Accidental Death & Dismemberment (AD&D) Insurance – This benefit is designed as an income protection benefit available to help your beneficiaries in the event of your death or serious injury due to an accident.
Coinsurance – After you meet your deductible, you and the Plan share the cost of your covered medical expenses by each paying a certain percentage of those costs, with Penn State paying the majority of the cost. You will pay this percentage until you reach your total out-of-pocket maximum.
Copayment – Flat dollar amount you pay typically at the time of service; office visit copayments are $10 or $20, for example.
Deductible – The medical and prescription drug expenses that you are 100 percent responsible for before coinsurance begins.
Dependent Care Flexible Spending Account (FSA) – Account that allows you to set aside pre-tax money to use to pay for qualified care for a dependent so you (and your spouse, if you have one) can go to work (or attend school full-time).
Discounted Rate – The cost that is agreed upon between your insurance carrier and the medical services provider you use for in-network health care (such as your doctor or hospital).
Evidence of Insurability (EOI) – A process in which you provide information on the status of your health or your dependent’s health to obtain certain types of insurance coverage.
Explanation of Benefits (EOB) – A statement you receive from your insurance carrier that includes how much you owe your doctor for health care services provided, how much your insurance carrier will pay, your progress toward meeting the deductible and other important information about your health care coverage.
Health Care Flexible Spending Account (FSA) – If you are a faculty or staff member enrolled in the PPO Savings Plan but are not eligible for a Health Savings Account or if you are enrolled in the PPO Plan, you may use the Healthcare Flexible Spending Account to set aside pre-tax money to use to pay for qualified healthcare expenses. You cannot contribute to both a Healthcare FSA and an HSA.
Health Savings Account (HSA) – The tax-advantaged Health Savings Account is an account that both you and Penn State can contribute to if you are enrolled in the PPO Savings Plan as an active employee (certain eligibility rules apply). You can use the money in this account to pay for qualified healthcare costs.
In-Network – Medical service providers who are in the insurance carrier’s network and agree to charge a discounted rate.
Long-Term Disability (LTD) Insurance – This benefit provides you and your family with protection from loss of your income, should you become unable to work because of an accident, illness or injury.
Out-of-Network – Medical service providers who do not participate in the network and have not agreed to charge a discounted rate. These out-of-network providers charge higher fees than those who are in-network.
Out-of-Pocket Maximum – The most you will pay out of your pocket in a year for certain covered health expenses. This includes deductible and coinsurance for medical and prescription drugs. Once you reach this limit, the Plan pays 100 percent of your costs for the rest of the year (aside from your premiums that come out of your pay).
Premium – The amount you pay in pre-tax dollars each pay period to be covered on the PPO Savings Plan or PPO Plan, Dental Plan or Vision Plan. This lowers your taxable income, which means you will pay less in taxes — saving you money.
Preventive Care – Exams, screenings and some prescription drugs that are covered at no cost to you. An annual physical, blood pressure screening, diet counseling, immunizations and aspirin to prevent heart attacks are considered preventive and therefore do not require you to pay any amount.