1. Person covered under the Blue Cross/Blue Shield subscriber’s contract including the subscriber or contract holder who is the person named on the membership identification card and in the case of (1) two-person coverage, (2) one adult–one child coverage, or (3) family coverage, eligible family dependents enrolled under the subscriber’s contract. 2. Individual who purchases health insurance coverage. Also called certificate holder, enrollee, insured, policyholder , and subscriber .

Continuation of insurance coverage without lapse when making a change from one group to another or one health plan to another.

Health insurance plan’s complex formula that measures and tracks the insured’s overall health levels such as how often they are in emergency departments, how often they receive preventive care, and whether they take needed medications.