Short Term Medical Insurance GA, Medicare Supplement Georgia, Employee Benefits Broker Georgia, Disability Insurance Georgia, Atlanta Insurance Broker - Heart of Georgia Insurance Brokers in Macon and Atlanta Georgia
A , B , C , D E F , G H , I , L , M N O , P , Q , R , S T , U , V W Y
- Accidental Death Benefit
- In a life insurance policy,
benefit in addition to the death benefit paid to the beneficiary, should death
occur due to an accident. There can be certain exclusions as well as time and
- Active Participant
- Person whose absence from a planned
event would trigger a benefit if the event needs to be canceled or postponed.
- Activities of Daily Living
- Bathing, preparing and eating meals,
moving from room to room, getting into and out of beds or chairs, dressing,
using a toilet.
- Actual Cash Value
- Cost of replacing damaged or destroyed
property with comparable new property, minus depreciation and obsolescence.
- A specialist in the mathematics of insurance who
calculates rates, reserves, dividends and other statistics.
- Adjustable Rate
- An interest rate that changes based on
changes in a published market-rate index.
- A representative of the insurer who seeks to
determine the extent of the insurer's liability for loss when a claim is
- Admitted Assets
- Assets permitted by state law to be
included in an insurance company's annual statement. These assets are an
important factor when regulators measure insurance company solvency. They
include mortgages, stocks, bonds and real estate.
- individual who sells and services insurance policies
in either of two classifications: 1. Independent
agent represents at least two insurance companies and (at least in theory)
services clients by searching the market for the most advantageous price for
the most coverage. The agent's commission is a percentage of each premium paid
and includes a fee for servicing the insured's policy. 2. Direct or
career agent represents only one company and sells only its policies. This
agent is paid on a commission basis in much the same manner as the independent
- Aggregate Limit
- Usually refers to liability insurance and
indicates the amount of coverage that the insured has under the contract for a
specific period of time, usually the contract period, no matter how many
separate accidents might occur.
- Annual Administrative Fee
- Charge for expenses associated
with administering a group employee benefit plan.
- Process by which you convert part or all of
the money in a qualified retirement plan or non-qualified annuity contract into
a stream of regular income payments, either for your lifetime or the lifetimes
of you and your joint annuitant. Once you choose to annuitize, the payment
schedule and the amount is generally fixed and can't be altered.
- Annuitization Options
- Choices in the way to annuitize.
- An agreement by an insurer to make periodic
payments that continue during the survival of the annuitant(s) or for a
- Approved for Re-insurance
- Indicates the company is
approved (or authorized) to write re-insurance on risks in this state. A
license to write reinsurance might not be required in these states.
- Approved or Not Disapproved for Surplus Lines
the company is approved (or not disapproved) to write excess or surplus lines
in this state.
- Assets refer to "all the available properties
of every kind or possession of an insurance company that might be used to pay
its debts." There are three classifications of assets: invested assets,
all other assets, and total admitted assets. Invested assets refer to things
such as bonds, stocks, cash and income-producing real estate. All other assets
refer to non-income producing possessions such as the building the company
occupies, office furniture, and debts owed, usually in the form of deferred and
unpaid premiums. Total admitted assets refer to everything a company owns. All
other plus invested assets equals total admitted assets. By law, some states
don't permit insurance companies to claim certain goods and possessions, such
as deferred and unpaid premiums, in the all other assets category, declaring
- Attained Age
- Insured's age at a particular time.
- Benefit Period
- In health insurance, the number of days for
which benefits are paid to the named insured and his or her dependents. For
example, the number of days that benefits are calculated for a calendar year
consist of the days beginning on Jan. 1 and ending on Dec. 31 of each year.
- Insurance salesperson that searches the marketplace
in the interest of clients, not insurance companies.
- Independent insurance salesperson that
represents particular insurers but also might function as a broker by searching
the entire insurance market to place an applicant's coverage to maximize
protection and minimize cost. This person is licensed as an agent and a broker.
