Benefits Glossary

Insurance can come with a lot of jargon. Use these plain-language definitions to understand your benefits.

Copay: A fixed amount you pay for a covered health service, usually at the time of care. For example, a $25 copay for a doctor's visit.
Coinsurance: The percentage of costs of a covered service you pay after you've met your deductible. If your coinsurance is 20%, the plan pays 80%.
Deductible: The amount you pay for covered services before your insurance plan starts to pay. Some services may be covered before you meet it.
Dependent: A person, such as a spouse, domestic partner, or child, who is eligible for coverage under your benefits plan.
Formulary: A list of prescription drugs covered by your plan, often organized into pricing tiers.
HSA (Health Savings Account): A tax-advantaged savings account paired with a high-deductible health plan that you can use to pay for qualified medical expenses.
In-Network: Providers and facilities that have contracted with your insurance plan to provide services at lower negotiated rates.
Open Enrollment: The annual period when you can enroll in, change, or cancel your benefits coverage without a qualifying life event.
Out-of-Pocket Maximum: The most you'll have to pay for covered services in a plan year. After you reach it, the plan pays 100% of covered costs.
Premium: The amount you pay for your insurance coverage, typically deducted from each paycheck.
Qualifying Life Event: A change in your situation, such as marriage, birth, or loss of coverage, that lets you change benefits outside of Open Enrollment.
Voluntary Benefits: Optional coverage you can choose to buy, often at group rates, such as accident, critical illness, legal, or identity theft protection.

Benefits Glossary

Insurance can come with a lot of jargon. Use these plain-language definitions to understand your benefits.

Copay: A fixed amount you pay for a covered health service, usually at the time of care. For example, a $25 copay for a doctor's visit.
Coinsurance: The percentage of costs of a covered service you pay after you've met your deductible. If your coinsurance is 20%, the plan pays 80%.
Deductible: The amount you pay for covered services before your insurance plan starts to pay. Some services may be covered before you meet it.
Dependent: A person, such as a spouse, domestic partner, or child, who is eligible for coverage under your benefits plan.
Formulary: A list of prescription drugs covered by your plan, often organized into pricing tiers.
HSA (Health Savings Account): A tax-advantaged savings account paired with a high-deductible health plan that you can use to pay for qualified medical expenses.
In-Network: Providers and facilities that have contracted with your insurance plan to provide services at lower negotiated rates.
Open Enrollment: The annual period when you can enroll in, change, or cancel your benefits coverage without a qualifying life event.
Out-of-Pocket Maximum: The most you'll have to pay for covered services in a plan year. After you reach it, the plan pays 100% of covered costs.
Premium: The amount you pay for your insurance coverage, typically deducted from each paycheck.
Qualifying Life Event: A change in your situation, such as marriage, birth, or loss of coverage, that lets you change benefits outside of Open Enrollment.
Voluntary Benefits: Optional coverage you can choose to buy, often at group rates, such as accident, critical illness, legal, or identity theft protection.