Glossary
Dental
Dental - often comes in the form of “100-80-50” meaning that the insurance provider pays for 100 percent of the cost of preventive care (such as cleanings and routine checkups), 80 percent of the cost of basic procedures (such as fillings), and 50 percent of the cost of more advanced procedures (such as bridges or crowns).
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Preventive care - routine dental exams and cleanings (every 6 months) are covered.
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Restorative care - Consists of any minor procedures to treat damaged or decayed teeth, like filings.
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Endodontics - More advanced damage or decay will require more involved procedures like root canals.
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Oral Surgery - Common oral surgeries include teeth removal, the drainage of infections, and gum tissue biopsies.
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Orthodontics - Installation, maintenance, and removal of braces and retainers.
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Periodontics - Involves the treatment of gum disease, infections, and lesions.
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Prosthodontics - Fittings and installations of dentures and bridges can be expensive, you will need a quality insurance policy to help alleviate this cost.
Vision
Vision - helps with the cost of examinations, treatments, prescriptions, surgical procedures, and equipment. LASIK is generally not covered by insurance because it is deemed by many providers as elective or cosmetic surgery.
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Eye Exams
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Eyewear
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Lens coatings & enhancements
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Surgery
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Cost of Service without & with insurance respectively:
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Eye Exam - $154 vs. $15 (copay)
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Eyeglass Frames - $159 vs. $9
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Eyeglass Lenses - $86 vs. $25 (copay)
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Lens Enhancements - $268 vs. $170
Disability
Disability insurance, also called Paycheck Protection, provides income if you are unable to work or earn money due to a sickness or accident.
Important Terms:
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Short Term - offers the employee a portion of their salary if they are unable to work for a short period of time (3-6 months).
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Long Term - offers the employee a portion of their salary if they are unable to work for a longer period of time (6+ months).
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Elimination Period - the period of time in which the person must be disabled before receiving benefits.
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Definition of Disability - an important distinction to be aware of. The language in the contract will either state the insured has to have a loss of income AND loss of material duties. Or, it will say the insured has to have a loss of income OR a loss of duties.
Life
3 Main Components:
Example: The insured might be a parent and the beneficiaries might be their children
Important Terms:
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Accidental Death Benefit Rider - additional life insurance coverage in the event the insured’s death is accidental.
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Waiver of Premium Rider - protects the policyholder in the event they become disabled or unable to work and can’t make their premium payments.
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Disability Income Rider - pays monthly income if the policyholder is unable to work for several months or more due to a serious illness or injury.
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Accelerated Death Benefit Rider - If the insured is diagnosed with a terminal illness, this rider allows them to collect a portion or all of the death benefit.
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Long-Term Care Rider - a type of accelerated death benefit that can be appropriated for the payment of a nursing home, assisted living, or in-home care if the insured requires help with daily living activities.
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Guaranteed Insurability Rider - allows the policyholder to purchase additional insurance at a later time without medical review.
Worksite Voluntary Benefits
Sometimes called supplemental insurance or employee-paid benefits, voluntary benefits are offered by an employer at the worksite. The most common voluntary benefits: