See: Managing general agent (MGA).
Insurance Encyclopedia
Penalize
To inflict a burden or penalty on an individual.
Penalized claim
Insurance claim submitted to an insurance carrier that did not pass the claim edits and a penalty was applied, thus reducing payment. Also see downcoding.
Penalties
Penalties consists of indemnity for the loss or punitive damages imposed by the courts, restitution of the property or loss, injunctive relief precluding future conduct or action, and other remedies, including possession of the property or an accounting of the property entrusted.
Penalty
(i) Limit of an Insurers’ liability under a fidelity bod or surety bond. (ii) Amount by which an insured’s recovery is reduced because of a Policy provision such as a coinsurance clause. See Also: “Coinsurance.”
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UK: 1. A punishment like a fine or monetary payment. It is against public policy to allow a person to insure against fines but legal defence cover is available under liability and legal expenses insurances. Penalties along with liquidated damages arising under contract are commonly excluded under liability policies. 2. The nominal sum payable by an obligor, an insurer, on breach of a condition in a bond.
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MEDICAL,USA: 1. Punishment established by law. 2. Under Medicare, the amount added to the patient’s monthly premium for Medicare Part B or for a Medicare drug plan if the individual does not join when first able. For Medicare Part D, this higher amount is deducted as long as the patient has Medicare.
Penalty (Surety)
The maximum value the insurance company is liable for, according to a Fidelity Bond.
Pending claim
Insurance claim held in suspense due to review or other reason. These claims may be cleared for payment or denied. See delinquent claim.
Penetration rate
Percentage rate at which eligible employees in a group select a system to provide their health coverage.
Pension
Funds payable monthly or annually to an individual who has retired.
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UK: A lifetime payment to a person during his retirement years having previously been an active member of a pension scheme and/or become entitled to a state pension.
Pension Benefit Guaranty Corporation (PBGC)
Federal organization that was created by the Employee Retirement Income Security Act of 1974 (ERISA) to manage the Pension Plan Termination Insurance program. It insures benefits in qualified defined benefit pension plans (DBPP) and makes sure participants receive the benefits.