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In addition, payment to dental professionals is based on the CDT code(s) reported on the ADA Claim Form, so using the most current codes helps to maximize reimbursement and minimize audit liability. [6] In the near future, dental professionals will be required to use diagnosis codes in support of the procedures and services they provide.
With indemnity dental plans, the insurance company generally pays the dentist a percentage of the cost of services. Restrictions may include the co-payment requirements, waiting period, stated deductible, annual limitations, graduated percentage scales based on the type of procedure, and the length of time that the policy has been owned.
The loading "refers to the amount of the premium necessary to cover other expenses, particularly sales expenses, and to allow for a profit". The gross rate "is the pure premium and the loading per exposure unit". Finally, the gross premium is the premium paid by the insured consisting of the gross rate multiplied by the number of exposure units ...
In the insurance industry, gross premiums written is the sum of both direct premiums written (see next paragraph) and assumed premiums written, before deducting ceded reinsurance. Direct premiums written represents the premiums on all policies the company's insurance subsidiaries have issued during the year.
Employee benefits in the United States include relocation assistance; medical, prescription, vision and dental plans; health and dependent care flexible spending accounts; retirement benefit plans (pension, 401(k), 403(b)); group term life insurance and accidental death and dismemberment insurance plans; income protection plans (also known as ...
The law includes a large number of health-related provisions, most of which took effect in 2014, including expanding Medicaid eligibility for people making up to 133% of FPL, [319] subsidizing insurance premiums for individuals and families making up to 400% of FPL and capping expenses from 2% to 9.8% of annual income.
A health insurance policy is a insurance contract between an insurance provider (e.g. an insurance company or a government) and an individual or his/her sponsor (that is an employer or a community organization). The contract can be renewable (annually, monthly) or lifelong in the case of private insurance.
The government contributes 72% of the weighted average premium of all plans, not to exceed 75% of the premium for any one plan (calculated separately for individual and family coverage). [1] The FEHB program allows some insurance companies, employee associations, and labor unions to market health insurance plans to governmental employees.