 |
|
|
Directory
of 1,000 Healthcare Recruiters Calendar of Health Observance Dates Recommended
Reading Lists & Healthcare Bookstore Glossary of Managed Care Terms Health Care Companies & Hospitals Tools for Physician Executives Tools for Traveling Executives
To search this site, click here.
"The secret of success is constancy of
purpose."
(Benjamin Disraeli)
|
You are here > Home > Managed Care Terminology > M Words Glossary of Terms in Managed Health Care The following are definitions of commonly used terms in the medical provider, hospital and managed care industries. This dictionary is comprised of 26 individual pages, one for each letter of the alphabet. To find a certain word that starts with this letter of the alphabet, may we suggest that you please try the "find" or "search" function in your browser. Or you may simply scroll down the list. If your word starts with another letter, please use the alphabet index below. This glossary can now also be purchased
in printed book format if you would like to have it accessible at your desk.
A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | Search | M MAAC - See Maximum Allowable Actual Charge, below.
Major Medical
Expense Insurance - Policies designed to help offset the heavy
medical expenses resulting from catastrophic or prolonged illness or injury.
They generally provide benefits payments for 75 to 80 percent of most types of
medical expenses above a deductible paid by the insured. Malpractice Insurance - Insurance against the risk of suffering financial damage due to professional misconduct or lack of ordinary skill. Malpractice requires that the patient prove some injury and that the injury was the result of negligence on the part of the professional. A practitioner is liable for damages or injuries caused by malpractice. Managed Behavioral Health Organization (MBHO)
- An organization that provides behavioral health services by implementing
managed care techniques. Managed Behavioral
Health Program - A program
of managed care specific to psychiatric or behavioral health care. This usually
is a result of a "carve-out" by an insurance company or managed care
organization (MCO). Reimbursement may be in the form of sub-capitation, fee for
service or capitation. See also Carve-Out. Managed Care - Systems and techniques used to control the
use of health care services. Includes a review of medical necessity, incentives
to use certain providers, and case management. The body of clinical, financial
and organizational activities designed to ensure the provision of appropriate
health care services in a cost-efficient manner. Managed care techniques are
most often practiced by organizations and professionals that assume risk for a
defined population (e.g., health maintenance organizations) but this is not
always the case. Managed care is a broad term and encompasses many
different types of organizations, payment mechanisms, review mechanisms and
collaborations. Managed care is sometimes used as a general term for the
activity of organizing doctors, hospitals, and other providers into groups in
order to enhance the quality and cost-effectiveness of health care. Managed Care
Organizations (MCO) include HMO, PPO, POS, EPO, PHO, IDS, AHP, IPA, etc. Usually
when one speaks of a managed care organization, one is speaking of the entity
that manages risk, contracts with providers, is paid by employers or patient
groups, or handles claims processing. Managed care has effectively formed a
"go-between", brokerage or 3rd party arrangement by existing as the
gatekeeper between payers and providers and patients. The term managed care is
often misunderstood, as it refers to numerous aspects of healthcare management,
payment and organization. It is best to ask the speaker to clarify what he or
she means when using the term "managed care". In the purest sense, all
people working in healthcare and medical insurance can be thought of as
"managing care." Any system of health payment or delivery arrangements
where the plan attempts to control or coordinate use of health services by its
enrolled members in order to contain health expenditures, improve quality, or
both. Arrangements often involve a defined delivery system of providers with
some form of contractual arrangement with the plan. See Health Maintenance
Organization, Independent Practice Association, Preferred Provider Organization.
Managed Care
Organization (MCO) - A
health plan that seeks to manage care. Generally, this involves contracting with
health care providers to deliver health care services on a capitated (per-member
per-month) basis. For specific types of managed care organizations, see also
health maintenance organization and independent practice association. Managed Care Plan
- A health plan that uses
managed care arrangements and has a defined system of selected providers that
contract with the plan. Enrollees have a financial incentive to use
participating providers that agree to furnish a broad range of services to them.
