Snyder Insurance December 3, 2013 No Comments

Healthcare Reform Acronyms Have Your Head Spinning?

Seems there’s an acronym for everything these days, and, if you’ve read a news story about ObamaCare recently, you know that healthcare reform is no exception. ACA, DOL, HCR, HCERA, OOP, SHOP — it’s a world of abbreviations that will leave your head spinning. No worries! I’ve put together a cheat sheet for you!


Max Says

A Handy Glossary of Healthcare Reform Acronyms

— A —

ACA: The Affordable Care Act. Used to refer to the final, amended version of the healthcare reform legislation.

— C —

CDC: The Centers for Disease Control and Prevention.

CHIP: The Children’s Health Insurance Program. Program that provides health insurance to low-income children, and in some states, pregnant women who do not qualify for Medicaid but cannot afford to purchase private health insurance.

— D —

DOL: United States Department of Labor.

— E —

EBSA: Employee Benefits Security Administration. A division of the DOL responsible for compliance assistance regarding benefit plans.

EPO Plan: An exclusive provider organization plan. A managed care plan that only covers services in the plan’s network of doctors, specialists or hospitals (except in an emergency).

ERRP: The Early Retiree Reinsurance Program. A temporary program created under health care reform to provide coverage to early retirees.

— F —

FPL: Federal poverty level. A measure of income level issued annually by HHS and used to determine eligibility for certain programs and benefits.

FLSA: The Federal Fair Labor Standards Act. Amended by PPACA to incorporate health care reform-specific provisions.

FSA: Flexible spending account.

— H —

HCERA: The Health Care and Education Reconciliation Act of 2010. Enacted on March 30, 2010, to amend and supplement PPACA.

HCR: Healthcare reform.

HDHP: High deductible health plan.

HHS: United States Department of Health and Human Services.

HMO: Health maintenance organization. A type of health insurance plan that typically limits coverage to care from medical providers who work for or contract with the HMO.

HRA: Health reimbursement arrangement or account.

HSA: Health savings account.

— I —

IRO: An independent review organization. An organization that performs independent external reviews of adverse benefit determinations.

— M —

MLR: Medical loss ratio. Refers to the claims costs and amounts expended on health care quality improvement as a percent of total premiums. This ratio excludes taxes, fees, risk adjustments, risk corridors and reinsurance.

— N —

NAIC: The National Association of Insurance Commissioners.

— O —

OCIIO: The Office of Consumer Information and Insurance Oversight. A division of HHS responsible for implementing many of the healthcare reform provisions.

OOP: Out-of-pocket limit. The maximum amount you have to pay for covered services in a plan year.

— P —

PCE: Pre-existing condition exclusion. A plan provision imposing an exclusion of benefits due to a pre-existing condition.

PCIP: The Pre-Existing Condition Insurance Plan. A temporary high-risk insurance pool to provide coverage to eligible individuals until 2014.

POS Plan: Point-of-service plan. A type of plan in which you pay less if you go to doctors, hospitals and other health care providers that belong to the plan’s network. POS plans require a referral from your primary care doctor to see a specialist.

PPACA: The Patient Protection and Affordable Care Act. Enacted on March 23, 2010, as the primary healthcare reform law.

PPO: Preferred provider organization. A type of health plan that contracts with medical providers (doctors, hospitals) to create a network of participating providers. You pay less when using providers in the plan’s network, but can use providers outside the network for an additional cost.

— Q —

QHP: Qualified health plan. A certified health plan that provides an essential health benefits package. Offered by a licensed health insurer.

— S —

SHOP Exchange: The Small Business Health Options Program. A program that each health insurance exchange must create to assist eligible small employers when enrolling their employees in qualified health plans offered in the small-group market.

There may be other acronyms lurking out there, but, rest assured, you can always give a member of the Snyder Insurance team a call at (630) 960-4848 to help make things EASY. No abbreviation on that one!