A situation where covered insureds or the designated service provider must select one primary care physician. That physician is the only one allowed to refer the patient to other health care providers within the plan. Also called Closed Panel or Gatekeeper Model.
Insurance Encyclopedia
Closed adoption
To take into one’s own family by legal process and raise as one’s own child, but the identifying information about the adoptive and birth families is not shared. The adoptive and birth families do not establish or maintain contact.
Closed claim
Status of an insurance claim when all benefits have been paid.
Closed contract
Insurance agreement in which rates and policy provisions cannot be changed between the policy owner and the insurer. Commercial insurance companies write closed contracts. Fraternal insurance companies are not permitted to write this type of insurance.
Closed Contract of Insurance
An Insurance contract under which rats and Policy provisions cannot be changed.
Closed formulary
List of drugs covered by a benefit plan in which the drugs on it are the only ones covered. Sometimes nonformulary drugs can be covered if authorization is obtained and if there is a good medical reason. See also open formulary and restricted formulary.
Closed fracture
Fracture of the bone with no skin wound.
Closed fund
A life insurance fund maintained for a particular group of policies with no new business being accepted for the fund.
Closed grievance
Decision that has been made and cannot be appealed or is not under appeal by the member of a managed care plan.
Closed line
the amount for which an insurer becomes liable in the event of a slip being over- subscribed (see written line).