Insurance Glossary

The following list contains words you may see used on the Federal Benefits Programs website. If you do not see the word you are looking for, please email us at fehb@opm.gov and ask us to add it to the glossary.

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Accidental Death (FEGLI)

Death caused solely through violent, external, and accidental means. This has meaning under FEGLI if, as a direct result of the bodily injuries, independently of all other causes, you die within 1 year of the accidental injury.

Accidental Death & Dismemberment Exclusions (FEGLI)

The Office of Federal Employees' Group Life Insurance (OFEGLI) will not pay AD&D benefits if your death or loss in any way results from, is caused by, or is contributed to by:

• physical or mental illness;
• the diagnosis of or treatment of a physical or mental illness;
• ptomaine or bacterial infection (however, OFEGLI will pay AD&D benefits if the loss is caused by an accidentally sustained external wound);
• a war (declared or undeclared), any act of war, or any armed aggression against the United States, in which nuclear weapons are actually being used;
• a war (declared or undeclared), any act of war, or any armed aggression or insurrection in which you are in actual combat at the time bodily injuries are sustained;
• suicide or attempted suicide;
• injuring yourself on purpose;
• illegal or illegally obtained drugs that you administer to yourself;
• driving a vehicle while intoxicated, as defined by the laws of the jurisdiction in which you were operating the vehicle.

Accidental Dismemberment (FEGLI)

Bodily injuries caused solely through violent, external and accidental means. This has meaning under FEGLI if, as a direct result of the bodily injuries, independently of all other causes, you lose your limb(s) or eyesight in one or both eyes within 1 year of the accidental injury.

• Loss of hand means loss by severance at or above the wrist joint, or equivalent loss, as determined by OFEGLI.
• Loss of foot means loss by severance at or above the ankle joint, or equivalent loss, as determined by OFEGLI.
• Loss of sight means total and permanent absence of any usable vision in one or both eyes.

Accreditation (FEHB)

A rigorous and comprehensive evaluation process where independent organizations assess the quality of the key systems and processes that manage care organizations use. Accreditation may also include an assessment of the care and service plans are delivering in important areas of public concern such as immunization rates, mammography rates, and member satisfaction. Check your health plan's brochure for its accreditation level or look for the Health Plan Accreditation link at www.opm.gov/insure/health.

Age Multiplication Factor (FEGLI)

A factor used to determine the extra amount of Basic insurance payable at the time of your death, if you die before age 45 (also referred to as the "extra benefit").

Annuitant (General)

A former employee entitled to an annuity under a retirement system established for employees.

Assign and Assignment (FEGLI)

Your irrevocable transfer of all ownership of FEGLI coverage (except Dismemberment coverage and Option C) to another individual, corporation, or trustee.

Assignee (FEGLI)

The individual, corporation, or trustee to whom you irrevocably transfer ownership of FEGLI coverage (except Dismemberment coverage and Option C).

Assignment (Medicare related)

An arrangement where a doctor or medical supplier agrees to accept the Medicare-approved amount (see definition) as full payment for services and supplies covered under Part B. When your doctor accepts assignment, you can be billed only for the difference between the Medicare-approved amount and the combined payments made by Medicare and any secondary payer.

Automatic Cancellation of Waiver (FEGLI)

The automatic entitlement to Basic insurance and the ability to elect Optional insurance if you are reinstated after a break in service of at least 180 days.

Basic Insurance (FEGLI)

Coverage (based on your annual rate of basic pay) that you have as an eligible employee unless you waive it.

Basic Insurance Amount (FEGLI)

The amount of Basic insurance on which you pay premiums. It is determined by:

• Taking your annual rate of basic pay;
• Rounding it up to the next higher thousand (if not already an even thousand dollar amount); and
• Adding $2,000.

Brand Name Drug (FEHB)

A prescription drug that is protected by a patent, supplied by a single company, and marketed under the manufacturer's brand name.

Brochure (FEHB and FEDVIP)

A plan's description of benefits, limitations, exclusions, and definitions under the FEHB and FEDVIP Programs.

CAHPS* Consumers Assessment of Healthcare Providers and Systems (FEHB)

A survey that asks questions to evaluate members' satisfaction with their health plans.

*CAHPS is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).

Cancellation of Insurance (FEGLI)

Your written declaration that you no longer want Basic or all or part of your Optional life insurance coverage.

