Health
FASB
The Financial Accounting Standards Board.
Family Dependent
A person entitled to coverage because he or she is: 1. The enrollee's
spouse, or 2. A single dependent child of either the enrollee or the enrollee's
spouse (including stepchildren or legally adopted children), and 3. A
resident of the enrollee's home.
Family Expense Policy
A policy which insures the medical expenses of all members of a family.
Federal Qualification
Approval of any HMO made by the HCFA after conducting their evaluation
of methods of doing business, documents, contracts, facilities, and systems.
Fee-for-Service Equivalency
The difference between the amount a provider receives from a reimbursement
system such as capitation (a flat charge per month, for instance) compared
to fee-for-service reimbursement.
Fee-for-Service Reimbursement
A health care system where physicians and other providers receive payment
based on their billed charge for each service provided.
Fee Maximum
The maximum amount available to a provider for specific health care services
under a contract.
Fee Schedule
A list of maximum fees for providers who are on a fee-for-service basis.
Field Underwriting
The initial screening of prospective buyers of health insurance, performed
by sales personnel "in the field." May also include quoting
of premium rates.
Financial Accounting Standards Board (FASB)
A non-governmental group that sets standards for generally accepted accounting
principles.
Fiscal Intermediary
A commercial insurer contracted by the Department of Health and Human
Services for the purpose of processing and administering Part A Medicare
claims.
501(c)(9) Trust
A voluntary employee beneficiary association.
Flat Maternity Benefit
A stipulated benefit in a Hospital Reimbursement policy that is paid for
maternity confinement, regardless of the actual cost of the confinement.
Flexible Benefit Plan
A type of program where employees can tailor their benefits to meet their
own specific needs.
Formulary
See Drug Formulary.
401Trust
Governed by IRS Codes, these accounts have limited use for tax-free funding
of postretirement benefits. An employer's 401(h) contribution is limited
to no more than 25% of total contributions to all retiree benefits, including
pension benefits. Since the health liabilities for most employers are
so large, a 401(h) could provide only incidental funding.
Franchise Insurance
A plan for covering groups of persons with individual policies having
uniform provisions, although they may differ in benefits. Individual contracts
are issued to each person with individual underwriting. It is usually
applied to groups too small to qualify for true group coverage, and the
solicitation of cases usually takes place among an employer's work force
with his consent. In Life Insurance, it is sometimes called Wholesale
Insurance. Contrast with True Group Insurance.
Fraternal Insurance
Insurance offered a special group of people, namely, members of a lodge
or a fraternal order. Such insurance may be written on an assessment basis
or on a legal reserve basis.
Free-Standing Emergency Medical Service Center
A facility whose primary purpose is the provision of care for emergency
medical conditions. Also called emergi-center or urgi-center.
Free-Standing Outpatient Surgical Center
A facility which only provides outpatient surgical services. Also called
surgi-center
Frequency
The number of times a service is provided over a given time period.
Fringe Benefits
See Employee Benefit Program.
Funding Level
The dollar amount required to purchase a particular medical care program.
Usually measured by the premium rate for an insured program, or an amount
assessed for expected claim loss and related fees under a self-funded
program.
Funding Methods
The agreed means by which an employer pays for health coverage. Future
Increase Option. An option which allows the insured to increase disability
income benefits at predetermined times, specified in the policy, without
evidence of insurability.
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