Providers may be paid on a pre-negotiated basis. (See also Health Maintenance
Organization, Point-of-Service Plan, and Preferred Provider Organization.) Managed Competition - A health insurance system that bands together employers, labor groups and others to create insurance purchasing groups; employers and other collective purchasers would make a specified contribution toward insurance purchase for the individuals in their group; the employer's set contribution acts as an incentive for insurers and providers to compete. This term first surfaced as a result of Bill Clinton's health reform package in the early 1990s. Managed Dental Care - Any dental plan
offered by an organization that provides a benefit plan that differs from a
traditional fee-for-service plan. Managed Health
Care Plan - An arrangement
that integrates financing and management with the delivery of health care
services to an enrolled population. It employs or contracts with an organized
system of providers that delivers services and frequently shares financial risk. Managed Indemnity Plans - Health insurance plans that are administered like traditional indemnity plans but which include managed care "overlays" such as precertification and other utilization review techniques. Management
Information System (MIS) -
The common term for the computer hardware and software that provides the support
of managing the plan. Management
Services Organization (MSO)
- Usually an entity owned by a hospital, physician group, PHO or IDS that
provides management services and administrative systems to one or more medical
practices. The management services organization provides administrative and
practice management services to physicians. A hospital, hospitals, or investors
may typically own an MSO. Large group practices may also establish MSOs to sell
management services to other physician groups. See also Medical Services
Organization. Mandated Benefits - Benefits that health plans are required by
law to provide. Mandated Providers - Providers whose services must be included
in coverage offered by a health plan. State or federal law can require these
mandates. Manual Rates and Manual Rating - Rates based on a health plan's average
claims data and adjusted for certain factors, such as group demographics or
industry. MA-PD - See Medicare Advantage Prescription Drug Plan. Market Area - The targeted geographic area or areas of
greatest market potential. The market area does not have to be the same as the
post acute facility's catchment area. Market Basket Index - A common term in the field of economics. In healthcare business, this refers to a ratio or index of the annual change in the prices of goods and services providers used to produce health services. Different market baskets exist for PPS based hospital inputs and capital inputs, DRG exempt facility operating inputs (such as SNF, home health agency and renal dialysis facility). Also called input price index. Market Segmentation - The process of dividing the total market for a product or service into smaller, more manageable subsets or groups of customers. Market Share - A certain percentage of the market area or
targeted market population. Usually used to describe a forecasted goal or a past
penetration of the market. Master Patient /
Member Index - An index or
file with a unique identifier for each patient or member that serves as a key to
a patient's or member's health record. Maximum Allowable Actual Charge (MAAC) - A limitation on billed charges for Medicare services provided by nonparticipating physicians. For physicians with charges exceeding 115 percent of the prevailing charge for nonparticipating physicians, MAACs limit increases in actual charges to 1 percent a year. For physicians whose charges are less than 115 percent of the prevailing, MAACs limit actual charge increases so they may not exceed 115 percent. Maximum Defined Data Set - Under HIPAA, this is all of the required data elements for a particular standard based on a specific implementation specification. An entity creating a transaction is free to include whatever data any receiver might want or need. The recipient is free to ignore any portion of the data that is not needed to conduct their part of the associated business transaction, unless the inessential data is needed for coordination of benefits. Maximum Out-of-Pocket Expenses - Limit on total number of co-payments or limit on total cost of deductibles and co-insurance under a benefit plan. MBHO - See Managed Behavioral Health Program. McCarran-Ferguson Act - A 1945 Act of Congress exempting insurance businesses from federal commerce laws and delegating regulatory authority to the states. A federal act that placed the primary responsibility for regulating health insurance companies and HMOs that service private sector (commercial) plan members at the state level. MCE - See Medical Care Evaluation Studies. MCO - See Managed Care Organization. MCR - See Medicare Cost Report. Medicaid (Title XIX) - A joint federal and state program that helps with medical costs for some people with low incomes and limited resources. Medicaid serves the poor, blind, aged, disabled or members of families with dependent children (AFDC). Each state has its own standards for qualification. A Federally aided, state-operated and administered program that provides medical benefits for certain indigent or low-income persons in need of health and medical care. The program, authorized by Title XIX of the Social Security Act, is basically for the poor. It does not cover all of the poor, however, but only persons who meet specified eligibility criteria. Subject to broad Federal guidelines, states determine the benefits covered, program eligibility, rates of payment for providers, and methods of administering the program. Medicaid programs vary from state to state, but most health care costs are covered for citizens who qualify for both Medicare and Medicaid. All states but Arizona have Medicaid programs. Medical Advisory Committee - The MCO