Cancellation of Waiver (FEGLI)

Obtaining Basic or Optional life insurance coverage after you have previously waived or cancelled it.

Catastrophic Limit (FEHB and FEDVIP)

The maximum amount of certain covered charges you have to pay out of your pocket during the year. Setting a maximum amount protects you. Separate limits are usually applied on a per person and per family basis.

Coinsurance (FEHB and FEDVIP)

The amount you pay as your share for services you receive, such as a doctor's visit. Coinsurance is a percentage of the plan's allowance for the service (you pay 20% for example).

Compensationer (General)

An employee or former employee who is entitled to compensation and whom the Department of Labor determines is unable to return to duty.

Consumer-Driven Plans (FEHB)

Describes a wide range of approaches to give you more incentive to control the cost of either your health benefits or health care under the FEHB Program. You have greater freedom in spending health care dollars up to a designated amount, and you receive full coverage for in-network preventive care. In return, you assume significantly higher cost sharing expenses after you have used up the designated amount. The catastrophic limit (see definition) is usually higher than those common in other plans. Common features include full or partial employee responsibility for several thousand dollars in expenses, and catastrophic coverage covering costs above a certain level, usually higher than those common in other plans.

Contributions (FEGLI)

Amounts which each agency is required to pay from its salary appropriations or other available funds as the employer's share of the cost of Basic insurance.

Conversion (FEHB)

The exchange of group insurance for insurance under an individual policy purchased from a private insurance company approved by the Office of Personnel Management.

Coordination of Benefits (COB) (FEHB and FEDVIP)

When you or a family member have more than one insurance plan covering the same benefits, one plan normally pays its benefits in full as the primary payer (see definition) and the other plan(s) pays a reduced benefit as the secondary payor (see definition). Payment is coordinated under the COB rule to ensure that no more than 100% of any claim is paid by both plans.

Medicare related - If you and/or your family member are covered under both Medicare and FEHB, Medicare makes the final determination as to whether they are the primary payor.

See Section 9 (Coordinating benefits with other coverage) of your FEHB brochure.

Copayment (FEHB and FEDVIP)

The amount you pay as your share of services you receive, such as a doctor's visit. Copayment is a fixed dollar amount (you pay $15 for example).

Court Order (FEGLI)

A court decree of divorce, annulment, or legal separation, or a court order or court-approved property settlement agreement relating to any court decree of divorce, annulment, or legal separation, the terms of which require FEGLI benefits to be paid to a specific person or persons.

Covered Charges (FEHB and FEDVIP)

Services or benefits for which the health plan makes either partial or full payment, subject to any applicable deductible.

Deductible (FEHB and FEDVIP)

The dollar amount of covered expenses an individual or family must pay out of pocket before an FEHB or FEDVIP plan begins to pay benefits. There may be separate deductibles for different types of services. For example, a plan can have a prescription drug benefit deductible or an outpatient deductible separate from its calendar year deductible.

Designation of Beneficiary (FEGLI)

Notice, signed by you and witnessed by two persons, indicating the person(s) you want to receive your life insurance benefits. The form generally used for life insurance designations is the Designation of Beneficiary form (SF 2823).

Durable Medical Equipment (DME) (FEHB)

Medical equipment ordered by a doctor for use in the home. DME must be re-usable. DME includes items such as walkers, wheelchairs, and hospital beds. Check the FEHB plan brochure to see if there are limitations or exclusions on the types of equipment covered.

Enroll (General)

You enroll when you first sign up to join a Program.

Extension of Coverage (FEGLI)

Automatic continuation of your life insurance coverage for 31 days after your life insurance terminates, except by your waiver or cancellation of coverage. Accidental Death & Dismemberment coverage is not included.

FEDVIP

The Federal Employees Dental and Vision Insurance Program

Fee-for-Service (FFS) Plan (FEHB)

Health coverage in which doctors and other providers receive a fee for each service such as an office visit, test, procedure, or other health care service. The plan will either pay the medical provider directly or reimburse you for covered services after you have paid the bill and filed an insurance claim. When you need medical attention, you visit the doctor or hospital of your choice; the amount the plan plays may depend on whether the provider has a participation agreement with the plan.

