providers
Glossary Template Headline
- Effective Date
- Date on which a group member's coverage begins, typically occurring at the end of an eligibility period stipulated by the group.
- Elective Surgery
- Surgery for a condition that is not considered an emergency.
- Eligibility
- Insured person's qualification for coverage as an eligible member under the contract at the time health care is rendered.
- Eligibility Period
- Period of time before a group member becomes eligible for benefits. This is defined by each group.
- Emergency Care
- Care for patients with severe or life-threatening conditions that require immediate intervention.
- Emergency Surgery
- Procedure that must be performed in a situation that is serious or life-threatening for the patient.
- Enrollee
- An individual who is enrolled and eligible for coverage under a health plan contract. Also known as the "insured."
- Enrollment
- Process by which a person completes an enrollment form or application in order to become a member of health insurance coverage under a contract.
- Evidence of Coverage (EOC)
- A summary detailing the terms, conditions and limitations of your group coverage.
- Exclusion
- Specific circumstances or services listed in the contract for which benefits will not be provided.
- Experimental Procedures
- Any service or supply that is in the developmental stage or is in the process of human or animal testing.
- Expiration Date
- See Termination Date.
- Explanation of Benefits (EOB)
- A statement a member receives that describes how a claim was processed for benefits, including the member's liability for services rendered
