Family Dependent
Person entitled to coverage because they are: 1) Enrollee's spouse, or 2) Single dependent child of either the enrollee or the enrollee's spouse (including stepchildren or legally adopted children), and 3) Resident of the enrollee's home.
Family Expense Policy
Policy insuring medical expenses of all members of a family.
Fee-for-Service Equivalency
Difference between amount a provider receives from a reimbursement system such as capitation (a flat charge per month, for instance) compared to fee-for-service reimbursement.
Fee-for-Service Reimbursement
Health care system where physicians and providers receive payment based on billed charge for each service provided.
Fee Maximum
Maximum amount available to a provider for health care services specified in a contract.
Fee Schedule
List of maximum fees for providers on a fee-for-service basis.
Field Underwriting
Initial screening "in the field" of prospective buyers of health insurance, performed by sales personnel. Also may include quoting of premium rates.
Flat Maternity Benefit
Stated benefit in a policy that is paid for maternity confinement, regardless of the actual cost of the confinement.
Flexible Benefit Plan
Program where employees tailor their benefits to meet their specific needs.
Franchise Insurance
Plan for covering groups of persons with individual policies having uniform provisions, although policies may differ in benefits. Each person is issued an indivisual contract with individual underwriting. Usually applied to groups too small to qualify for true group coverage, and solicitation usually takes place among an employer's work force with his consent.
Frequency
Number of times a particular service is provided over a given time period.
Funding Level
Dollar amount required to purchase a particular program. Measured by the premium rate for an insured program, or amount assessed for expected claim loss and related fees under self-funded program.
Funding Methods
Agreed means by which an employer pays for health coverage. |