FEGLI

The Federal Employees' Group Life Insurance Program

FEHB

The Federal Employees Health Benefits Program

First Payor (FEDVIP)

If you and/or your family member are covered under both an FEHB plan and a FEDVIP plan, the FEHB plan is considered the primary payor and pays first, while the FEDVIP plan is considered the secondary payor. If you are enrolled in a High Deductible Health Plan (HDHP), your FEDVIP plan is considered the primary payor and the HDHP is considered the secondary payor.

See Section 3 (How You Obtain Care) of your FEDVIP brochure for more information.

FLTCIP

The Federal Long Term Care Insurance Program

Formulary or Prescription Drug List (FEHB)

A list of both generic and brand name drugs, often made up of different cost-sharing levels or tiers that are preferred by your health plan. Health plans choose drugs that are medically safe and cost-effective. A team, including pharmacists and physicians, meets to review the drug list and make changes as necessary.

FSAFEDS

The Federal Flexible Spending Account Program

Generic Drug (FEHB)

A generic medication is an equivalent of a brand name drug (see definition). A generic drug provides the same effectiveness and safety as a brand name drug and usually costs less. A generic drug may have a different color or shape than its brand name counterpart, but it must have the same active ingredients, strength, and dosage form (pill, liquid or injection).

Health Maintenance Organization (HMO)

A type of health benefits plan that provides care through a network of physicians and hospitals in particular geographic or service areas. HMOs coordinate the health care services you receive and free you from completing paperwork or being billed by the provider for covered services. Your eligibility to enroll in an HMO is determined by where you live or, for some plans, where you work. Some FEHB HMOs have agreements with providers in other service areas for non-emergency care if you travel or are away from home for lengthy periods. If you or a covered family member moves out of the plan's service area (or your job location changes) you may change your enrollment to another plan without waiting for Open Season.

Health Reimbursement Arrangement (HRA) (FEHB)

An HRA is an employer-funded tax-sheltered account to reimburse allowable medical expenses. HDHP members, who do not qualify for an HSA, will be provided an HRA. There is no additional paperwork needed for enrollment into the HRA. Please visit HRA for more information.

Health Savings Account (HSA) (FEHB)

An HSA is a tax-sheltered trust account you own for the purpose of paying qualified medical expenses for yourself, your spouse, and your dependents. When you enroll in an HDHP, the health plan determines whether you are eligible for a Health Savings Account (HSA) or a Health Reimbursement Arrangement (HRA) based on the information you provide. Please visit the HSA section for more information.

HEDIS*

Healthcare Effectiveness Data and Information Set (FEHB). A set of health plan performance measures that center on how the plan performs in preventing and treating common conditions (e.g., cervical cancer screening, prenatal care, diabetes care) that reflect a plan's quality of care and services. The National Committee for Quality Assurance (NCQA) requires HEDIS and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) accepts HEDIS in accrediting health plans.

*HEDIS is a registered trademark of the National Committee for Quality Assurance.

High Deductible Health Plan (HDHP) (FEHB)

Provides comprehensive coverage for high-cost medical events and a tax-advantaged to help you build savings for future medical expenses. The HDHP/HSA or HRA gives you greater flexibility and discretion over how you use your health care benefits.

The HDHP features higher annual deductibles (a minimum of $1,300 for Self Only and $2,600 for Self Plus One and Self and Family coverage) than traditional health plans. The maximum amount out-of-pocket limits for HDHPs participating in the FEHB Program for Self Only, Self Plus One and Self and Family enrollments are based on IRS rules. With the exception of preventive care, you must meet the annual deductible before the plan pays benefits. Preventive care services are generally paid as first dollar coverage or after a small deductible or copayment. A maximum dollar amount may apply.

When you enroll in an HDHP, the health plan determines if you are eligible for a Health Savings Account (HSA) or a Health Reimbursement Arrangement (HRA). Each month, the plan automatically credits a portion of the health plan premium into your HSA or HRA, based on your eligibility as of the first day of the month. You can pay your deductible with funds from your HSA or HRA. If you have an HSA, you can also choose to pay your deductible out-of-pocket, allowing your savings account to grow.

If you are enrolled in a FEDVIP plan and you have a High Deductible Health Plan (HDHP), your FEDVIP plan is considered the primary payor and the HDHP is considered the secondary payor.

Incontestability (FEGLI)

A statutory provision permitting erroneous enrollments that have continued for at least two years to become valid, if you have paid the applicable premiums during the period of erroneous coverage.

