Common Benefit Terms
Actively Employed (or actively-at-work)
You are currently performing work duties for your employer on a regular, full-time basis at the employer’s usual place of business or another location defined by them as a place of business. If you will not be actively employee starting [plan start date], please notify your FFGA representative.
The period of time when eligible employees have the opportunity to enroll in or change their current benefit elections.
The amount you must pay out-of-pocket every plan year before insurance will start paying for covered expenses.
The calendar year begins January 1 and ends December 31.
The percentage or costs of a covered health care service you pay after you’ve paid your deductible; the insurance company pays the rest.
This is when carriers allow eligible employees to apply for coverage without answering medical questions or taking a health exam. It is usually only available during the initial eligibility period and/or for new hires, plus pre-existing condition and active employment provisions will apply as outlined in the plan.
A list of doctors, hospitals, dentists, and other providers who are contracted as a network provider within your plan.
The limit the insured can pay in co-insurance for covered expenses.
Your plan year begins Sept. 1 and ends Aug. 31, during which your benefits are in force.
This includes any medical issue, such as an illness, injury or disease, for which you take prescription drugs and/or receive medical care (including diagnostic and consultation services).
Applies to any illness, injury or condition for which the participant has been under the care of a health care provider, taken prescription drugs or is under a health care provider’s orders to take drugs, or receive medical care or services (including diagnostic and/or consultation services).