Glossary

Term Definition
AD&D Accidental Death and Dismemberment.
AutoPay Withdrawals that you authorize CoPower to automatically and periodically deduct from your bank account to pay premiums.
Beneficiary A person designated by a plan participant or by the terms of an insurance plan, who is or may become entitled to a benefit.
Carrier An organization, such as an insurance company, that provides or administers programs that arrange for health, dental, life or other insurance services.
COBRA Consolidated Omnibus Budget Reconciliation Act: a federal law that, among other things, requires employers to offer continued health insurance coverage to certain employees and their beneficiaries whose group health insurance has been terminated if they undergo a qualifying event.
Deductible The amount of eligible expenses a covered person must pay each year from his/her own pocket before the plan will make payment for eligible benefits.
Dependent A covered person who relies on another person for support or obtains health coverage through a spouse or parent who is the covered person under a plan.
DE 6 Quarterly Wage report that the Employer must file with the government.
Effective Date The date insurance coverage begins.
Employee Census List of employees and their pertinent information: ID#,social security number, date of birth, and date of hire.
Enrollee An Employee or their Dependent who is enrolled to receive benefits, or an Individual who chooses to pay for Continuation of Coverage through COBRA.
EOC Evidence of Coverage.
GSR CoPower Group Service Representative.
Loss of Coverage When coverage is no longer in effect.
Maximum The greatest dollar amount a carrier will procedures in any calendar year
Open Enrollment There are three types of open enrollment:

1.The period during which participants in a benefit program have an opportunity to choose among health or dental plans being offered to them.
2.An employer is able to change their benefits on their anniversary.
3. Late enrollees can come onto a plan during their anniversary (only available in select CoPower plans).

Premium The cost of insurance coverage for a specified benefit over a
specific time period.
Proof of Loss of Coverage Documentation indicating the reason for a loss of coverage.
Qualifying Event An event that may entitle a person to continue insurance coverage or allow an employee or dependent to come onto a plan after their eligibility has expired. Examples of qualifying events include termination of employment, loss of coverage,reduction in work hours, death of an insured employee, divorce or legal separation, a dependent child’s loss of dependent status, birth of a child, adoption or marriage.
UCR Usual, customary and reasonable charges as compared to charges for like treatment, services and supplies in the geographic area where treatment is performed.