- Captive Agent
- Representative of a single insurer or fleet
of insurers who is obliged to submit business only to that company, or at the
very minimum, give that company first refusal rights on a sale. In exchange,
that insurer usually provides its captive agents with an allowance for office
expenses as well as an extensive list of employee benefits such as pensions,
life insurance, health insurance, and credit unions.
- Case Management
- A system of coordinating medical services
to treat a patient, improve care and reduce cost. A case manager coordinates
health care delivery for patients.
- Liability or loss resulting from an accident.
- Casualty Insurance
- That type of insurance that is
primarily concerned with losses caused by injuries to persons and legal
liability imposed upon the insured for such injury or for damage to property of
others. It also includes such diverse forms as plate glass, insurance against
crime, such as robbery, burglary and forgery, boiler and machinery insurance
and Aviation insurance. Many casualty companies also write surety business.
- A demand made by the insured, or the insured's
beneficiary, for payment of the benefits as provided by the policy.
- Comprehensive Insurance
- Auto insurance coverage providing
protection in the event of physical damage (other than collision) or theft of
the insured car. For example, fire damage or a cracked windshield would be
covered under the comprehensive section.
- Concurrent Periods
- In hospital income protection, when a
patient is confined to a hospital due to more than one injury and/or illness at
the same time, benefits are paid as if the total disability resulted from only
- Conditional Reserves
- This item represents the aggregate of
various reserves which, for technical reasons, are treated by companies as
liabilities. Such reserves, which are similar to free resources or surplus,
include unauthorized reinsurance, excess of statutory loss reserves over
statement reserves, dividends to policyholders undeclared and other similar
reserves established voluntarily or in compliance with statutory regulations.
- The scope of protection provided under an
insurance policy. In property insurance, coverage lists perils insured against,
properties covered, locations covered, individuals insured, and the limits of
indemnification. In life insurance, living and death benefits are listed.
- Convertible -Term life insurance coverage that can be
converted into permanent insurance regardless of an insured's physical
condition and without a medical examination. The individual cannot be denied
coverage or charged an additional premium for any health problems.
- A predetermined, flat fee an individual pays
for health-care services, in addition to what insurance covers. For example,
some HMOs require a $10 co-payment for each office visit, regardless of the
type or level of services provided during the visit. Co-payments are not
usually specified by percentages.
- Creditable Coverage
- Term means that benefits provided by
other drug plans are at least as good as those provided by the new Medicare
Part D program. This may be important to people eligible for Medicare Part D
but who do not sign up at their first opportunity because if the other plans
provide creditable coverage, plan members can later convert to Medicare Part D
without paying higher premiums than those in effect during their open
D, E and F
- Death Benefit
- The limit of insurance or the amount of
benefit that will be paid in the event of the death of a covered person.
- Amount of loss that the insured pays before the
insurance kicks in.
- Direct Premiums Written
- The aggregate amount of recorded
originated premiums, other than reinsurance, written during the year, whether
collected or not, at the close of the year, plus retrospective audit premium
collections, after deducting all return premiums.
- Direct Writer
- An insurer whose distribution mechanism is
either the direct selling system or the exclusive agency system.
- Disease Management
- A system of coordinated health-care
interventions and communications for patients with certain illnesses.
- The return of part of the policy's premium for a
policy issued on a participating basis by either a mutual or stock insurer. A
portion of the surplus paid to the stockholders of a corporation.
- Earned Premium
- The amount of the premium that as been paid
for in advance that has been "earned" by virtue of the fact that time
has passed without claim.
- Elimination Period
- The time which must pass after filing a
claim before policyholder can collect insurance benefits. Also known as
- Employers Liability Insurance
- Coverage against common law
liability of an employer for accidents to employees, as distinguished from
liability imposed by a workers' compensation law.
- Items or conditions that are not covered by the
general insurance contract.
- Measure of vulnerability to loss, usually
expressed in dollars or units.
- File-and-Use Rating Laws
- State-based laws which permit
insurers to adopt new rates without the prior approval of the insurance
department. Usually insurers submit their new rates with supporting statistical
- Future Purchase Option
- Life and health insurance
provisions that guarantee the insured the right to buy additional coverage
without proving insurability. Also known as "guaranteed insurability
G and H
- General Account
- All premiums are paid into an insurer's
general account. Thus, buyers are subject to credit-risk exposure to the
insurance company, which is low but not zero.
