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The net income you earn from your own trade or business. For example, any net income (profit) you earn from goods you sell or services you provide to others counts as self-employment income.
- Browse Related Terms: Alimony, Cancelled Debts, Capital Gains, dividend, Income Level, Investment Income, Net Rental Income, Rental or Royalty Income, Self-Employment Income
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Group health plans may be self-insured or fully insured. A plan is self-insured (or self-funded), when the employer assumes the financial risk for providing health care benefits to its employees. A plan is fully insured when all benefits are guaranteed under a contract of insurance that transfers that risk to an insurer.
- Browse Related Terms: COBRA, COBRA coverage, Employer Choice, Employee Choice, Employer Contribution, Employer or Union Retiree Plans, Flexible Benefits Plan, Fully Insured Job-based Plan, Group Health Plan, Health Reimbursement Account (HRA), Job-based Health Plan, Large Group Health Plan, Medicare Hospital Insurance Tax, Premium, Self-insured, Self-Insured Plan, Small Employer, Third Party Administrator (TPA), Wellness Programs, Worker's compensation
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Type of plan usually present in larger companies where the employer itself collects premiums from enrollees and takes on the responsibility of paying employees’ and dependents’ medical claims. These employers can contract for insurance services such as enrollment, claims processing, and provider networks with a third party administrator, or they can be self-administered.
- Browse Related Terms: COBRA, COBRA coverage, Employer Choice, Employee Choice, Employer Contribution, Employer or Union Retiree Plans, Flexible Benefits Plan, Fully Insured Job-based Plan, Group Health Plan, Health Reimbursement Account (HRA), Job-based Health Plan, Large Group Health Plan, Medicare Hospital Insurance Tax, Premium, Self-insured, Self-Insured Plan, Small Employer, Third Party Administrator (TPA), Wellness Programs, Worker's compensation
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A geographic area where a health insurance plan accepts members if it limits membership based on where people live. For plans that limit which doctors and hospitals you may use, it's also generally the area where you can get routine (non-emergency) services. The plan may disenroll you if you move out of the plan's service area.
- Browse Related Terms: Complication of Pregnancy, Complications of Pregnancy, Emergency Medical Transportation, Emergency Room Care, Emergency Services, Service Area
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- See Health Plan Categories
- Browse Related Terms: Bronze Health Plan, Cost Sharing Reduction, Gold Health Plan, Health Plan Categories, Platinum Health Plan, Silver Health Plan
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Services from licensed nurses in your own home or in a nursing home. Skilled care services are from technicians and therapists in your own home or in a nursing home.
Services from licensed nurses in your own home or in a nursing home. Skilled care services are from technicians and therapists in your own home or in a nursing home.
Services from licensed nurses in your own home or in a nursing home. Skilled care services are from technicians and therapists in your own home or in a nursing home.
- Browse Related Terms: Acute Care Facility, Assisted Living, Board and Care Facility (Long Term), Hospice Care, Inpatient Care, Long-term Care, Skilled Nursing Care, Skilled Nursing Facility (SNF), Skilled Nursing Facility Care
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Often called a "SNF." A SNF provides medical care under the supervision of a medical professional or technician, and dispenses medications, performs diagnostics, and can do minor surgery.
- Browse Related Terms: Acute Care Facility, Assisted Living, Board and Care Facility (Long Term), Hospice Care, Inpatient Care, Long-term Care, Skilled Nursing Care, Skilled Nursing Facility (SNF), Skilled Nursing Facility Care
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Skilled nursing care and rehabilitation services provided on a continuous, daily basis in a skilled nursing facility. Examples of skilled nursing facility care include physical therapy or intravenous injections that can only be given by a registered nurse or doctor.
- Browse Related Terms: Acute Care Facility, Assisted Living, Board and Care Facility (Long Term), Hospice Care, Inpatient Care, Long-term Care, Skilled Nursing Care, Skilled Nursing Facility (SNF), Skilled Nursing Facility Care
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The SHOP is a program of Maryland Health Connection, the new online health insurance marketplace. The SHOP enables small businesses and their employees to compare and shop for qualified health plans (QHPs). The SHOP is the only place where Maryland’s small businesses can get federal tax credits to lower their costs.
- Browse Related Terms: agent, Authorized Representative, Broker, Brokers, Connector Organizations, Exchange, Marketplace, Small Business Health Options Program (SHOP), Uninsured
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In California's insurance code, a small employer is anyone who employs from 2-50 people. The employer(s) can be included in this number.
- Browse Related Terms: COBRA, COBRA coverage, Employer Choice, Employee Choice, Employer Contribution, Employer or Union Retiree Plans, Flexible Benefits Plan, Fully Insured Job-based Plan, Group Health Plan, Health Reimbursement Account (HRA), Job-based Health Plan, Large Group Health Plan, Medicare Hospital Insurance Tax, Premium, Self-insured, Self-Insured Plan, Small Employer, Third Party Administrator (TPA), Wellness Programs, Worker's compensation
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The market for health insurance coverage offered to small businesses - those with between 2 and 50 employees in most states, including Minnesota. The ACA will broaden the market to those with between 1 and 100 employees. Minnesota Statutes, Chapter 62L governs health insurance in the small group market.