committee that evaluates proposed policies and action plans related to clinical
practice management, including changes in provider contracts, compensation, and
changes in authorization procedures, reviews data regarding new medical
technology, and examines proposed medical policies. Medical Allied
Manpower - This category
includes some sixty occupations or specialties that can be divided into two
large categories based on time required for occupational training. The first
category includes those occupations that require at least a baccalaureate
degree, for example, clinical laboratory scientists and technologists,
dietitians and nutritionists, health educators, medical record librarians, and
occupational speech and rehabilitation therapists. The second group includes
those occupations that require less than a baccalaureate degree, such as aides
for each of the above categories as well as physician assistants and
radiological technicians. Medical Care Evaluation Studies (MCE) - The name given to a generic form of health care review in which problems in the quality of the delivery and organization of health care services are addressed and monitored. A program recommended as a way of meeting the federal government's requirements for an internal quality assurance program for federally qualified HMOs. Medical Code Sets - Codes that characterize a medical condition or treatment. These code sets are usually maintained by professional societies and public health organizations. Compare to administrative code sets. Medical Error - A mistake or negligence that occurs when a planned treatment or procedure is delivered incorrectly or when a wrong treatment or procedure is delivered. Also see Tort Reform and Risk Management. Medical Group
Practice - The American
Group Practice Association, the American Medical Association, and the Medical
Group Management Association define medical group practice as: provision of
health care services by a group of at least three licensed physicians engaged in
a formally organized and legally recognized entity sharing equipment,
facilities, common records and personnel involved in both patient care and
business management. Medical
Informatics - Medical informatics
is the systematic study, or science, of the identification, collection, storage,
communication, retrieval, and analysis of data about medical care services to
improve decisions made by physicians and managers of health care organizations.
Medical informatics will be as important to physicians and medical managers as
the rules of financial accounting are to auditors. Medical Loss Ratio (MLR) - Cost ratio of total benefits used compared to revenues received. Usually referred to by a ratio, such as 0.96--which means that 96% of premiums were spent on purchasing medical services. The goal is to keep this ratio below 1.00--preferably in the 0.80 ranges, since the MCO's or insurance company's profit comes from premiums. Currently, successful HMOs do have MLRs in the 0.70-0.80 range. The ratio between the cost to deliver medical care and the amount of money that was taken in by a plan. Insurance companies often have a medical loss ratio of 96 percent or more: tightly managed HMOs may have medical loss ratios of 75 percent to 85 percent, although the overhead (or administrative cost ratio) is concomitantly higher. See also Loss Ratio and Incurred Claims Loss Ratio. Medically Appropriate Services - Diagnostic or treatment measures for which the expected health benefits exceed the expected risks by a margin wide enough to justify the measures. Medically Necessary, Medical Necessity, Medical Necessary Services - Services or supplies which meet the following tests: They are appropriate and necessary for the symptoms, diagnosis, or treatment of the medical condition; They are provided for the diagnosis or direct care and treatment of the medical condition; They meet the standards of good medical practice within the medical community in the service area; They are not primarily for the convenience of the plan member or a plan provider; and They are the most appropriate level or supply of service which can safely be provided. Medical-Necessity Review - See Prior Authorization or Pre-Cert.
Medically Needy - Individuals who meet the financial resource requirements
of categorically needy individuals, but whose monthly income exceeds specified
maximums. Persons who are categorically eligible for
Medicaid and whose income, less accumulated medical bills, are below state
income limits for the Medicaid program. Often seen as a problem among the
"working poor" or among the senior population. See spend down. Medical Management
Information System (MMIS) - A
data system that allows payers and purchasers to track health care expenditure
and utilization patterns. May also be referred to as Health Information System
(HIS), Health Information Management (HIM) or Information System (IS). See also
Electronic Medical Record (EMR). Medical Review,
Medical Review Criteria –
Screening of healthcare utilization and the criteria used for this screening.
Medical reviews are usually conducted by insurance companies, third-party
payers, review organizations and case managers. This is the underlying
basis for reviewing the quality and appropriateness of care provided to selected
cases. Insurance companies rely heavily
on medical review and their own criteria as cost control. Through medical
review, payers are able to limit or reduce the utilization of health care
services. Medical review may sometimes put patients at odds with their insurance
companies or hospitals and doctors in conflict with payers. Medical Savings
Account (MSA) - An account
in which individuals can accumulate contributions to pay for medical care or
insurance. Some states give tax-preferred status to MSA contributions, but such
contributions is still subject to federal income taxation. MSAs differ from
medical reimbursement accounts, sometimes called flexible benefits or Section
115 accounts, in that they need not be associated with an employer.