- General Liability Insurance
- Insurance designed to protect
business owners and operators from a wide variety of liability exposures.
Exposures could include liability arising from accidents resulting from the
insured's premises or operations, products sold by the insured, operations
completed by the insured, and contractual liability.
- Grace Period
- The length of time (usually 31 days) after a
premium is due and unpaid during which the policy, including all riders,
remains in force. If a premium is paid during the grace period, the premium is
considered to have been paid on time. In Universal Life policies, it typically
provides for coverage to remain in force for 60 days following the date cash
value becomes insufficient to support the payment of monthly insurance
- Guaranteed Insurability Option
- See "future purchase
- Guaranteed Issue Right
- The right to purchase insurance
without physical examination; the present and past physical condition of the
applicant are not considered.
- Guaranteed Renewable
- A policy provision in many products
which guarantees the policy owner the right to renew coverage at every policy
anniversary date. The company does not have the right to cancel coverage except
for nonpayment of premiums by the policy owner; however, the company can raise
rates if they choose.
- Guaranty Association
- An organization of life insurance
companies within a state responsible for covering the financial obligations of
a member company that becomes insolvent.
- A circumstance that increases the likelihood or
probable severity of a loss.
- Hazardous Activity
- Bungee jumping, scuba diving, horse
riding and other activities not generally covered by standard insurance
policies. For insurers that do provide cover for such activities, it is
unlikely they will cover liability and personal accident, which should be
provided by the company hosting the activity.
- Health Maintenance Organization (HMO)
- Prepaid group health
insurance plan that entitles members to services of participating physicians,
hospitals and clinics. Emphasis is on preventative medicine, and members must
use contracted health-care providers.
- Health Reimbursement Arrangement
- Owners of high-deductible
health plans who are not qualified for a health savings account can use an HRA.
- Health Savings Account
- Plan that allows you to contribute
pre-tax money to be used for qualified medical expenses. HSAs, which are
portable, must be linked to a high-deductible health insurance policy.
- Impaired Insurer
- An insurer which is in financial
difficulty to the point where its ability to meet financial obligations or
regulatory requirements is in question.
- Restoration to the victim of a loss by payment,
repair or replacement.
- Insurance Adjuster
- A representative of the insurer who
seeks to determine the extent of the insurer's liability for loss when a claim
is submitted. Independent insurance adjusters are hired by insurance companies
on an "as needed" basis and might work for several insurance
companies at the same time. Independent adjusters charge insurance companies
both by the hour and by miles traveled. Public adjusters work for the insured
in the settlement of claims and receive a percentage of the claim as their fee.
A.M. Best's Directory of Recommended Insurance Attorneys and Adjusters lists
independent adjusters only.
- Insurance Attorneys
- An attorney who practices the law as
it relates to insurance matters. Attorneys might be solo practitioners or work
as part of a law firm. Insurance companies who retain attorneys to defend them
against law suits might hire staff attorneys to work for them in-house or they
might retain attorneys on an as-needed basis. A.M. Best's Directory of
Recommended Attorneys and Adjusters lists insurance defense attorneys who
concentrate their practice in insurance defense such as coverage issues, bad
faith, malpractice, products liability, and workers' compensation.
- Insurance Institute of America (IIA)
- An organization which
develops programs and conducts national examinations in general insurance, risk
management, management, adjusting, underwriting, auditing and loss control
- Insurance Regulatory Information System (IRIS)
by the National Association of Insurance Commissioners in 1974 to identify
insurance companies that might require further regulatory review.
- Least Expensive Alternative Treatment
- The amount an
insurance company will pay based on its determination of cost for a particular
- Broadly, any legally enforceable obligation. The
term is most commonly used in a pecuniary sense.
- Liability Insurance
- Insurance that pays and renders
service on behalf of an insured for loss arising out of his responsibility, due
to negligence, to others imposed by law or assumed by contract.
