A variety of provisions relating to health insurance designed to ensure that consumers can accurately compare insurance plans.
An unintended consequence of the Affordable Care Act when an employee is offered affordable ESI through their work place but the coverage offer is not extended to the employees’ family, or is unaffordable for the family. This leaves the employees’ spouse and/or children both ineligible for exchange subsidies and without access to other affordable coverage.
Federal Employees Health Benefits Program (FEHBP)
A health insurance program that allows federal employees, retirees, and those receiving survivor benefits to compare and select from a number of different health care plans.
Federally Qualified Health Center (FQHC)
A health care setting that meets requirements under HHS to receive additional reimbursement to carry out their mission of providing primary care services to underserved populations.
Federal Medical Assistance Percentage (FMAP)
The total percent of a state’s Medicaid expenses that are paid for by the federal government. This percentage can vary from 50 percent to 83 percent. The FMAP for beneficiaries made eligible by the Affordable Care Act’s voluntary Medicaid expansion provisions will be 100 percent initially, scaling back to 90 percent in future years.
Federal Poverty Level (FPL)
The federal government uses two different definitions of poverty. Official poverty population statistics uses the U.S. Census poverty threshold while the eligibility for public programs and subsidies is based on the poverty guidelines by the U.S. Department of Health and Human Services.
A method of paying for health or medical services. Doctors and hospitals are paid for each individual service they provide to the patient. Bills can be paid in two different ways; paid by the patient who submits the claims to the insurance company or the provider can submit for reimbursement to the patient's insurance carrier.
First Dollar Coverage
A health insurance plan that pays covered medical claims without any deductible amount paid first by the plan enrollee, can also be referred to as Zero-Deductible Health plans.
Fiscal Intermediary (FI)
Private insurance companies that are contracted to administer and handle Medicare claims.
Fiscal Year (FY)
A period used for calculating annual financial statements in business and other organizations.