Under Medicaid programs, medical services required by state statutes for needy individuals such as inpatient and outpatient hospital services, laboratory tests, x-rays, home health care, family planning, nurse midwives, nursing facility care, dental services, renal dialysis services, and medical transportation. Also referred to as mandated benefits .
Insurance Encyclopedia
Mandatory
Requiring strict conformity or obedience.
Mandatory approval
The IR must approve an occupational pension scheme that meets the requirements of ICTA 1988, s.590(3). The benefit under such schemes (approved schemes) must be a pension on retirement at a specified age between 60 and 75 not exceeding onesixtieth of final remuneration for each year of service up to a maximum of 40. Cash commutation must not exceed three-eightieths of final remuneration for each year of service. A widow(er)’s pension in death after retirement must not exceed two-thirds of the employee’s pension. These and other restrictions result in most schemes preferring exempt approved scheme status.
Mandatory enrollment
Required membership in a program (e.g., Medicaid managed care, Medicare Part D).
Mandatory offer
An offer that a Lloyd’s member or group of members holding 75 per cent of a syndicate’s capacity must make to acquire the syndicate’s residual capacity. In practice it means that corporate members aligned to a syndicate are obliged to make an offer to buy out the unaligned members who are not obliged to accept. See MAJOR SYNDICATE TRANSACTION.
Mandatory outpatient surgery
List of surgical procedures that should be performed as an outpatient to reduce unnecessary inpatient hospital admission.
Mandatory retirement (Pensions)
A retirement age mandated by a pension plan. When the insured reaches this age, he or she must retire, regardless of willingness to do so.
mandatory securities valuation reserve (MSVR)
Liability account designed to absorb, within specified limits, realized and unrealized gains and losses that result from an insurance company’s investments.
Mandatory spending
Outlay of funds for entitlement programs such as Medicare and Medicaid that are not subject to the federal appropriations process.
Mandatory supplemental benefits
Medical services not covered by Medicare that enrollees must purchase as a condition of enrollment in a Medicare Advantage Plan. Usually those services are paid for by premiums and/or cost sharing. Mandatory supplemental benefits can be different for each Medicare Advantage Plan. Medicare Advantage Plans must ensure that any particular group of Medicare beneficiaries does not use mandatory supplemental benefits to discourage enrollment.