Term life group insurance policy for employees of an employer.

Federal legislation enacted in 1974 that protects pension rights of employees, prohibits states from applying specific mandates to self-insured group health benefit plans, and shields self-insured employers from paying premium taxes, which insurance companies and managed care plans must do. Additional ERISA provisions require that health plans provide a description of the benefits of the plan, identify the persons responsible for operating the plan, explain the arrangements for funding and amending the plan, provide an explanation of benefits (EOB) when a claim is denied, and provide information on members’ rights of appeal if a claim has been denied. The Department of Labor administers the law. Also called the Pension Reform Act .

Qualified employee-benefit plan that invests some or all plan assets in employer stock. Under ERISA, an ESOP is a qualified stock bonus plan or a combination qualified stock bonus plan and defined contribution pension plan that invests in employer securities. The employer’s contributions are tax deductible for the employer and tax deferred for the employee.

Group insurance plan in which the employees pay all of the premium.

In workers’ compensation cases, a physician or medical facility chosen by the employee more than 30 days from the date of when the injury is reported.

In a retirement plan, an amount that is subtracted from the total amount of distribution to the plan to determine the amount of the distribution subject to federal tax. Cost basis is the amount on which an employee has already been taxed. It includes the amount of nondeductible contributions made to the plan by the participant, cost of plan-provided life insurance reported as taxable income by the participant, and amount of employer contributions previously taxed as income to the participant.

1. In workers’ compensation, an employer includes any person or entity that engages the services of a person. It includes an individual employer, partnership, legal representative of a deceased employer, or a corporation. It also includes the state and every state agency, every country, every city, and all public and quasi-public corporations and agencies. 2. Under Medicare Secondary Payer guidelines, in addition to individuals (including self-employed persons) and organizations engaged in a trade or business, other entities exempt from income tax such as religious, charitable, and educational institutions. Included are the governments of the United States, the individual states, Puerto Rico, the Virgin Islands, Guam, American Samoa, the Northern Mariana Islands, the District of Columbia, and foreign governments.

Electronic bulletin board service offered by the coordination of benefits (COB) contractor. Employers who have to report on fewer than 500 workers can fulfill their requirements under the Internal Revenue Service/Social Security Administration/Health Care Financing Administration (IRS/SSA/HCFA) data match law by downloading a questionnaire entry application from the bulletin board. The information will be processed through several logic and consistency edits. Once the employer has completed the information, he or she will return the completed file through the bulletin board.

Employers who partner together to administer and manage their health insurance plan and also make purchases at discounted rates for the benefit of the members.

Group of employees who are eligible for health care benefits extended through a benefits plan provider. A contract is drawn up and an employee-employer relationship must exist. Groups that would not qualify include social clubs and independent contractors.