Insurance agent who works for one insurance company and is not permitted to sell products of other companies. He or she may be salaried or work on a commission basis. Also known as captive agent .

Type of managed health care plan that combines features of HMOs and PPOs. It is referred to as exclusive because it is offered to large employers who agree not to contract with any other plan. EPOs are regulated under state health insurance laws. Such plans are for large clinics to participate in and combine fee-for-service PPO and HMO benefits.
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A plan that requires some or all services to be provided by a very limited number of medical care providers. It is similar to but more restrictive in its provider network than the HMO.

Under the general agency distribution system, a region in which no person other than the general agent is allowed to sell the insurance company’s products.

1. Sole right to render a service or benefit. The provider or group may provide certain services and does not have to share the right with other providers or groups. 2. Clause sometimes found in managed care contracts that prohibits contracting with other plans.

Section in a contract that forbids physicians from contracting with more than one managed care plan (e.g., health maintenance organization, preferred provider organization).

State law in community-property states that lets an insurance company pay proceeds of a life insurance policy in accordance with the terms of that policy without fear of double liability.

Section of an insurance contract that is signed by the insurer indicating that the insurance company has entered into a contract and is bound by its terms.