Frequently, MSA specifically refers to the Medicare+Choice delivery
option that consists of a high-deductible catastrophic insurance policy and a
tax-preferred medical savings account established for individual Medicare
beneficiaries. President George W. Bush promoted MSAs
heavily in his 2004 presidential campaign as a method to provide coverage for
the uninsured. However, MSAs are unlikely to meet that need due to the disparity
between income levels and health care costs. Medical Services
Organization (MSO) - An
organized group of physicians, usually from one hospital, into an entity able to
contract with others for the provision of services. See also Management Services
Organization and MSO. Medical Underwriting - The process that an insurance company uses to decide, based on an applicant's medical history, whether or not to take the applicant's application for insurance, whether or not to add a waiting period for pre-existing conditions (if that state law allows it), and how much to charge the applicant for that insurance. Medicare (Title
XVIII) - A federal program
for the elderly and disabled, regardless of financial status. It is not
necessary, as with Medicaid, for Medicare recipients to be poor. A U.S. health
insurance program for people aged 65 and over, for persons eligible for social
security disability payments for two years or longer, and for certain workers
and their dependents who need kidney transplantation or dialysis. Monies from
payroll taxes and premiums from beneficiaries are deposited in special trust
funds for use in meeting the expenses incurred by the insured. It consists of
two separate but coordinated programs: hospital insurance (Part A) and
supplementary medical insurance (Part B) - and a separate drug coverage program
administered by the private sector (Part D). Medicare covers more than 16% of population. Medicare Advantage Plan - A plan offered by a private company that contracts with Medicare to provide an enrollee with all your Medicare Part A and Part B benefits. Medicare Advantage Plans are HMOs, PPOs, Private Fee-for-Service Plans, and Special Needs Plans. When an individual is enrolled in a Medicare Advantage Plan, Medicare services are covered through the plans, and are not paid for under Original Medicare. Medicare Advantage Prescription Drug Plan (MA-PD) - A Medicare Advantage plan that offers Medicare Prescription Drug coverage and Part A and Part B benefits in one plan. Medicare Approved Amount - In the Original Medicare Plan, this is the amount a doctor or supplier can be paid, including what Medicare pays and any deductible, coinsurance, or copayment that the citizen pays. Same as Medicare Approved Charge. Medicare Approved Charge - The amount Medicare approves for payment to a physician. Typically, Medicare pays 80 percent of the approved charge and the beneficiary pays the remaining 20 percent. Physicians may bill beneficiaries for an additional amount (the balance) not to exceed 15 percent of the Medicare approved charge. See balance billing. Medicare Contractor - A Medicare Part A Fiscal Intermediary (institutional), a Medicare Part B Carrier (professional), or a Medicare Durable Medical Equipment Regional Carrier (DMERC) Medicare Coordinated Care Plan - A Medicare Advantage HMO or PPO Plan. Medicare Cost Plans - Medicare cost plans are a type of HMO that contracts as a Medicare Health Plan. As with other HMOs, the plan only pays for services outside its service area when they are emergency or urgently needed services. However, when enrolled in a Medicare Cost Plan, if an enrollee gets routine services outside of the plan's network without a referral, the Medicare-covered services will be paid for under the Original Medicare Plan, and the plan enrollee will be responsible for the Original Medicare deductibles and coinsurance. Medicare Cost Report (MCR) - An annual report required of institutions participating in the Medicare program. The MCR records each institution's total costs and charges associated with providing services to all patients, the portion of those costs and charges allocated to Medicare patients, and the Medicare payments received. Medicare Coverage - Made up of two parts: Hospital Insurance (Part A) and Medical Insurance (Part B). The term of coverage does not include Medicare Drug Plans (Part D). See Medicare Part A and Medicare Part B. Medicare Economic Index (MEI) - An index that tracks changes over time in physician practice costs. From 1975 through 1991, for example, increases in prevailing charge screens were limited to increases in the MEI. Medicare Health Plans - A plan offered by a private company that contracts with Medicare to provide the enrollee with Medicare