Employee Benefits Acronyms

June 27, 2018 by in category Uncategorized with 0 and 0

Are you familiar with commonly used terms within the employee benefits industry? The following is a list of frequently used acronyms:

 

-A-

  • ACA – Affordable Care Act
  • ACO – Accountable Care Organization
  • ADA – Americans with Disabilities Act
  • AD&D – Accidental Death and Dismemberment
  • ADB – Accidental Death Benefit
  • ADEA – Age Discrimination in Employment Act
  • ADL – Activities of Daily Living
  • ADR – Alternative Dispute Resolution
  • APL – Automatic Premium Loan
  • APS – Attending Physician’s Statement
  • Archer MSA – Archer Medical Savings Account
  • ART – Annually Renewable Term (also known as YRT – Yearly Renewable Term for life insurance)
  • ASO – Administrative Services Only

-C-

  • CDHC – Consumer Driven Health Care
  • CDHP – Consumer Driven Health Plan
  • CFR – Code of Federal Regulations
  • CHAMPUS – Civilian Health and Medical Program of the Uniformed Services (now TRICARE)
  • CHIP – Children’s Health Insurance Program
  • CLU – Chartered Life Underwriter
  • CMS – Centers For Medicare & Medicaid Services (formerly HCFA)
  • CMS-1500 – Claim form used by medical professionals
  • COB – Coordination of Benefits
  • COC – Certificate of Coverage
  • COLA – Cost-of-living Adjustments
  • COBRA – Consolidated Omnibus Budget Reconciliation Act
  • CPT – Current Procedural Terminology

-D-

  • DB – Defined Benefits
  • DC – Defined Contributions
  • DCAP – Dependent Care Assistance Program
  • DCTC – Dependent Care Tax Credit
  • DFVC Program – Delinquent Filer Voluntary Compliance Program
  • DME – Durable Medical Equipment
  • DO – Doctor of Osteopath
  • DOB – Date of Birth
  • DOS – Date of Service
  • DOL –Department of Labor
  • DOMA – Defense of Marriage Act
  • DRGs – Diagnostic Related Groups
  • DX – Diagnosis Code

-E-

  • EAP – Employee Assistance Program
  • EBSA – Employee Benefits Security Administration (formerly PWBA)
  • EDI – Electronic Data Interchange
  • EEO – Equal Employment Opportunity
  • EEOC – Equal Employment Opportunity Commission
  • EFAST – ERISA Filing Acceptance System
  • EFT – Electronic Funds Transfer
  • EGTRRA – Economic Growth and Tax Relief Reconciliation Act
  • EIC – Earned Income Tax Credit
  • EOB – Explanation of Benefits
  • EOI – Evidence of Insurability
  • EOMB – Explanation of Medical Benefits
  • EPO – Exclusive Provider Organization
  • ERD – Equal Rights Division
  • ERISA – Employee Retirement Income Security Act
  • ERRP –Early Retirement Reinsurance Program
  • ESRD – End Stage Renal Disease

-F-

  • FCRA – Fair Credit Reporting Act
  • FEHBP – Federal Employees Health Benefits Program
  • FICA – Federal Insurance Contributions Act
  • FLSA – Fair Labor Standards Act
  • FMLA – Family Medical Leave Act
  • FSA – Flexible Spending Arrangement (or Account)
  • FUTA – Federal Unemployment Tax Act

-G-

  • GINA – Genetic Information Nondiscrimination Act
  • GTL – Group-term life insurance

-H-

  • HCE – Highly Compensated Employee
  • HCFA – Health Care Financing Administration (now CMS)
  • HCR – Health Care Reform
  • HCTC – Health Coverage Tax Credit
  • HDHC – High Deductible Health Coverage
  • HDHP – High Deductible Health Plan
  • Health FSA – Health Flexible Spending Arrangement (or Account)
  • HHS – Department of Health and Human Services
  • HIAA – Health Insurance Association of America
  • HIPAA – Health Insurance Portability and Accountability Act
  • HMO – Health Maintenance Organization
  • HRA – Health Reimbursement Arrangement (or Account)
  • HSA – Health Savings Account

-I-

  • IDEA – Individuals with Disabilities Education Act of 1997
  • ICD-10 – International Classification of Diseases, 10th edition
  • IME – Independent Medical Exam
  • IPA – Independent Practice Association
  • IPS – Investment Policy Statement
  • IRA – Individual Retirement Account
  • IRC – Internal Revenue Code
  • IRO – Independent Review Organization
  • IRS – Internal Revenue Service

