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Top 10 Open Enrollment Acronyms

10/27/2016

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Healthcare Definitions: Understanding Open Enrollment Jargon

With open enrollment around the corner, people are researching new health plans. With the complexity of the Affordable Care Act (ACA) and all that comes along with it, sometimes it may be difficult for individuals to understand the jargon.

To ease understanding, here are the top 10 most commonly used open enrollment acronyms defined:

1. CDHC: Consumer Driven Healthcare

In an effort to curb rising healthcare costs, consumer driven healthcare is a trend in health insurance to lower premiums and raise deductibles by incentivizing individuals to become more educated about healthcare and price conscious of their healthcare plan.

2. CDHP: Consumer Driven Health Plan 

A consumer driven health plan is an increasingly popular type of health insurance amongst individuals with lower medical expenses. A CDHP plan allows individuals to pay less in monthly premiums, instead covering more of their medical expenses through out-of-pocket deductibles.

3. DME: Durable Medical Equipment

Durable medical equipment describes the supplies ordered by a healthcare provider for everyday or extended use. DME typically includes things like oxygen equipment, wheelchairs, crutches, slings, walkers, etc. — essentially any piece of equipment that an individual may require to function on a daily basis. 

4. EOB: Explanation of Benefits

An explanation of benefits (also called a “member health statement”) is a record of how much you owe that your health insurance provider sends you every time you use your health insurance. In addition to how much you owe, the EOB also shows the total cost of care, how much your plan paid, and the allowed amount an in-network doctor or other healthcare professional is permitted to charge a plan member.

5. FSA: Flexible Spending Account

A flexible spending account is a cost-savings tool that allows you to spend pre-tax dollars on qualified healthcare-related expenses. Money deposited in an FSA must be spent within the same year, or they are forfeited — otherwise known as the “use it or lose it” rule. 

6. HRA: Health Reimbursement Account

A health reimbursement account is an employer-funded savings plan that reimburses any out-of-pocket medical expenses you may have. However, unlike an FSA, unused balances will roll over and accumulate over time, though they may not be cashed out. 

7. HSA: Health Savings Account 

A health savings account is similar to an FSA, and it can be funded through pre-tax deductions by either the employee or the employer. However, HSAs are only available to people enrolled in a high-deductible health plan, and unlike an FSA, balances accumulate over time and you won’t lose any unused balances after the year is up.

8. MSA: Medical Savings Account

A medical savings account is a savings account, generally associated with self-employed individuals, in which tax-deferred deposits can be made for qualified medical and dental expenses, including co-payments or deductibles. 

9. PCP: Primary Care Physician

A primary care physician is a doctor who directly provides a wide range of medical services for a patient and include medical doctors, doctors of osteopathic medicine, internists, family practitioners, general practitioners, OB/GYNs, and pediatricians — essentially any provider that’s not a specialist. 

10. QLE: Qualifying Life Event

A qualifying life event is a change in your life that allows you to make changes to your health coverage outside of the annual open enrollment period. These events can include a change in marital status, the number of eligible children or a family member’s benefits eligibility under another plan. 

Knowing these common acronyms and what they mean will make the open enrollment process easier on you. If you should have any questions, don’t hesitate to contact your local LBMC Employment Partner representative. We are well versed in all things open enrollment and relating to the ACA, and we are here to make this process as easy as possible.