Part A and/or Part B benefits. Medicare Health Plans include Medicare Advantage plans (including HMO, PPO, or Private Fee-for-Service Plans); Medicare Cost Plans; PACE plans; and special needs plans. Medicare Managed Care Plan - A type of Medicare Advantage Plan that is available in some areas of the country. In most managed care plans, enrollees can only go to doctors, specialists, or hospitals on the plan's list. Plans must cover all Medicare Part A and Part B health care. Some managed care plans cover extras, like prescription drugs. Medicare Part A - The Medicare component that provides basic hospital insurance to cover the costs of inpatient hospital services, confinement in nursing facilities or other extended care facilities after hospitalization, home care services following hospitalization, and hospice care. Medicare Part B - The Medicare component that provides benefits to cover the costs of physicians' professional services, whether the services are provided in a hospital, a physician's office, an extended-care facility, a nursing home, or an insured's home. Medicare Part D - See Medicare Prescription Plan, below. Medicare+Choice - The Medicare component that addresses how covered services are delivered to enrollees and increases the numbers and types of healthcare organizations allowed to participate in Medicare. Medicare Prescription Drug Coverage - See Medicare Prescription Drug Plan, below. Medicare Prescription Drug Plan (PDP or MPDP) - A stand-alone drug plan, offered by insurers and other private companies to beneficiaries that receive their Medicare Part A and/or B benefits through the Original Medicare Plan; Medicare Private Fee-for-Service Plans that don’t offer prescription drug coverage; and Medicare Cost Plans offering Medicare prescription drug coverage. These stand-alone plans add prescription drug coverage to the Original Medicare Plan and to some Medicare Cost Plans and Medicare Private Fee-for-Service Plans. Managed by commercial and private entities, these PDPs are a type of managed care and discounting. When people join a Medicare Prescription Drug Plan, they use the plan member cards that are received from the plans when they go to the pharmacies to purchase prescriptions. When they use their cards, they will normally get discounts on their prescriptions, provided that the drugs are on the approved or covered lists and they are not operating within the "donut hole". Costs will vary depending on recipients' financial situations and which Medicare Prescription Drug Plans they chose. If an individual has limited income and resources, he or she may get extra help to cover prescription drugs for little or no cost. All MPDPs are not the same and will have varying costs, benefits, doctor choices, conveniences, and quality. See also Medicare Part D. Medicare Provider Analysis and Review (MedPAR) File - A CMS data file that contains charge data and clinical characteristics, such as diagnoses and procedures, for every hospital inpatient bill submitted to Medicare for payment. Medicare Remittance Advice Remark Codes - A national administrative code set for providing either claim-level or service-level Medicare-related messages that cannot be expressed with a Claim Adjustment Reason Code. This code set is used in the X12 835 Claim Payment & Remittance Advice transaction. Medicare Risk Contract - An agreement by an HMO or competitive medical plan to accept a fixed dollar reimbursement per Medicare enrollee, derived from costs in the fee-for-service sector, for delivery of a full range of prepaid health services. Medicare Select - A Medicare supplement that uses a preferred provider organization to supplement Medicare Part B coverage. A type of Medigap policy that may require enrollees to use certain hospitals and, in some cases, certain doctors within its network to be eligible for full benefits. See Medigap, below. Medicare Summary Notice (MSN) - A notice that the patients get after the doctors or providers file claims for Part A and Part B services in the Original Medicare Plan. It explains what the providers billed for, the Medicare-approved amounts, how much Medicare paid, and what the citizen must pay. Medicare Supplement or Medicare Supplemental Policy - A private medical expense insurance policy that provides reimbursement for out-of-pocket expenses, such as deductibles and coinsurance payments, or benefits for some medical expenses specifically excluded from Medicare coverage. See Medigap.
Medigap - Individual medical expense insurance policies sold by
state-licensed private insurance companies. Private health insurance plans that
supplement Medicare benefits by covering some costs not paid for by Medicare.
