Don’t understand some of those tricky words and terms your health insurance company uses? Here are some quick definitions and explanations to help you better understand your health insurance and get the most out of your plan.

COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985): A federal law that allows an employee or an employee’s dependents to maintain group health insurance coverage through an employer’s health insurance plan (at the individual’s expense) for up to 18 months under certain circumstances (COBRA coverage can be extended beyond 18 months under certain circumstances).

• COBRA rules typically apply when an employee loses coverage through loss of employment (excluding cases of gross misconduct) or due to a reduction in work hours. COBRA benefits extend to spouses or other dependents in case of divorce or death of the employee.Children who are born to, adopted, or placed for adoption with the covered employee while he/she is on COBRA coverage are entitled to covered. All companies who have an average of at least 20 full-time employees over the past year must comply with COBRA regulations.

Cost-Sharing: Refers to amounts that a member has to pay when drugs or services are received.

• This includes any combination of the following three types of payments: (1) any deductible amount a plan may impose before drugs/services are covered; (2) any fixed co-payment amounts that a plan may require be paid when specific drugs/services are received; or (3) any coinsurance amount that must be paid as a percentage of the total amount paid for a drug/service.

Calendar Year: The period that begins on January 1st and ends twelve (12) consecutive months later on December 31st.

Some definitions found at eHealth. For more health insurance definitions please visit eHealth Health Insurance Glossary.

Published February 27, 2018