Glossary

Glossary

B

Behavioral Care
Behavioral care refers to treatment for a mental illness or disorder, a functional nervous disorder, or addiction.  Behavioral care is also commonly called psychoanalytic care or psychiatric care.

Related Terms: Mental Health Parity Act of 1996
Benefit
A benefit is a product or service that a plan pays for in part or in whole.

Related Terms: Covered Expenses, Mandated Benefits, Qualified Benefits, Qualified Medical Expenses
Benefit Booklet
A benefit booklet is the summary plan description (SPD) for a self-funded plan or the insurance certificate for a fully insured plan.

Related Terms: Summary Plan Description
Benefit Year
A benefit year refers to the fiscal 12-month period during which yearly plan design features such as the deductible, out-of-pocket maximum, and specific benefit maximums accumulate.  A benefit year is often, but not always, January 1 through December 31.

Related Terms: Plan Year
Broker/Agent
A broker or an agent is an authorized representative of a group who solicits insurance contracts and services on the group's behalf even though an insurance company or third-party administrator (TPA) may pay the broker or agent commissions.

Related Terms: Third-Party Administrator
Bundling
Bundling is a method by which two or more medical services are combined for payment.
Business Associate
A business associate is a third party that acts on behalf of a covered entity by performing a function or activity that HIPAA's Administrative Simplification rules regulate or that provides certain services (e.g., legal or consulting services) that involve the use or disclosure of individually identifiable health information.

Related Terms: Covered Entity, Health Insurance Portability and Accountability Act of 1996, Protected Health Information

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