA, HIPAA, HITECH, PPACA, FMLA, 5500 Filing, Section 125, Section 105, and more.

  • Annuities – Immediate Non-variable

    an annuity contract that provides for the fixed payment of the annuity at the end of the first interval of payment after purchase. The interval may vary, however the annuity payouts must begin within 13 months.

  • Asset Allocation Fund

    A common trust fund or mutual fund that spreads its portfolio among a wide variety of investments, including domestic and foreign stocks and bonds, government securities, and real estate stocks. This gives small investors far more diversification than they could get allocating money on their own. Some of these funds keep the proportions allocated between different sectors relatively constant, while others alter the mix as market conditions change.

  • Benefits and Healthcare Consulting

    TriBridge will meet with you and your team throughout the year and discuss the effectiveness of your benefits and health plans, provide updates, make suggestions, changes, etc.

  • Blackout Period

    When a plan sponsor decides to switch from one plan vendor to another, there is typically a period during which participants are not permitted to make changes in their investment selections. This is known as the blackout period. Once the blackout period commences and until it ends, participants can no longer direct the investments in their accounts. Blackout periods can last up to 60 days.

  • Capital Gains (Loss)

    excess (deficiency) of the sales price of an asset over its book value. Calculated on the basis of original cost adjusted, as appropriate, for accrual of discount or amortization of premium and for depreciation.

  • Captive Insurer

    a financial risk financing method- where a large organization established a separate subsidiary insurance company to write its own insurance.

  • Coinsurance

    A clause contained in most property insurance policies to encourage policy holders to carry a reasonable amount of insurance. If the insured fails to maintain the amount specified in the clause (Usually at least 80%), the insured shares a higher proportion of the loss. In medical insurance a percentage of each claim that the insured will bear.

  • Compliance Services Outsourcing

    COBRA, ERISA, Plan Document, 5500, etc

  • Deferred Annuity

    annuity payment to be made as a single payment or a series of installments to begin at some future date, such as in a specified number of years or at a specified age.

  • Defined Benefit

    A defined benefit plan is an employer maintained plan that pays out a specific, pre-determined amount to retirees. Defined benefit plans are guaranteed by PBGC.

  • Defined Contribution

    A defined contribution plan does not promise a specific benefit at retirement, but does provide regular, set contributions to a pension fund. Defined contribution plans tend to be less expensive than defined benefit plans.

  • Disease Management

    is a voluntary program provide as part of your health plan.  This program is designed to help individuals with chronic health conditions understand their condition and work with their doctor to better manage their care.

  • Employee Education

    TriBridge can assist you in organizing and deploying the educational sessions during open enrollment, on-boarding, and throughout the year.

  • Enrollment Audits

    Post open-enrollment we will conduct and audit to ensure all of your employees have been enrolled in the appropriate plans. This avoids costly remedial and reactionary issues later in the year.

  • Exclusions

    usually apply either to certain perils, types of losses, types of property, or types of activities that eliminates coverage for some type of risk. Exclusions narrow the scope of coverage provided by the insuring agreement. In many insurance policies, the insuring agreement is very broad.

  • Fiduciary

    A person with the authority to make decisions regarding a plan’s assets or important administrative matters. Fiduciaries are required under ERISA to make decisions based solely on the best interests of plan participants.

  • Financial Wellness Fairs

    TriBridge can provide educators for single or multi-day seminars to your workforce on a variety of topics including will preparation, estate planning, life insurance planning, long term care planning for parents, investing, and retirement planning.

  • Fully Automated HRIS Benefits Administration

    Same as fully integrated but Automation adds the ability to direct enroll (feed) employees to the benefit plans without any manual intervention.

  • Fully Integrated HRIS Benefits Administration

    The administration system is designed to fully integrate with all of your existing technology and web-based resources – including payroll providers.

  • Hazard

    is an act or condition that increased the likelihood of the occurrence of a loss and/or increases the severity of a loss if a peril does occur.

  • Healthcare/Benefit Advocacy Services

    In order to cut down on the volume of calls and questions that come through to HR, professional advocacy and resource services are available to employees and their families both during and after standard business hours.

  • HR Hotline

    Live Human Resources Support to answer questions and take on projects as needed.

  • Individual Health Insurance Support

    Current employees (and families) and COBRA-eligible employees have access to support. This resource has proven to be an excellent alternative to expensive COBRA premiums, dependent coverage, or for employees who are not eligible for benefits.

  • Individual Retirement Account (IRA)

    Personal retirement vehicles in which a person can make annual tax deductible contributions. These accounts must meet IRS Code 408 requirements, but are created and funded at the discretion of the employee. They are not employer sponsored plans.

  • Law of large numbers

    is a principle of probability according to which the frequencies of events with the same likelihood of occurrence even out, given enough trials or instances.

  • Loss Ratios

    can be calculated in various ways, but the most common way is to divide losses incurred plus loss adjustment expenses incurred by earned premiums.

  • Managed Care

    system of health care delivery that attempts to influence the utilization, quality, and cost of services provided.

  • Medicare Advantage Plan (Part C)

    A type of Medicare health plan offered by a private company that contracts with Medicare to provide you with all your Part A and Part B benefits. Medicare Advantage Plans include Health Maintenance Organizations, Preferred Provider Organizations, Private Fee-for-Service Plans, Special Needs Plans, and Medicare Medical Savings Account Plans. If you’re enrolled in a Medicare Advantage Plan, most Medicare services are covered through the plan and aren’t paid for under Original Medicare. Most Medicare Advantage Plans offer prescription drug coverage.

  • Medicare Advantage Prescription Drug (MA-PD) Plan

    A Medicare Advantage plan that offers Medicare prescription drug coverage (Part D), Part A, and Part B benefits in one plan.

