Tampa Healthcare Group Benefits Acronyms and Definitions. (THGBAD)

Problogger’s recent article “Where to find Free Images Online” reminded me of some golden rules to follow when posting online.

It was a clear attempt to help fellow marketers like myself with a reference article and a go to place for free image websites. Now through my travels online I may have run across of few of these sites and bookmarked them, but now I have them all in one place.

Not only did they identify one of the very high level problems every marketer seems to have, finding images to use for blog posts, websites, they solved the problem in one nice neat article post.

The article made me think about the industry I write for Insurance, Healthcare, and Employee Benefits and the confusing mess a lot of the terms being used today in the industry can cause.

As internal dialogue speak we use these terms on a daily basis, but even I get confused when I attempt to use some of the Acronyms being used today in the healthcare industry.

It started to feel like you needed a thesaurus to reference when someone is talkig about healthcare. Did you know there is a Wikipedia page for Acronyms in Healthcare?

At Accurate Insurance Solutions we recognized the need for a listing of terms and their meanings in regards to the ever changing landscape of healthcare reform.

Probably by the time we are done writing this article there will already be more terms to add to it but for now with the help from our friends at Zywave, we have compiled a list below of common acronyms being used in health care reform.

So here is my Problogger attempt and as a bonus we added the definition of each.

ACA: The Affordable Care Act. Used to refer to the final, amended version of the health care reform legislation.

CDC: The Centers for Disease Control and Prevention.

CHIP: The Children’s Health Insurance Program. Program that provides health insurance to low-income children, and in some states, pregnant women who do not qualify for Medicaid but cannot afford to purchase private health insurance.

DOL: United States Department of Labor.

EBSA: Employee Benefits Security Administration. A division of the DOL responsible for compliance assistance regarding benefit plans.

EPO Plan: An exclusive provider organization plan. A managed care plan that only covers services in the plan’s network of doctors, specialists or hospitals (except in an emergency).

ERRP: The Early Retiree Reinsurance Program. A temporary program

FPL: Federal poverty level. A measure of income level issued annually by HHS and used to determine eligibility for certain programs and benefits.

FLSA: The Federal Fair Labor Standards Act. Amended by PPACA to incorporate health care reform-specific provisions.

FSA: Flexible spending account.

HCERA: The Health Care and Education Reconciliation Act of 2010. Enacted on March 30, 2010, to amend and supplement PPACA.

HCR: Health care reform.

HDHP: High deductible health plan.

HHS: United States Department of Health and Human Services.

HMO: Health maintenance organization. A type of health insurance plan that typically limits coverage to care from medical providers who work for or contract with the HMO.

HRA: Health reimbursement arrangement or account.

HSA: Health savings account.

IRO: An independent review organization. An organization that performs independent external reviews of adverse benefit determinations.

MLR: Medical loss ratio. Refers to the claims costs and amounts expended on health care quality improvement as a percent of total premiums. This ratio excludes taxes, fees, risk adjustments, risk corridors and reinsurance.

NAIC: The National Association of Insurance Commissioners.

OCIIO: The Office of Consumer Information and Insurance Oversight. A division of HHS responsible for implementing many of the health care reform provisions

OOP: Out-of-pocket limit. The maximum amount you have to pay for covered services in a plan year.

PCE: Pre-existing condition exclusion. A plan provision imposing an exclusion of benefits ue to a pre-existing condition.

PCIP: The Pre-existing Condition Insurance Plan. A temporary high-risk insurance pool that provided coverage to eligible individuals until 2014.

POS Plan: Point-of-service plan. A type of plan in which you pay less if you go to doctors, hospitals and other health care providers that belong to the plan’s network. POS plans require a referral from your primary care doctor to see a specialist.

PPACA: The Patient Protection and Affordable Care Act. Enacted on March 23, 2010, as the primary health care reform law.

PPO: Preferred provider organization. A type of health plan that contracts with medical providers (doctors, hospitals) to create a network of participating providers. You pay less when using providers in the plan’s network, but can use providers outside the network for an additional cost.

QHP: Qualified health plan. A certified health plan that provides an essential health benefits package. Offered by a licensed health insurer.

SHOP Exchange: The Small Business Health Options Program. A program that each health insurance exchange must create to assist eligible small employers when enrolling their employees in qualified health plans offered in the small-group market.

As an employee benefits/HR consulting firm in Tampa, Florida we pride ourselves on providing exceptional customer service. We look to provide our clients with more than they expect.

Whether it's a list of definitions, a state of the art benefits portal, assistance in compliance with the new Affordable Health Care laws, or designing a wellness program for your employees.

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