- Indicates the company is incorporated (or
chartered) in another state but is a licensed (admitted) insurer for this state
to write specific lines of business for which it qualifies.
- Licensed for Reinsurance Only
- Indicates the company is a
licensed (admitted) insurer to write reinsurance on risks in this state.
- Lifetime Reserve Days
- Sixty additional days Medicare pays
for when you are hospitalized for more than 90 days in a benefit period. These
days can only be used once during your lifetime. For each lifetime reserve day,
Medicare pays all covered costs except for a daily coinsurance amount.
- Living Benefits
- This feature allows you, under certain
circumstances, to receive the proceeds of your life insurance policy before you
die. Such circumstances include terminal or catastrophic illness, the need for
long-term care, or confinement to a nursing home. Also known as
"accelerated death benefits."
- Loss Adjustment Expenses
- Expenses incurred to investigate
and settle losses.
- Losses and Loss-Adjustment Expenses
- This represents the
total reserves for unpaid losses and loss-adjustment expenses, including
reserves for any incurred but not reported losses, and supplemental reserves
established by the company. It is the total for all lines of business and all
- Loss Control
- All methods taken to reduce the frequency
and/or severity of losses including exposure avoidance, loss prevention, loss
reduction, segregation of exposure units and non-insurance transfer of risk. A
combination of risk control techniques with risk financing techniques forms the
nucleus of a risk management program. The use of appropriate insurance,
avoidance of risk, loss control, risk retention, self insuring, and other
techniques that minimize the risks of a business, individual, or organization.
- Loss Reserve
- The estimated liability, as it would appear
in an insurer's financial statement, for unpaid insurance claims or losses that
have occurred as of a given evaluation date. Usually includes losses incurred
but not reported (IBNR), losses due but not yet paid, and amounts not yet due.
For individual claims, the loss reserve is the estimate of what will ultimately
be paid out on that claim.
- Losses Incurred (Pure Losses)
- Net paid losses during the
current year plus the change in loss reserves since the prior year end.
M, N and O
- Mortality and Expense Risk Fees
- A charge that covers such
annuity contract guarantees as death benefits.
- Mutual Insurance Companies
- Companies with no capital
stock, and owned by policyholders. The earnings of the company--over and above
the payments of the losses, operating expenses and reserves--are the property
of the policyholders. There are two types of mutual insurance companies. A non-assessable
mutual charges a fixed premium and the policyholders cannot be assessed
further. Legal reserves and surplus are maintained to provide payment of all
claims. Assessable mutuals are companies that charge an initial fixed premium
and, if that isn't sufficient, might assess policyholders to meet losses in
excess of the premiums that have been charged.
- Named Perils
- Perils specifically covered on insured
- National Association of Insurance Commissioners (NAIC)
- Association of state insurance commissioners whose purpose is to promote
uniformity of insurance regulation, monitor insurance solvency and develop
model laws for passage by state legislatures.
- Contract terms, including costs that can
never be changed.
- An event that results in an insured loss. In
some lines of business, such as liability, an occurrence is distinguished from
accident in that the loss doesn't have to be sudden and fortuitous and can
result from continuous or repeated exposure which results in bodily injury or
property damage neither expected not intended by the insured.
- Out-of-Pocket Limit
- A predetermined amount of money that
an individual must pay before insurance will pay 100% for an individual's
- Own Occupation
- Insurance contract provision that allows
policyholders to collect benefits if they can no longer work in their own
- Paid-Up Additional Insurance
- An option that allows the
policyholder to use policy dividends and/or additional premiums to buy
additional insurance on the same plan as the basic policy and at a face amount
determined by the insured's attained age.
- The cause of a possible loss.
- Personal Injury Protection
- Pays basic expenses for an
insured and his or her family in states with no-fault auto insurance. No-fault
laws generally require drivers to carry both liability insurance and personal
injury protection coverage to pay for basic needs of the insured, such as
medical expenses, in the event of an accident.
- Point-of-Service Plan
- Health insurance policy that allows
the employee to choose between in-network and out-of-network care each time
medical treatment is needed.
