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  Insurance Terms

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Occurrence
An event that results in an insured loss.

One Hundred Year Flood
A flooding condition which has a one percent chance of occurring each year.† The 100-year flood level is used as the base planning level for floodplain management in the National Flood Insurance Program.

Open Enrollment
A specified period of time when new subscribers may enroll in a health insurance plan or HMO regardless of their health.

Ordinary Life Insurance
Usually applied to level premium whole life policies.

Original Age Conversion
A conversion of a term life insurance policy to a permanent plan of insurance at a premium rate, based on the insuredís age when the original term policy was purchased.†

Out-of-pocket Limit
Is a dollar limit on the portion of covered medical expenses that the insured must pay during a benefit period (usually a calendar year). When the out of pocket limit is met, the insured will not have to pay further deductibles or coinsurance for that year. To illustrate, say the out of pocket is $1000 per calendar year and the insuredís coinsurance is 20%. When $5000 of covered medical expenses have been incurred, the $1000 out of pocket limit will be met ($5000 at 20%). Thereafter, the plan will pay benefits at 100% and the insuredís portion will be $0 for the remainder of that year.

Outpatient Services
Services usually provided in clinics, physician or provider officers, ambulatory surgical centers, hospices, home health services, and so forth.

 

 




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