See: percentage contribution .
Tag: RAW
Member health index
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.
Member index
See: master patient index .
Member month (Health Insurance)
The amount of participants who are considered members each month.
Member months
Total managed care plan membership each month for a given time period (e.g., 200 members serviced each month for 6 months equals 1200 member months). Operating figures for managed care companies may be expressed in terms of member months (e.g., per member per month [PMPM] or per member per year [PMPY]).
Member of a household
See: ‘Any Member Of The Insured’s Household’.
Member services department
Payment section of the insurance carrier that acts as a patient advocate to resolve problems and take insurance claims appeals to a committee after all other processes have been used.
Member to member liability
See: Members Clubs.
Member trustees/member-nominated trustees
Trustees appointed specifically in their capacity as scheme members whose appointments have been influenced by other members. This includes selection by a trade union. Not all member trustees are member-nominated trustees within the meaning of PA 1995. Under PA 1995 occupational scheme members have the right to select at least one-third of the trustees, unless the members have approved an alternative proposal by the employer. Previously the employer alone could appoint or remove trustees.
Member-nominated director
Person who becomes a director of a corporate trustee and is chosen by the members of an occupational pension scheme.