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Acquisition Cost

The cost to an insurer to acquire new business. It includes costs such as underwriting the risk, issuing a new policy, paying commissions and overhead or office expenses.
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Activities of Daily Living ...

Everyday activities which are used to measure an individual's ability to function independently. ADLs define the disability in long term care insurance. The loss of some number of ADLs is an insuring or
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Actual Charge

The amount a physician or supplier actually bills for a particular medical services or supply.
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Actuary

A professional who mathematically analyzes and determines the price of the risk associated with providing insurance coverage. An actuary may also determine the anticipated cost of providing future benefits.
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Acute Care

Care for illness or injury that develops rapidly, has pronounced symptoms ad is finite in length. Traditional medical insurance, Medicare and Medicare supplements are designed to provide coverage for
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Adjusted Average Per Capita ...

Health Care Financing Administration (HCFA) basis of payment to HMOs and CMPs.
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Adjusted Community Rate (ACR)

Uniform capitation rate that is charged to all enrollees in a plan based on adjustments for risk factors such as age and sex.
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Administrative Services Only ...

A type of contract with an insurance company or a third-party administrator that provides an employer with administrative services. It does not provide coverage for risk of insurance protection. The usual
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Administrator

A person who is designated to be responsible for the proper operation and administration of a plan. When the plan sponsor does not designate a person for this duty, the ERISA considers the pan sponsor
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Adult Day Care

Social, recreational and/or rehabilitative services provided for persons who benefit from daytime supervision. An alternative between care in the home or in a institution.
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Adverse Selection

A tendency which occurs when a person makes a decision based on his/her diminished health condition or frequency of needed treatment and is, therefore considered a poorer claims risk than most others
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Ageism

Prejudice against people because of their age.
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Agent

Licensed by the state, performs the functions for sole proprietors and small businesses that Human Resource Departments do for larger businesses, gathers census data, prepares proposals, makes presentations
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Aggregate Amount (limit)

Maximum amount of total losses for which a plan sponsor (employer) is liable for any one-plan year.
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Aid to Families with Dependent ...

Public assistance program that provides payment to families with children 18 years of age and under who have an income below a defined poverty line.
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Alternate Care Benefit

Payment for a special arrangement of services specifically designed to allow the person to reside in a setting other than a nursing facility (i.e. services to provide assistance, capital improvements
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Alternate Care Facility

(1) A hospice; or (2) a place that provides ongoing care to inpatients in one location and which (a) provides 24-hour care and services sufficient to support needs resulting from inability to perform
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Alternative Care Benefit

payment for a special arrangement of services specifically designed to allow the person to reside in a setting other than a nursing facility (i.e. services to provide assistance, capital improvements
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Alzheimer's Disease

A form of organic dementia resulting in premature mental deterioration, first described in 1906 by German neurologist, Alois Alzheimer. In California, as well as most of the rest of the United States,
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Ambulatory Care

Medical services provided on an outpatient (non-hospitalized) basis. Services may include diagnosis, treatment, surgery, and rehabilitation.
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