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WORDS TO KNOW

Before you begin, we think that understanding certain words will help you better understand the choices you need to make. So here are some definitions of words and phrases that you'll see on this website.

 

MEDICAL PLANS

  • Deductible: A fixed annual dollar amount that you pay out of pocket during the calendar year, toward health care services before the health plan begins to pay. Details on the services that require satisfying the deductible are outlined on the medical webpage and in the plan documents.
  • Copay: A fixed dollar amount you pay at the time health care services or prescription drugs are received, regardless of the total charge for service. The health plan pays the rest.
  • Coinsurance: A fixed percentage of covered health care services or prescription drug costs that you pay, after the deductible amount (if any) was paid. The health plan pays the rest.
  • Out-of-pocket maximum: The most you pay before the health plan begins to pay 100% of covered charges.
  • In-network: Health care professionals and facilities that have contracts with Cigna Health and Life Insurance Company ("Cigna") to deliver services at a negotiated rate (discount). You pay a lower amount for those services.
  • Out-of-network: A health care professional or facility that doesn't participate in your plan's network and doesn't provide services at a discounted rate. Using an out-of-network health care professional or facility will cost you more.
 

PRESCRIPTION DRUGS

  • Formulary - A list of prescription drugs, both generic and brand name, used by practitioners to identify drugs that offer the greatest overall value. Drugs considered for the formulary are evaluated by a committee of experts and are chosen for their safety and effectiveness.
  • Generics: Generic medications have the same active ingredients, dosage, and strength as their brand-name counterparts. You'll usually pay less for generic medications.
  • Preferred brands: Preferred brand medications will usually cost more than generics but may cost less than non-preferred brands on your plan.
  • Non-preferred brands: Non-preferred brand medications generally have generic alternatives and/or one or more preferred brand options within the same drug class. You'll usually pay more for non-preferred brand medications.
 

TAX SAVINGS PLANS

  • Flexible Spending Account (FSA): A pre-tax employee- or employer-funded account that can be set up to reimburse you for qualified medical expenses. Dartmouth has two types of FSA's:
    • A Health Care FSA (HCFSA) allows you to use pre-tax dollars to pay your share of eligible health care expenses not covered by your medical or dental plan.
    • A Dependent Care FSA (DCFSA) allows you to use pre-tax dollars to pay for childcare or care for an elderly or disabled family member.
  • Health Reimbursement Account (HRA): An employer funded account that pays up to a pre-determined amount toward certain out-of-pocket medical costs. Your unused HRA funds may be carried over to the next benefit year if you remain in the same health plan. This is a new plan for 2017.
  • Health Savings Account (HSA): A tax-free, individually owned savings account used to pay for you and your eligible dependents' qualified medical expenses in the current year or in future years.
 

LIFE INSURANCE PLANS

  • Beneficiary: The person who you assign to receive the payout of life insurance benefits, in the case of a death.
  • Guaranteed Issue: Means you do not have to complete a series of health related questions called a Statement of Health. You are automatically approved for the indicated level of life insurance coverage.
  • Conversion: Generally allows you to convert your Group Life Insurance benefit to an Individual Whole Life Insurance policy, if your coverage terminates.
  • Portability: Generally allows you to continue your Group Life Insurance benefit and AD&D Insurance coverage with MetLife if your coverage terminates.
  • Statement of Health: A series of health related questions that you must answer prior to being approved for an increase in life insurance coverage.
 

OTHER

  • Full Time Equivalent (FTE): The number of regularly scheduled hours that represents one full-time employee during a specific time period. For example an employee regularly working 20 hours/week and 12 months/year would be considered a 0.5 FTE, whereas an employee who regularly works 40 hours/week, 12 months/year would be considered a 1.0 FTE.
  • Plan Cost/Rates: Is the plan rate or premium for a particular benefit. For some benefits, Dartmouth will pay the full cost, some you will share the cost, and others you will pay the full cost. Your share of the plan rate/premium is deducted from your paycheck. For an estimate on medical plan costs, please visit the Medical Plan Cost Estimator at dartgo.org/medical-cost-estimator

Last Updated: 11/13/16