We've listed all the relevant insurance terminology we could think of...and then some! If you don't find what you're looking for, just send us an email with your question and we'll get right back to you with the answer!
Abnormal condition or illness caused by factors associated with the workplace. Like occupational injuries, this is covered by workers compensation policies.
Insurance that pays claims arising out of incidents that occur during the policy term, even if they are filed many years later.
Open Competition States
States where insurance companies can set new rates without prior approval, although the state's commissioner can disallow them if they are not reasonable and adequate or are discriminatory.
Open Enrollment Period
A period when new beneficiaries may elect to enroll in a policy of insurance regardless of health. For Medicare beneficiaries an annual period during which Medicare beneficiaries can switch Medicare Advantage plans or leave Medicare Advantage altogether and go back to original Medicare. The OEP occurs January 1 through March 31 each year. Medicare Advantage plans are not required to open their plans for enrollment during an OEP.
A type of health plan other than a closed panel plan that provides incentives for the enrollee to use providers selected by the plan.
Optional Supplemental Benefits
Additional benefits offered by Medicare coordinated care plans that you may choose and that may include additional premiums.
Ordinance or Law Coverage
Endorsement to a property policy, including homeowners, that pays for the extra expense of rebuilding to comply with ordinances or laws, often building codes, that did not exist when the building was originally built. For example, a building severely damaged in a hurricane may have to be elevated above the flood line when it is rebuilt. This endorsement would cover part of the additional cost.
Ordinary Life Insurance
(See Whole life insurance)
A decision by a Medicare Advantage organization regarding the amount of service provided or the price the plan will reimburse for the service.
Original Equipment Manufacturer (OEM) parts
Refers to the use of replacement parts which are made by the same manufacturer which produced the original parts.
Expenses paid by you in addition to plan premiums, which may include any or all of the following:
Deductible: A fixed amount paid for covered services prior to the plan making payments. Deductibles are usually required to be paid annually. Expenses counted towards your Medicare deductible are the amounts that Medicare would pay for the service, not what you may have actually paid.
Copayment: A fixed dollar amount. For example, many health plans require that you pay a fixed amount for each drug prescription you receive.
Coinsurance: A fixed percentage of the total cost of services, paid each time you use the service.
Outline of Coverage
The document given to each individual policyholder or group health plan member that summarizes the benefits, copayment, coinsurance, deductibles and other requirements for obtaining services covered by the individual policy or group health plan that are listed in full detail in the contract.