1. Individual who qualifies and is permitted to apply and maintain membership in a health insurance plan. 2. Individual who was covered under a group health plan and who may qualify to purchase an individual insurance policy regardless of previous health problems.
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Similar to eligible employee except it could be a contract covering people who are not employees of a specified employer. An example might e members of an association, club, committee or union.
Insurance Encyclopedia
Eligible person (Health Insurance)
A person deemed eligible for coverage under the contract. Unlike an eligible employee, this person does not necessarily work for a certain employer. They may be union members or part of an association.
Elimination period
MEDICAL,USA,REFERENCE: See: waiting period (WP) .
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The duration of time between the beginning of an insured person’s disability and the start of a policy’s benefits. Also called waiting period.
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The period that must elapse before disability income is payable under a health insurance policy covering disability income loss.
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This is the period between the onset of the disability and the time the insured begins to draw benefits. As with higher deductibles in property insurance, the longer waiting period, the lower the premium. Frequently offered waiting periods are 30, 60, 90, 180, 365, and 720 days. The decision about a waiting period depends on the amount of savings a person has.
Elimination period (Health Insurance)
The waiting or probation period in a health insurance policy.
ELOS
See: estimated length of stay (ELOS) .
EM
HCPCS Level II modifier that may be used with CPT or HCPCS Level II codes indicating emergency reserve supplies for end-stage renal disease (ESRD). This is for supplies dispensed to patients on home dialysis.
Emancipated minor
Person younger than 18 years of age who lives independently, is totally self-supporting, and possesses decision-making rights. See age of majority, mature minor, and minor .
Embargo
Prohibition of ships from sailing under tonnage.
Embedded value
Actuarially estimated economic value of the in-force life insurance contracts of an insurer but excluding any value attributable to future new business. Embedded value earnings are the difference between the opening year value and the year-end value (after adjustments for any capital movements such as dividends and capital injections). The change in value measures the performance of the company’s life insurance operations.
Embezzlement
US: Fraudulent use or taking of another’s property or money which has been entrusted to one’s care.
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Misappropriation by an employee of money or goods of the employer coming into possession of the employee before they reach actual or constructive possession of the employer.
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UK: The conversion to his own use by an employee of property received by him on behalf of his master (Larceny Act 1916, s.17 (1)). It now falls within the definition of theft (Theft Act 1968). It is a fidelity guarantee risk, not insurable under a theft insurance except in a limited way under money insurance.
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The fraudulent use of money or property that has been entrusted to one’s care.
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MEDICAL,USA: Willful act by an employee of taking possession of an employer’s money.