  • Medicare health plan

    Generally, a plan offered by a private company that contracts with Medicare to provide Part A and Part B benefits to people with Medicare who enroll in the plan. Medicare health plans include all Medicare Advantage Plans, Medicare Cost Plans, and Demonstration/Pilot Programs. Programs of All-inclusive Care for the Elderly (PACE) organizations are special types of Medicare health plans. PACE plans can be offered by public or private entities and provide Part D and other benefits in addition to Part A and Part B benefits.

  • Medicare Part A (Hospital Insurance)

    Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

  • Medicare Part B (Medical Insurance)

    Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services. Part B provides benefits for most medical expenses not covered under Part A.

  • Medicare Prescription Drug Plan (Part D)

    Part D adds prescription drug coverage to Original Medicare, some Medicare Cost Plans, some Medicare Private-Fee-for-Service Plans, and Medicare Medical Savings Account Plans. These plans are offered by insurance companies and other private companies approved by Medicare. Medicare Advantage Plans may also offer prescription drug coverage that follows the same rules as Medicare Prescription Drug Plans.

  • Medicare Supplement

    Insurance coverage sold on an individual or group basis to help fill the “gaps” in the protections granted by the federal Medicare program. This is strictly supplemental coverage and cannot duplicate any benefits provided by Medicare. It is structured to pay part or all of Medicare’s deductibles and co-payments. It may also cover some services and expenses not covered by Medicare. Also known as Medigap” insurance.

  • Medigap Open Enrollment Period

    A one-time-only, 6-month period when federal law allows you to buy any Medigap policy you want that’s sold in your state. It starts in the first month that you’re covered under Part B and you’re age 65 or older. During this period, you can’t be denied a Medigap policy or charged more due to past or present health problems. Some states may have additional open enrollment rights under state law.

  • Mutual Insurance Company

    is a not for profit insurance company owned by its policy owners.

  • Non-Integrated Benefits Administration

    The marketplace offers many cost-free options to manage your benefits via third party administrators and other service providers. These providers are consistently upgrading their technology to remain relevant. TriBridge can assist in selecting the best solution to meet your requirements.

  • Peril

    refers to the cause of loss.  Perils are commonplace and include unemployment, illness, old age, death flood, earthquake, etc.

  • Private Exchange

    are marketplaces of health insurance and other related products. Employers purchase health insurance through the private exchange, and then their employees can choose a health plan from those supplied by participating payors. Employees then access a personal benefits portal and use the employer’s allocation to select the medical, dental, and other benefit options that best meet their family’s needs. There are decision support tools available to relieve HR of the responsibility to help employee’s make decisions.

  • Qualified Plan

    Any plan that qualifies for favorable tax treatment by meeting the requirements of section 401(a) of the Internal Revenue Code and by following applicable regulations. Includes 401(k) and deferred profit sharing plans.

  • Quarterly Claims Review

    For clients who are not fully insured (or who enroll in our Disease Management Program), we will provide full detail claims review and updates to assist you in forecasting future costs and focusing on high claim drivers.

  • Reinsurance

    is an arrangement in which an insurance company transfers to another insurance company some or all of the risks it has taken on by writing primary insurance.

  • Reverse Discrimination Testing

    We will review your disability income protection programs to ensure that the highly-compensated are not being discriminated against.

  • Risk

    A probability or threat of damage, injury, liability, loss, or any other negative occurrence that is caused by external or internal vulnerabilities, and that may be avoided through preemptive action.

  • Risk Tolerance Level

    is the degree to which that individual is attracted to or averse to the possibly of loss.

  • Self-Insurance

    often applied to any retention of financial risk, generally appropriate only for a large business in which the business acts like an insurance company for its own risk.

  • Service Plan Roadmap development and management

    ou will receive a full one or two year project plan that illustrates different objectives we plan to accomplish, the deadlines and milestones associated with each objective, and methods of measuring success.

  • Simplified employee-pension plan (SEP)

    A defined contribution plan in which employers make contributions to individual employee accounts (similar to IRAs). Employees may also make pre-tax contributions to these accounts. As of January, 1997 no new SEP plans may be formed.

  • Stewardship Reports

    TriBridge can compile an annual summary to illustrate the work we have done for you, the status of any open projects, and recommended projects for the future.

  • Stop Loss/Excess Loss

    individual or group policies providing coverage to a health plan, a self-insured employer plan, or a medical provider providing coverage to insure against the risk that any one claim or an entire plan’s losses will exceed a specified dollar amount.

  • Telemedicine

    This benefit is quickly becoming one of the most effective cost-management tools. It allows employees and their families to receive diagnosis, guidance, and prescription without having to take time off work, wait in the doctor’s office, or deal with other inconveniences for most non-emergency medical issues.

  • Third Party Administrator (TPA)

    is a person or organization that processes claims and performs other administrative services in accordance with a service contract, usually in the field of employee benefits.

  • Underwriting

    is the selection and pricing of insurance applications that are offered to an insurer.

  • Vesting Schedule

    The structure for determining participants’ ownership right to company contributions (see matching contributions). In a plan with immediate vesting, participants own all company contributions as soon as they are deposited into individual accounts. In cliff vesting, company contributions will be fully owned (i.e., vested) only after a specific amount of time, and employees leaving before the allotted time are not entitled to any company contributions (with certain exceptions for retirees). In plans with graduated or graded vesting, vesting occurs in specified increments.

  • Workforce Engagement Benchmarking (Employee Retention)

    If one of your objectives is to maintain or increase the retention rate of your top talent, you will benefit from our nationally benchmarked and tested employee engagement strategies.

  • Year-round Benefits Service and Support

    Our service team is ready and eager to assist you or your team with questions or challenges as they arise.