Except in Massachusetts,
Minnesota, and Wisconsin, there are 12 standardized plans labeled Plan A through
Plan L. Medigap policies only work with the Original Medicare Plan. Medigap plans vary from
state to state; standardized Medigap plans also may be known as Medicare Select
plans. Medigap Open Enrollment Period - A one-time-only six month period when a citizen can buy any Medigap policy that is sold in the state. It starts in the first month that the citizen is covered under Medicare Part B and the citizen is age 65 or older. During this period, no citizen can be denied coverage or charged more due to past or present health problems. Medigap Policy - See Medigap MedPAR - See Medicare Provider Analysis and Review. MEI - See Medicare Economic Index. Member - Used synonymously with the terms enrollee and insured. A member is any individual or dependent who is enrolled in and covered by a managed health care plan. Also see Enrollee. Member Services - The broad range of activities that an MCO and its employees undertake to support the delivery of the promised benefits to members and to keep members satisfied with the company. Mental Health
Parity and Mental Health
Parity Act - Mental health
parity refers to providing the same insurance coverage for mental health
treatment as that offered for medical and surgical treatments. The Mental Health
Parity Act was passed in 1996 and established parity in lifetime benefit limits
and annual limits. Mental Health Provider - Psychiatrist, social worker, hospital or other facility licensed to provide mental health services. Messenger Model - A type of independent practice association (IPA) that simply negotiates contract terms with MCOs on behalf of member physicians, who then contract directly with MCOs using the terms negotiated by the IPA. This type of IPA is most often used with fee-for-service or discounted fee-for-service compensation arrangements. This model is also used by PHOs. MET - See Multiple Employer Trust. MEWA - See Multiple Employer Welfare Arrangement.
Military Health System (MHS) and Military Treatment Facilities (MTFs) - A worldwide healthcare system operated by the U.S. Department of Defense that focuses its efforts on population health improvement by integrating the delivery of healthcare services for active-duty personnel, retirees, and the families of active-duty personnel and retirees. Minimum Necessary - A HIPAA Privacy Rule standard
requiring that when protected health information is used or disclosed, only the
information that is needed for the immediate use or disclosure should be made
available by the health care provider or other covered entity. This standard
does not apply to uses and disclosures for treatment purposes (so as not to
interfere with treatment) or to uses and disclosures that an individual has
authorized, among other limited exceptions. Justification regarding what
constitutes the minimum necessary will be required in some situations (e.g.,
disclosures with a waiver of authorization and non-routine disclosures). Miscellaneous Expenses - Hospital charges, other than room and board, such as those for x-rays, drugs, laboratory fees, and other ancillary services. MLR - See Medical Loss Ratio. Modified Community
Rating - Rating of medical
service usage in a given area, adjusted for data such as age, sex, etc. See also
Community Rating. Modified
Fee-for-Service - System
that pays providers fees for services provided, with certain maximum fees for
each service. See also Fee for Service, Benefits, and Preferred Providers. Morbidity - The extent of illness, injury, or disability
in a defined population. It is usually expressed in general or specific rates of
incidence or prevalence. Mortality - Death. Used to describe the relation of deaths to the population in which they occur. The mortality rate (death rate) expresses the number of deaths in a unit of population within a prescribed time and may be expressed as crude death rates (e.g., total deaths in relation to total population during a year) or as death rates specific for diseases and, sometimes, for age, sex, or other attributes (e.g., number of deaths from cancer in white males in relation to the white male population during a given year). MPDP - See Medicare Prescription Drug Plan. MSA - See Medical Savings Account. MSO - One of the following: Medical Staff
Organization An organized group of physicians, usually from one hospital, into
an entity able to contract with others for the provision of services, or
Management (or Medical) Services Organization. An entity formed by, for example,
a hospital, a group of physicians or an independent entity, to provide
business-related services such as marketing and data collection to a grouping of
providers like an IPA, PHO or CWW. This second definition is becoming the almost
exclusive usage. See Management Services Organization or Medical Services
Organization. Multiple Employer
Trust (MET) - A legal trust
established by a plan sponsor that brings together a number of small, unrelated
employers for the purpose of providing group medical coverage on an insured or
self-funded basis. Not quite a Health Plan Purchasing Cooperative, but along the
same lines. More market-oriented and usually smaller in scale. Redefined as a
MEWA by the Multiple Employer Welfare Arrangement Act of 1982. See below. Multiple Employer
Welfare Arrangement (MEWA) - As
defined in 1983 Erlenborn ERISA Amendment, an employee welfare benefit plan or
any other arrangement providing any of the benefits of an employee welfare
benefit plan to the employees of two or more employers. MEWAs that do not meet
the ERISA definition of employee benefit plan and are not certified by the U.S.
Department of Labor may be regulated by states. MEWAs that are fully insured and
certified must only meet broad state insurance laws regulating reserves. Multiple Option
Plan - Health care plan that
lets employees or members choose their own plan from a group of options, such as
HMO, PPO or major medical plan. See also Cafeteria Plan or Flexible Benefits
Plan. A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z | Home Copyright© 1997 - 2007, Pam Pohly, All Rights Reserved. |
