Insurance company payment that will be made under any circumstances and is not contingent on any predesignated condition.

Insured individual of a group insurance policy that has been issued a certificate of insurance, which certifies that an insurance contract has been written.This certification of insurance contains a summary of the coverage of the policy in general terms applicable to that member.
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The entity that is provided a certificate of insurance as evidence of the insurance maintained by another entity. In standard certificate forms, the certificate holder is usually listed in the space provided for that purpose.

Largest total payment limit that an insurance plan will generate for certain kinds of care that a member may receive while the certificate is valid.

Numeric or alphanumeric characters issued to an insured or member of an insurance plan and used for identification. It appears on an insured’s health insurance identification card and is placed on insurance claim forms when submitting claims or when communicating with insurance companies. Also called identification number (ID #).

In assumption reinsurance, each policyholder is sent an official document (certificate) when the policy has been ceded about a notice of the assumption and information about the new insurer.

1. State license to operate as a health maintenance organization (HMO). 2. Insurance company’s document that grants authority to a particular agent or group of agents to act on behalf of the insurer. 3. Certificate issued by a state’s insurance department that authorizes an insurance company to issue certain types of insurance in the state.

Federal document that legally protects researchers from having to disclose information about research participants as a result of a subpoena or court order. It is for projects involving information of a sensitive nature that, if released, could harm participants. See sensitive information.

Document given to an insured by the insurance company or any employer that offers a health plan. It describes the benefits in detail under the policy issued. It is required by state law. Also called evidence of coverage (EOC), benefit plan, insurance policy, subscriber agreement, subscriber certificate, and subscriber contract.

1. Document issued by an insurance company and given to the beneficiary of a life insurance policy that states a guaranteed minimum interest rate and the frequency of interest payments. 2. Short-term certification, 12 months or less, of a specific portion of debt due by the federal government to individual holders, bearing a fixed rate of interest.

1. Certification by a provider to an insurance carrier that a medical service or procedure is medically necessary because of the patient’s condition. 2. Form required by Medicare that allows the patient to use certain durable medical equipment prescribed by a physician or one of the physician’s staff. 3. In Medicare fraud, to complete a CMN for patients not personally and professionally known by the physician.