Molina Insurance Terms
Medicare - ✔️✔️Provides health insurance benefits to eligible people over 65 years of
age and some disabled people prior to age 65.
Health Maintenance Organization (HMO) - ✔️✔️Managed care health insurance with
an emphasis on preventative care.
Lapse - ✔️✔️Happens when the premium for the policy is not paid and grace period
has expired.
Worker's Compensation Insurance - ✔️✔️Insurance purchased by employers on their
employees in case of work related injuries. Employers are responsible regardless of
fault.
Long-Term Care Insurance - ✔️✔️Health Insurance that provides funds for people who
need home health care, extended health care or nursing home care.
Medical Information Bureau (MIB) - ✔️✔️A non-profit organization funded by member
life and health insurance companies. Prevents fraud or over-insurance.
Health Insurance Counseling & Advocacy Program (HICAP) - ✔️✔️A service provided
by volunteers that advises the elderly about insurance needs for no fee.
Eligibility / Enrollment Period - ✔️✔️Used in life and health group benefits. Period of
time a employee can enroll for benefits without proof of insurability.
Broker - ✔️✔️A licensed fire and casualty licensee who represents the client for a fee.
Pre-existing condition - ✔️✔️A health condition or sickness that occurred prior to the
issuing of a health policy.
Preferred Provider Organization - ✔️✔️Provides services at a pre-determined fee.
Fully Insured - ✔️✔️Used in Social Security where the worker has paid in for 40
quarters or 10 years.
Usual, customary & reasonable - ✔️✔️In health insurance, pays a dollar amount based
on the geographical location.
Medicare - ✔️✔️Provides health insurance benefits to eligible people over 65 years of
age and some disabled people prior to age 65.
Health Maintenance Organization (HMO) - ✔️✔️Managed care health insurance with
an emphasis on preventative care.
Lapse - ✔️✔️Happens when the premium for the policy is not paid and grace period
has expired.
Worker's Compensation Insurance - ✔️✔️Insurance purchased by employers on their
employees in case of work related injuries. Employers are responsible regardless of
fault.
Long-Term Care Insurance - ✔️✔️Health Insurance that provides funds for people who
need home health care, extended health care or nursing home care.
Medical Information Bureau (MIB) - ✔️✔️A non-profit organization funded by member
life and health insurance companies. Prevents fraud or over-insurance.
Health Insurance Counseling & Advocacy Program (HICAP) - ✔️✔️A service provided
by volunteers that advises the elderly about insurance needs for no fee.
Eligibility / Enrollment Period - ✔️✔️Used in life and health group benefits. Period of
time a employee can enroll for benefits without proof of insurability.
Broker - ✔️✔️A licensed fire and casualty licensee who represents the client for a fee.
Pre-existing condition - ✔️✔️A health condition or sickness that occurred prior to the
issuing of a health policy.
Preferred Provider Organization - ✔️✔️Provides services at a pre-determined fee.
Fully Insured - ✔️✔️Used in Social Security where the worker has paid in for 40
quarters or 10 years.
Usual, customary & reasonable - ✔️✔️In health insurance, pays a dollar amount based
on the geographical location.