- The written contract effecting insurance, or the
certificate thereof, by whatever name called, and including all clause, riders,
endorsements, and papers attached thereto and made a part thereof.
- Policyholder Surplus
- The sum of paid in capital, paid in
and contributed surplus, and net earned surplus, including voluntary
contingency reserves. It also is the difference between total admitted assets
and total liabilities.
- Pre-Existing Condition
- A coverage limitation included in
many health policies which states that certain physical or mental conditions,
either previously diagnosed or which would normally be expected to require
treatment prior to issue, will not be covered under the new policy for a
specified period of time.
- Preferred Provider Organization
- Network of medical
providers who charge on a fee-for-service basis, but are paid on a negotiated,
discounted fee schedule.
- The price of insurance protection for a specified
risk for a specified period of time.
- Premium Balances
- Premiums and agents' balances in course
of collection; premiums, agents' balances and installments booked but deferred
and not yet due; bills receivable, taken for premiums and accrued retrospective
- Premium Earned
- The amount of the premium that as been paid
for in advance that has been "earned" by virtue of the fact that time
has passed without claim. A three-year policy that has been paid in advance and
is one year old would have only partly earned the premium.
- Premium Unearned
- That part of the premium applicable to
the unexpired part of the policy period.
- Qualified High-Deductible Health Plan
- A health plan with
lower premiums that covers health-care expenses only after the insured has paid
each year a large amount out of pocket or from another source. To qualify as a
health plan coupled with a Health Savings Account, the Internal Revenue Code
requires the deductible to be at least $1,000 for an individual and $2,000 for
a family. High-deductible plans are also known as catastrophic plans.
- Qualified Versus Non-Qualified Policies
- Qualified plans
are those employee benefit plans that meet Internal Revenue Service
requirements as stated in IRS Code Section 401a. When a plan is approved,
contributions made by the employer are tax deductible expenses.
- Qualifying Event
- An occurrence that triggers an insured's
- Reciprocal Insurance Exchange -An unincorporated groups of individuals, firms or
corporations, commonly termed subscribers, who mutually insure one another,
each separately assuming his or her share of each risk. Its chief administrator
is an attorney-in-fact.
- Re-entry, which is the allowance for
level-premium term policy owners to qualify for another level-premium period,
generally with new evidence of insurability.
- In effect, insurance that an insurance company
buys for its own protection. The risk of loss is spread so a disproportionately
large loss under a single policy doesn't fall on one company. Reinsurance
enables an insurance company to expand its capacity; stabilize its underwriting
results; finance its expanding volume; secure catastrophe protection against
shock losses; withdraw from a line of business or a geographical area within a
specified time period.
- The automatic re-establishment of in-force status affected
by the payment of another premium.
- An amount representing actual or potential
liabilities kept by an insurer to cover debts to policyholders. A reserve is
usually treated as a liability.
- Residual Benefit
- In disability insurance, a benefit paid
when you suffer a loss of income due to a covered disability or if loss of
income persists. This benefit is based on a formula specified in your policy
and it is generally a percentage of the full benefit. It may be paid up to the
maximum benefit period.
- Risk Class
- Risk class, in insurance underwriting, is a
grouping of insured with a similar level of risk. Typical underwriting
classifications are preferred, standard and substandard, smoking and
nonsmoking, male and female.
- Risk Management
- Management of the pure risks to which a
company might be subject. It involves analyzing all exposures to the
possibility of loss and determining how to handle these exposures through
practices such as avoiding the risk, retaining the risk, reducing the risk, or
transferring the risk, usually by insurance.
- Risk Retention Groups
- Liability insurance companies owned
by their policyholders. Membership is limited to people in the same business or
activity, which exposes them to similar liability risks. The purpose is to
assume and spread liability exposure to group members and to provide an
alternative risk financing mechanism for liability. These entities are formed
under the Liability Risk Retention Act of 1986. Under law, risk retention
groups are precluded from writing certain coverages, most notably property
lines and workers' compensation. They predominately write medical malpractice,
general liability, professional liability, products liability and excess
liability coverages. They can be formed as a mutual or stock company, or a
S and T
- Section 1035 Exchange
- This refers to a part of the
Internal Revenue Code that allows owners to replace a life insurance or annuity
policy without creating a taxable event.
