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Glossary Of Terms

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Please Note: This information is a general reference tool. All terms, conditions and amounts may not be applicable to your benefit plan. Please refer to your Plan Document for a complete listing of terms, conditions, coverage and exclusions of your benefit plan.

Terms Beginning with the Letter "C"

Calendar Year means January 1st through December 31st of the same year.

Claims Administrator shall mean the entity providing the services delegated to it by the Employer in connection with the operation of the Plan, including processing and payment of claims.

COBRA means the Consolidated Omnibus Budget Reconciliation Act of 1985, as amended.

Coinsurance means you pay a certain percentage (generally 20%) of the costs of a service after a yearly deductible is met.

Co-payment. The amount of money paid by the Covered Person each time a particular service is used. Typically, there may be co-payments on some services and other services will not have any co-payments. There may also be different co-payments for different services. Co-payments do not accrue toward the 100% maximum out-of-pocket payment.

Cosmetic Dentistry means dentally unnecessary procedures. Covered Person or Covered Participant is an Employee or Dependent who is covered under this Plan. Creditable Coverage includes most health coverage, such as coverage under a group health plan (including COBRA continuation coverage), HMO membership, an individual health insurance policy, Medicaid or Medicare. Creditable Coverage does not include coverage consisting solely of dental or vision benefits.

Custodial Care is care (including room and board needed to provide that care) that is given principally for personal hygiene or for assistance in daily activities and can, according to generally accepted medical standards, be performed by persons who have no medical training. Examples of Custodial Care are help in walking and getting out of bed; assistance in bathing, dressing, feeding; or supervision over medication which could normally be self administered.