A

Accidental Death and Dismemberment – A group benefit that pays a lump sum if an employee dies or suffers a qualifying loss such as limb, sight, or hearing due to an accident.

Actuarial Value – The percentage of total average medical costs a health plan is expected to cover.

Additional Insured – A person or organization added to a commercial policy to receive liability protection.

Aggregate Limit – The maximum amount an insurer will pay for all claims during a policy period.

Allowed Amount – The maximum payment a health plan will consider for a covered service.

Assigned Risk – A state program that provides coverage to businesses unable to obtain insurance in the standard market.

B

Bailee Coverage – Protection for customer property in your care, custody, or control.

Beneficiary – The person or entity who receives benefits from group life or AD&D coverage.

Benefit Summary – A document outlining covered services, cost sharing, and plan rules for employees.

Binder – A temporary contract providing proof of coverage until the full policy is issued.

Blanket Coverage – Coverage that applies to multiple locations, properties, or categories under one limit.

Business Interruption Insurance – Coverage that replaces lost income when a business cannot operate due to a covered event.

Business Owner Policy – A package policy combining general liability and commercial property coverage for small businesses.

C

Carrier – The insurance company providing the group benefit plan.

Certificate of Insurance – A document showing proof of coverage, often required for contracts or vendors.

Claim – A request for payment under a commercial or group insurance plan.

Coinsurance – The percentage of costs an employee pays after meeting the deductible.

Commercial Auto Insurance – Coverage for vehicles used for business purposes.

Commercial Property Insurance – Protection for buildings, equipment, inventory, and other business property.

Coordination of Benefits – Rules determining how multiple health or dental plans share payment responsibility.

Copayment – A fixed dollar amount paid by the employee for a covered service. Course of

Construction – Coverage for buildings under construction, including materials and equipment.

Cyber Liability Insurance – Protection against losses from data breaches, cyberattacks, or system failures.

D

Deductible – The amount an employee must pay before the plan begins covering services.

Declarations Page – The section of a policy listing key details such as coverage limits, premiums, and named insureds.

Dependent – A spouse, child, or qualified family member eligible for coverage under an employer plan.

Directors and Officers Insurance – Coverage protecting company leaders from claims related to management decisions.

E

Eligibility Period – The timeframe during which a new employee can enroll in benefits.

Employee Assistance Program – A program offering counseling, mental health support, and wellness resources.

Employment Practices Liability Insurance – Coverage for claims such as discrimination, harassment, wrongful termination, or retaliation.

Errors and Omissions Insurance – Professional liability coverage for mistakes, negligence, or failure to perform professional duties.

Evidence of Insurability – A health questionnaire required when employees request coverage above guaranteed issue amounts.

Excess Liability – Additional liability coverage that sits above primary policy limits.

F

Fidelity Bond – Coverage protecting a business from employee theft or fraud.

Flexible Spending Account – A tax‑advantaged account employees use to pay for eligible medical, dental, vision, or dependent care expenses.

Flood Insurance – Coverage for water damage caused by flooding, often purchased separately from property insurance.

Formulary – A list of prescription drugs covered by a health plan.

G

General Liability Insurance – Coverage for bodily injury, property damage, and personal or advertising injury claims.

Guaranteed Issue – The amount of life or disability coverage available without medical underwriting.

Group Life Insurance – Employer‑provided life insurance offering a death benefit to employee beneficiaries.

H

Health Reimbursement Arrangement – An employer‑funded account that reimburses employees for qualified medical expenses.

Health Savings Account – A tax‑advantaged savings account paired with a high‑deductible health plan.

Hold Harmless Agreement – A contract where one party agrees to assume liability for another.

I

In Network Provider – A doctor or facility contracted with the health or dental plan to offer discounted rates.

Inland Marine Insurance – Coverage for movable property, tools, equipment, and goods in transit.

Insurable Interest – A financial stake in property or operations that allows a business to purchase insurance.

L

Liability Limit – The maximum amount an insurer will pay for a covered liability claim.

Long Term Disability – A benefit that replaces a portion of income when an employee cannot work for an extended period due to illness or injury.

M

Marine Insurance – Coverage for ships, cargo, and maritime operations.

Maximum Out of Pocket – The most an employee will pay for covered services in a plan year.

N

Network – The group of providers contracted with a health, dental, or vision plan.

O

Occurrence – A single event that results in a claim under a liability policy.

Open Enrollment – The annual period when employees can enroll in or change benefit elections.

P

Premium Only Plan – A plan allowing employees to pay insurance premiums with pre‑tax dollars.

Preventive Care – Services such as checkups and screenings covered at no cost under most health plans.

Product Liability Insurance – Coverage for injuries or damage caused by products a business manufactures or sells.

Professional Liability – Coverage for errors or negligence in professional services, also known as E&O.

Property Damage – Liability coverage for damage caused to another party’s property.

R

Referral – Approval from a primary care provider to see a specialist.

Replacement Cost – The amount needed to replace damaged property without deducting depreciation.

S

Short Term Disability – A benefit that replaces income for temporary disabilities lasting weeks or months.

Subrogation – The process where an insurer seeks reimbursement from a responsible third party after paying a claim.

Summary of Benefits and Coverage – A standardized document explaining health plan coverage and costs.

T

Telemedicine – Virtual medical visits covered by many group health plans.

Third Party Liability – Coverage for claims made by individuals or entities outside the insured business.

U

Umbrella Liability Insurance – Additional liability protection that extends beyond primary policy limits.

Underwriting – The process insurers use to evaluate risk and determine eligibility for group benefits.

V

Vision Insurance – Coverage for eye exams, glasses, and contact lenses.

W

Waiting Period – The time a new employee must wait before benefit coverage begins.

Workers’ Compensation – Coverage that pays for medical care and wage replacement when employees are injured on the job (benefits side) and provides statutory liability protection for employers (commercial side).