GROUP HEALTH INSURANCE: Is a policy that is purchased by an employer and is offered to eligible employees of the company (and often to the employees' family members) as a benefit of working for that company. A group health insurance plan is a key component of many employee benefits packages that employers provide for employees. One of the advantages for employees in a group health plan is the contribution that most employers make toward the cost of the health coverage premium.
COBRA COVERAGE: Cobra is a way to continue to use the insurance you had while you were employed (or through an employee) after a job loss. The job loss can be either voluntary like quitting or retiring or can be involuntary like being laid off or fired. With Cobra Coverage you and your family are able to keep using the exact same plan for up to 18 months, however you are responsible for paying the entire cost. The employer no longer helps with costs.
OPEN ENROLLMENT PERIOD: For group health insurance, this period is typically offered one time a year to allow employees to make changes to their plan, or enroll in the health insurance. With group coverage, you must join when you first become eligible or you will have to wait until the next annual open enrollment period.
PREMIUMS: Your premium is the amount you pay to the health insurance company each month to maintain your coverage. With group health insurance, part of your premium is usually paid by your employer.
DEDUCTIBLE: Your annual deductible is the amount you will be required to pay out-of-pocket before the insurance company will begin paying for medical claims. Keep in mind, your monthly premiums and copayments will often not count toward your deductible.
COINSURANCE: This is the percentage of the bill the insured is responsible for after the deductible has been reached until you have satisfied your maximum out-of-pocket limit. For example, if you have an 80/20 plan, with a $1000 deductible, and a $2000 out-of-pocket maximum, once you reach your $1000 deductible, you pay 20% of all bills, until you pay an additional $1000 out-of-pocket, then after that everything is covered at 100%.
COPAYMENT: Your copayment, or "copay" is the specific dollar amount you may be required to pay up front for a specific type of service, or a prescription drug.
MAXIMUM OUT-OF-POCKET: This is the maximum amount the insured is responsible for in a calendar year. Once you have paid out-of-pocket to the "maximum" amount (typically through deductibles, copayments or coinsurance), the insurance company pays the full charges for any additional covered medical services rendered that year. Your monthly premium will not count toward your maximum out-of-pocket costs.