- Browse Related Terms: Actuarial justification, Adjusted community rating, Age Rating, Annual Limit, Community rating, Guaranteed Issue, Guaranteed renewability, Guaranteed Renewal, Health Status Rating, Interstate compact, Lifetime limit, Medical Loss Ratio (MLR), Multi-state plan, Qualified health plan, Rate Review, Rating Factors, Rescission, Risk Adjustment, Small group market
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A system that distributes financial benefits to retired or disabled people, their spouses, and their dependent children based on their reported earnings. While you work, you may pay taxes into the Social Security system. When you retire or become disabled, you, your spouse, and your dependent children may get monthly benefits that are based on your reported earnings. Your survivors may be able to collect Social Security benefits if you die.
- Browse Related Terms: Annual Household Income, Modified adjusted gross income (MAGI), Pension (Retirement Benefit), Retirement Benefit (Pension), Social Security, Social Security Benefits, Social Security Survivors Benefits, Supplemental Security Income (SSI), Tax Household
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The amount you get from Social Security Disability, Retirement (including Railroad retirement), or Survivor's Benefits each month.
- Browse Related Terms: Annual Household Income, Modified adjusted gross income (MAGI), Pension (Retirement Benefit), Retirement Benefit (Pension), Social Security, Social Security Benefits, Social Security Survivors Benefits, Supplemental Security Income (SSI), Tax Household
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Social Security benefits based on your record (if you should die) that are paid to your:
- Browse Related Terms: Annual Household Income, Modified adjusted gross income (MAGI), Pension (Retirement Benefit), Retirement Benefit (Pension), Social Security, Social Security Benefits, Social Security Survivors Benefits, Supplemental Security Income (SSI), Tax Household
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The ability of a health insurance plan to meet all of its financial obligations. State insurance regulators carefully monitor the solvency of all health insurance plans and require corrective action if a plan's financial situation becomes hazardous. In extreme circumstances, a state may seize control of a plan that is in danger of insolvency. Minnesota Statutes, Chapter 60B provide this authority in Minnesota.
- Browse Related Terms: Appeal, Attest/Attestation, Carriers, Certificate of Coverage, Certificate of Creditable Coverage, Exclusions and/or Limitations, Independent Medical Review (IMR), Insurance Company, Medical Underwriting, policy, Reinsurance, Solvency, Summary of Benefits and Coverage, Summary of Benefits and Coverage (SBC)
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A time outside of the open enrollment period during which you and your family have a right to sign up for job-based health coverage. Job-based plans must provide a special enrollment period of 30 days following certain life events that involve a change in family status (for example, marriage or birth of a child) or loss of other job-based health coverage.
- Browse Related Terms: Conversion, Family and Medical Leave Act (FMLA), HIPAA Eligible Individual, Individual Health Insurance Policy, Minimum Essential Coverage, Nondiscrimination, Open Enrollment Period, Special Enrollment Period, State Continuation Coverage, Waiting Period (Job-based coverage)
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The health care and related needs of children who have chronic physical, developmental, behavioral or emotional conditions. Such needs are of a type or amount beyond that required by children generally.
- Browse Related Terms: Chronic Condition, Durable Medical Equipment (DME), Emergency Medical Condition, Hospice Services, Major Medical Plan, Public Health, Reconstructive Surgery, Special Health Care Need, Urgent Care
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A physician specialist focuses on a specific area of medicine or a group of patients to diagnose, manage, prevent or treat certain types of symptoms and conditions. A non-physician specialist is a provider who has more training in a specific area of health care.
A physician specialist focuses on a specific area of medicine or a group of patients to diagnose, manage, prevent or treat certain types of symptoms and conditions. A non-physician specialist is a provider who has more training in a specific area of health care.
A physician specialist focuses on a specific area of medicine or a group of patients to diagnose, manage, prevent or treat certain types of symptoms and conditions. A non-physician specialist is a provider who has more training in a specific area of health care.
- Browse Related Terms: assignment, Care Coordination, Evidence-Based Medicine, Hospital Readmissions, Medically Necessary, Patient-Centered Outcomes Research, Payment Bundling, Physician Services, primary care, Primary Care Physician, Primary Care Provider, Provider Category, Specialist
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Some plans already include dental as part of their basic plans. If the plan you select does not include this, you have the option of buying dental coverage separately. This is called “stand-alone” dental insurance.
- Browse Related Terms: Certified Applicant Counselor, Co-op, In Person Assistance Personnel Program, Individual Health Plan, Insurance Co-Op, navigator, Stand-Alone Coverage
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A state-based requirement similar to COBRA that applies to group health insurance policies of employers with fewer than 20 employees. In some states, state continuation coverage rules also apply to larger group insurance policies and add to COBRA protections. For example, in some states, if you're leaving a job-based plan, you must be allowed to continue your coverage until you reach the age of Medicare eligibility.
- Browse Related Terms: Conversion, Family and Medical Leave Act (FMLA), HIPAA Eligible Individual, Individual Health Insurance Policy, Minimum Essential Coverage, Nondiscrimination, Open Enrollment Period, Special Enrollment Period, State Continuation Coverage, Waiting Period (Job-based coverage)