Allowable charge

The maximum amount a plan will consider eligible for reimbursement, based upon prevailing fees in a geographic area. You are responsible for paying any amounts over a Plan’s allowable charge costs.

Beneficiary

The person you designate to receive benefits in the event of your death under the Life and AD&D Plans. You may have more than one beneficiary and can change this designation at any time. If you’re married, your spouse is automatically your beneficiary for the 401(k) Savings Plan. You can’t designate another 401(k) beneficiary without consent from your spouse.

Log into Workday to designate beneficiaries for your Life and AD&D coverage, and Fidelity NetBenefits for your 401(k) Savings Plan and Health Savings Account.

Balance Billing

When you receive care from an out-of-network provider and the provider bills you for the difference between what the plan pays for covered expenses and what the provider charges. This does not apply for in-network care because in-network providers have agreed to specific discounted rates with UnitedHealthcare.

Centers of Excellence

Best providers (physician and facility) for certain complex illnesses. A program rates providers and identifies Centers of Excellence based on use of treatments that provide the best chances for positive outcomes and on the efficiency or cost effectiveness of those treatments.

Coinsurance

The percentages of the total cost of health care services that you pay and that a plan pays after a deductible has been met (e.g., for in-network care under the CDHP 80 Plan you pay 20% and the plan pays 80% of the total cost of services after you meet a $2,600 deductible for Individual coverage).

Copayment (or Copay)

The fixed amount you pay for network services (such as office visits or prescriptions) in certain plans.

Deductible

The amount you pay each calendar year before the Plan pays benefits (excluding in-network preventive care, which is covered at 100%). There are separate in-and out-of-network deductibles.

Dental Plan Calendar Year Maximum Benefit

The most the Plan will pay in one calendar year for dental expenses. Once the annual maximum benefit is reached, you pay the full cost of dental care for the rest of the calendar year.

Emergency

Generally, a condition will be considered a true emergency under the Plan if it is severe, begins suddenly or unexpectedly, requires care as soon as possible after the condition begins and requires immediate treatment to avoid serious injury or death.

Evidence of Insurability (Good Health)

Information used to review factors concerning a person’s physical condition and medical history. From this information, the plan or insurance company evaluates whether the risk of the individual will be accepted and whether it will offer coverage to that individual.

Generic Drugs

Drugs that are labeled with the medication’s basic chemical name and usually have brand-name equivalents. They have exactly the same active ingredients as and are therapeutically equivalent to brand-name drugs. They must meet the same FDA standards for safety, purity, strength and quality but are generally less expensive.

Guaranteed Issue

The maximum amount of life insurance coverage that can be provided without having to provide Evidence of Insurability (Good Health).

Mail Order

The Mail Order Program allows you to obtain a 60- or 90-day supply of your prescription mailed directly to your home.

Network

A group of medical or dental providers, including physicians, specialists, primary care clinics and hospitals, who agree to provide care at pre-set rates.

Non-Preferred Brand-Name Drugs

Brand-name drugs that generally have either an equally effective generic equivalent and/or at least one preferred brand-name equivalent. They are therefore more expensive than generic and preferred brand-name drugs.

Out-of-Pocket Maximum

This is the most you will pay for covered expenses in a calendar year. Please note that if you use out-of-network providers, you may also have to pay more than the amount of the Plan’s allowable charge. These charges do not apply to the out-of-pocket maximum. There are separate maximums for in-network and out-of-network charges.

Pre-Certification of Care

Authorization for a specific medical procedure before it is done or for admission to an institution for care.

Preferred Brand-Name Drugs

Brand-name drugs that do not have a generic equivalent. They generally cost less than non-preferred brand-name drugs.

Preventive Care

Preventive care includes things like vaccinations, annual check-ups, screenings and exams. In-network preventive care is covered at 100% by all our medical plans.

Qualifying Life Event

A qualifying life event is an event that you or a covered family member may experience that allows you to change your benefit election during the year.

Specialty Medication

A medication that is used to treat a chronic or complex condition, requires extra oversight, has unique storage or shipping requirements and typically is not available at retail pharmacies.

Term Life Insurance

Provides a specific benefit to the covered person’s beneficiary(ies) when death occurs during the “term” period (such as while employed). This type of coverage does not build up cash reserves, and the death benefit generally decreases when the covered person reaches the age defined in the policy. Under the Life Insurance Plan, coverage decreases at age 70. See the Supplemental Term Life Insurance Reduction Factor Schedule for more details.