Gatekeeper Model
Under this model of HMO and PPO organizations, primary care physician (the gatekeeper) is the initial contact for the patient for medical care and for referrals. Also known as closed access or closed panel.
General Agent (GA)
Individual appointed by Health insurer to administer its business in a territory. Responsible for building his own agency and service force. Compensated on commission basis, although possibly has some additional expense allowances.
General LTC Rider
LTC (Long Term Care) rider attached to a life insurance policy but is independent of the life policy. The life insurance benefits are not reduced byt any LTC benefits paid.
Generic Drug
Drug that is exactly the same as a brand name drug and is allowed to be produced after the brand name drug's patent has expired. Also known as "generic equivalent."
Grievance Procedure
Procedure allowing member of a health plan or provider of benefits to express complaints and seek remedies.
Group
Coverage of a number of individuals under one contract. Commonly the group is employees of the same employer.
Group Certificate
Document provided to each member of a group plan. It details benefits provided under the group contract issued to the employer or other insured.
Group Contract
Contract of insurance made with an employer or other entity covering a group of persons identified by their relationship to the entity buying the contract. Generally used to cover employees of a common employer, members of a trade association or trusteeship, members of a welfare or employee benefit association, members of a labor union, or members of a professional or other association not formed only for the purpose of obtaining insurance.
Group Disability Insurance
Coverage provided for a group for loss of compensation due to accident or sickness.
Group Model HMO
Health plan where designated group of physicians is reimbursed for services provided at a negotiated rate. HMO also contracts with hospitals for the care of patients of physicians who belong to the group.
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