-J-

  • JCAHO – Joint Commission on Accreditation of Healthcare Organizations
  • JGTRRA – Jobs and Growth Tax Relief Reconciliation Act

-L-

  • LCSW – Licensed Clinical Social Worker
  • LHSO – Limited Health Service Organization
  • LTC – Long-term Care
  • LTD Plan – Long-term Disability Plan

-M-

  • MCO – Managed Care Organization
  • MSN – Medicare Summary Notice
  • Medigap – Medicare supplemental insurance
  • Med Supp – Medicare supplemental insurance
  • MET – Multiple Employer Trust
  • MEWA – Multiple Employer Welfare Arrangement
  • MHPA – Mental Health Parity Act
  • MIB – Medical Information Bureau
  • MIS – Management Information Systems
  • MSA – Medical Savings Account
  • MSP – Medicare Second Payer

-N-

  • NAIC – National Association of Insurance Commissioners
  • NAMCR – National Association of Managed Care Regulators
  • NCQA – National Committee for Quality Assurance
  • NICB – National Insurance Crime Bureau
  • NHCE (or Non-HCE) – Non-highly Compensated Employee
  • NMHPA – Newborns’ and Mothers’ Health Protection Act
  • Non-par – Non-participating provider

-O-

  • OBRA – Omnibus Budget Reconciliation Act of 1993
  • OCHI – Office of Consumer Health Insurance
  • OCR – Office for Civil Rights
  • OHCA – Organized Health Care Arrangement
  • OMB – Office of Management and Budget
  • OOP – Out-of-pocket limit
  • OPM – Office of Personnel Management (for federal employee benefits)
  • OTC Drug – Over-the-counter Drug

-P-

  • Par – Participating Provider
  • PCE – Pre-existing Condition Exclusion
  • PCP – Primary Care Physician
  • PDA – Pregnancy Discrimination Act
  • PEO – Professional Employer Organization
  • PFFS – Private Fee For Service (alternative form of Medicare)
  • PHI – Protected Health Information
  • PHSA – Public Health Service Act
  • POA – Power of Attorney
  • PHO – Physician Hospital Organization
  • PMPM – Per Member Per Month
  • POP – Premium-only Plan
  • POS – Point-of-service
  • PPA – Preferred Provider Arrangement
  • PPACA – Patient Protection and Affordable Care Act
  • PPO – Preferred Provider Organization
  • PWBA – Pension and Welfare Benefits Administration (now EBSA)

-Q-

  • QDRO – Qualified Domestic Relations Order
  • QHP – Qualified Health Plan
  • QMB – Qualified Medical Beneficiary
  • QMCSO – Qualified Medical Child Support Order

-R-

  • RBC – Risk Based Capital
  • ROC – Review Oversight Committee
  • RTW – Return to Work (date for disability coverage)

-S-

  • SAR – Summary Annual Report
  • SBC – Summary of Benefits and Coverage
  • SBJPA – Small Business Job Protection Act
  • SEP – Simplified Employee Pension
  • SHIP – Senior Health Insurance Program
  • SHOP Exchange –Small Business Health Options Program
  • SLOB – Separate Line of Business
  • SMM – Summary of Material Modifications
  • SNF – Skilled Nursing Facility
  • SPD – Summary Plan Description
  • SPDA – Single-premium Deferred Annuity
  • SPIA – Single-premium Immediate Annuity
  • SSA – Social Security Administration
  • SSDI – Social Security Disability Insurance

-T-

  • TPA – Third-party Administrator
  • TPPP – Third Party Prescription Program
  • TRICARE – Triple option benefit plan for military families (formerly CHAMPUS)

-U-

  • UB04 – Billing form used by hospitals
  • U&C (R&C or UCR) – Usual Customary, Reasonable and Customary, Usual Customary and Reasonable
  • UR – Utilization Review
  • URAC – Utilization Review Accreditation Commission
  • USC – United States Code
  • USERRA – Uniformed Services Employment and Re-employment Rights Act

-V-

  • VEBA – Voluntary Employees’ Beneficiary Association
  • VFC – Voluntary Fiduciary Correction Program
  • VHSP – Voluntary Health Service Plan

W-

  • WHCRA – Women’s Health and Cancer Rights Act
  • WP – Waiver of Premium For Disability Benefit
  • WPHCP – Women’s Principle Health Care Provider

-Y-

  • YTD – Year-to-date
  • YRT – Yearly Renewable Term Insurance (also known as ART – Annually Renewable Term Insurance)

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