Glossary of Terms
Get educated on HR and benefits terms and defintions.
Affordable Care Act (ACA)
A comprehensive healthcare reform law enacted in the United States in 2010. Also commonly known as Obamacare, it’s aimed to improve access to healthcare, increase affordability, and enhance consumer protections.
Department of Labor (DOL)
A federal government agency responsible for overseeing and promoting labor laws, workers’ rights, workplace safety, and employment-related policies.
Direct Primary Care (DPC)
A healthcare model in which patients pay a monthly or annual fee to a primary care physician or practice for comprehensive primary care services. DPC eliminates the involvement of insurance companies or third-party payers in the provision and payment of primary care services.
Employee Assistance Program (EAP)
A workplace benefit program designed to provide employees with various personal and work-related challenges that may affect their well-being, job performance, and overall mental health with professional counseling.
Employee Retirement Income Security Act (ERISA)
A federal law enacted in 1974 to protect the rights and interests of employees who participate in employee benefit plans. It establishes rules for plan administration, fiduciary responsibilities, reporting and disclosure, and participant rights.
Evidence of Coverage (EOC)
A document provided by health insurance companies to their policyholders detailing benefits, coverage, and terms of the health insurance plan.
Family and Medical Leave Act (FMLA)
A federal law that provides eligible employees with job-protected leave for certain family and medical reasons such as birth or adoption of a child, caring for a seriously ill family member (spouse, child, or parent), or the employee’s own serious health condition that makes them unable to perform their job.
Flexible Spending Account (FSA)
A tax-advantaged financial account that allows employees to set aside a portion of their pre-tax income to pay for qualified medical expenses. .
Health Insurance Portability and Accountability Act (HIPAA)
A comprehensive healthcare reform law enacted in the United States in 2010. Also commonly known as Obamacare, it’s aimed to improve access to healthcare, increase affordability, and enhance consumer protections.
Health Reimbursement Arrangement (HRA)
A type of employer-funded health benefit plan that reimburses employees for qualified medical expenses. Unlike an HSA or FSA, HRAs are entirely funded by the employer, and employees do not contribute to the account.
Health Savings Account (HSA)
A tax-advantaged savings account that is designed to help individuals and families save money for medical expenses. It offers several advantages including tax benefits and the ability to save for future healthcare costs.
Health Share (or Medical Cost Sharing)
A community-based membership that helps members pay for larger medical bills.
Healthcare Navigation
A service that assists individuals in accessing high-quality, affordable care, getting second opinions, and guiding them through the complexities of the intricate healthcare system.
Independent Third Party Administrator (TPA)
A company or organization that is an independent entity separate from the insurance company that provides administrative services for health insurance plans on behalf of employers. TPAs are responsible for managing various aspects of the health plan, including claims processing, enrollment, customer service, and provider network management.
Individual Coverage Health Reimbursement Arrangement (ICHRA)
A type of health benefit plan that where employers offer a defined contribution to their employees for their individual health insurance premiums and other qualified medical expenses. Employees can choose and purchase their own health insurance coverage, and the employer reimburses them for a portion or all of the premium costs.
Level-Funded Health Plans
A hybrid healthcare funding strategy that offers employers a fixed monthly premium with the potential of unused medical funds returned after the close of the plan year.
Prescription Advocacy
A service that helps patients navigate the complex world of prescription medications. Prescription advocates work on behalf of patients to help them obtain the medications they need at an affordable cost, while also ensuring that the medications are safe and appropriate for their medical conditions.
Prescription Program
A healthcare service offered by a pharmacy or other healthcare provider that helps patients manage their medications. Prescription programs may provide a variety of services, including medication dispensing, medication counseling, medication therapy management, and medication synchronization.
Self Funded Health Plan
A type of health insurance arrangement where an employer or organization takes on financial risk for providing health benefits to its employees or members. Rather than paying premiums to an insurance company to cover medical expenses, the employer or organization sets aside funds to pay for the healthcare costs of its employees or members.