The time frame in which money or other policy benefits are paid out to either the insured or the insured’s dependents.
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Benefit plan
Insurance contract that provides hospital, surgical, medical, or other health coverage; also called benefit contract .
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See: benefit package and certificate of coverage (COC) .
Benefit plan summary
See: benefit limitations .
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See: explanation of coverage (EOC) .
Benefit policy
Policies such as personal accident and life insurances where the amount to be paid is a pre-agreed benefit and is not based on actual losses as with indemnity contracts. Individuals are free to put their own value on life and limb; the main constraint is their ability to pay.
Benefit products
Phrase used by insurance companies and managed care companies that refers to the types of insurance plans they offer; also used as a synonym for benefits .
Benefit provision
Health care service explained in detail that the insurance company agrees to pay to a claimant, assignee, or beneficiary under a health insurance policy or contract.
Benefit schedule
Under a group insurance plan, a table that lists the amount of coverage given to each class of insured and may show earnings and job position. Also known as benefit payment schedule, schedule of benefits, table of allowances, fee schedule, fee allowance, fee maximum , or capped fee .
Benefit triggers (Health Insurance)
Conditions to be met before benefits are paid out.
Benefit verification letter
Official document from the Social Security Administration that provides information on how much an individual receives in monthly Social Security benefits and/or Supplemental Security Income payments. A letter is normally issued after a request from a beneficiary or his or her authorized representative.
Benefit waiting period
Time period that must elapse before health insurance benefits are payable.