- Section 7702
- Part of the Internal Revenue Code that
defines the conditions a life policy must satisfy to qualify as a life
insurance contract, which has tax advantages.
- Separate Account
- A separate account is an investment
option that is maintained separately from an insurer's general account. Investment
risk associated with separate-account investments is born by the contract
- State of Domicile
- The state in which the company is
incorporated or chartered. The company also is licensed (admitted) under the
state's insurance statutes for those lines of business for which it qualifies.
- Statutory Reserve
- A reserve, either specific or general,
required by law.
- Stop Loss
- Any provision in a policy designed to cut off an
insurer's losses at a given point.
- Sub-account Charge
- The fee to manage a sub-account, which
is an investment option in variable products that is separate from the general
- The right of an insurer who has taken over
another's loss also to take over the other person's right to pursue remedies
against a third party.
- Successive Periods
- In hospital income protection, when
confinements in a hospital are due to the same or related causes and are
separated by less than a contractually stipulated period of time, they are
considered part of the same period of confinement.
- Surrender Charge
- Fee charged to a policyholder when a life
insurance policy or annuity is surrendered for its cash value. This fee
reflectsexpenses the insurance
company incurs by placing the policy on its books, and subsequent administrative
- Surrender Period
- A set amount of time during which you
have to keep the majority of your money in an annuity contract. Most surrender
periods last from five to 10 years. Most contracts will allow you to take out
at least 10% a year of the accumulated value of the account, even during the
surrender period. If you take out more than that 10%, you will have to pay a
surrender charge on the amount that you have withdrawn above that 10%.
- Term Life Insurance
- Life insurance that provides protection
for a specified period of time. Common policy periods are one year, five years,
10 years or until the insured reaches age 65 or 70. The policy doesn't build up
any of the non-forfeiture values associated with whole life policies.
- The individual trained in evaluating risks and
determining rates and coverages for them. Also, an insurer.
- The process of selecting risks for insurance
and classifying them according to their degrees of insurability so that the
appropriate rates may be assigned. The process also includes rejection of those
risks that do not qualify.
- Unearned Premiums
- That part of the premium applicable to
the unexpired part of the policy period.
- Universal Life Insurance
- A combination flexible premium,
adjustable life insurance policy.
- Usual, Customary and Reasonable Fees
- An amount customarily
charged for or covered for similar services and supplies which are medically
necessary, recommended by a doctor or required for treatment.
- How much a covered group uses a particular
health plan or program.
V, W and Y
- A calculation of the policy reserve in life
insurance. Also, a mathematical analysis of the financial condition of a
- Valuation Reserve
- A reserve against the contingency that
the valuation of assets, particularly investments, might be higher than what
can be actually realized or that a liability may turn out to be greater than
the valuation placed on it.
- Variable Annuitization
- The act of converting a variable
annuity from the accumulation phase to the payout phase.
- Variable Life Insurance
- A form of life insurance whose
face value fluctuates depending upon the value of the dollar, securities or
other equity products supporting the policy at the time payment is due.
- Variable Universal Life Insurance
- A combination of the
features of variable life insurance and universal life insurance under the same
contract. Benefits are variable based on the value of underlying equity
investments, and premiums and benefits are adjustable at the option of the
- Viatical Settlement Provider
- Someone who serves as a sales
agent, but does not actually purchase policies.
- The terminally ill person who sells his or her life
- Voluntary Reserve
- An allocation of surplus not required by
law. Insurers often accumulate such reserves to strengthen their financial
- Waiting Period
- See "elimination period."
- Waiver of Premium
- A provision in some insurance contracts
which enables an insurance company to waive the collection of premiums while
keeping the policy in force if the policyholder becomes unable to work because
of an accident or injury. The waiver of premium for disability remains in
effect as long as the ensured is disabled.
- Whole Life Insurance
- Life insurance which might be kept in
force for a person's whole life and which pays a benefit upon the person's
death, whenever that might be.