In-Network (FEHB and FEDVIP)

You receive treatment from the doctors, clinics, health centers, hospitals, medical practices and other providers with whom your plan has an agreement to care for its members.

Inpatient Care (FEHB)

All types of health services that require an overnight hospital stay.

Inter Vivos Trust (FEGLI)

A trust that you establish during your lifetime.

Living Benefits (FEGLI)

Basic insurance benefits (full or partial) paid to you while you are still living, rather than paid to a beneficiary when you die. You must be terminally ill, with a life expectancy of 9 months or less, to qualify for a living benefit.

Medicare

The Federal health insurance program for people 65 years of age or older, certain younger people with disabilities, and people with End-Stage Renal Disease (those with permanent kidney failure who need dialysis or a transplant, sometimes called ESRD). Please visit www.medicare.gov for more information.

Medicare Advantage

A new Medicare program that provides more choices among health plans. Everyone who has Medicare Parts A and B is eligible, except those who have End-Stage Renal Disease (ESRD). Please visit www.medicare.gov for more information.

Medicare-Approved Amount

The amount Medicare determines to be reasonable for a service that is covered under Part B of Medicare. It may be less than the actual charge.

Medigap

A supplemental private insurance policy that you can buy for extra benefits either not covered or not fully covered by Medicare. There are 10 standard Medigap plans, ranging from a basic benefits package to ones that cover expenses such as the Part A deductible, Part B deductible, prescription drugs, and/or the skilled nursing coinsurance. Please visit www.medicare.gov for more information.

Nationwide Plan (FEHB and FEDVIP)

A plan that provides services throughout the United States and around the world.

OFEGLI

The Office of Federal Employees' Group Life Insurance, which makes payments to beneficiaries under the policy. OFEGLI is not a Federal agency. It is staffed by employees of the contracted life insurance carrier. The mailing address for OFEGLI is P.O. Box 6512, Utica, NY 13504-6512; the street address is 5950 Airport Rd., Oriskany, NY 13424-3926.

Open Season (General)

An open enrollment period held every year from the Monday of the first full work week in November through Monday of the first full work week in December when individuals eligible for the FEHB Program, FEDVIP, and FSAFEDS can enroll, or if already enrolled, change their enrollment.

FEGLI and FLTCIP do not participate in the annual Open Season. FEGLI Open Seasons are held infrequently and are announced by OPM. Individuals eligible for FLTCIP can apply for coverage at any time.

OPM

The U.S. Office of Personnel Management.

Option A (FEGLI)

$10,000 in coverage that you can elect in addition to Basic insurance also called Standard Optional insurance.

Option B (FEGLI)

Coverage, equal to up to 5 multiples of your annual basic rate of pay, that you can elect in addition to Basic insurance also called Additional Optional insurance.

Option C (FEGLI)

Coverage, to insure your spouse and eligible child(ren), that you can elect in addition to Basic insurance also called Family Optional insurance.. You can elect up to 5 multiples of the coverage amounts (each multiple equals $5,000 for a spouse and $2,500 for an eligible child).

Optional Insurance (FEGLI)

Insurance that you can elect in addition to Basic insurance. There are three types of Optional insurance: Option A (Standard Optional insurance), Option B (Additional Optional insurance), and Option C (Family Optional insurance).

Order of Precedence (FEGLI)

Under Federal law, the order in which life insurance benefits are paid to your survivors:

• If you assigned ownership of your life insurance by filing an Assignment, Federal Employees' Group Life Insurance (RI 76-10), OFEGLI will pay benefits:
  • First, to the beneficiary(ies) designated by your assignee(s), if any;
  • Second, if there is no such beneficiary, to your assignee(s).
• If you did not assign ownership and there is a valid court order (see page 22) on file, OFEGLI will pay benefits in accordance with that court order.
• If you did not assign ownership and there is no valid court order (see page 22) on file, OFEGLI will pay benefits
• Your designated beneficiary or beneficiaries;
• If there is no designated beneficiary, to your widow or widower;
• If neither of the above, to your child or children in equal shares, with the share of any deceased child distributed among the descendants of that child (see "Payment to a Minor");
• If none of the above, to your parents in equal shares - or the entire amount to the surviving parent;
• If none of the above, to the executor or administrator of your estate;
• If none of the above, to the next of kin as determined under the laws of the State where you lived.

The order of precedence does not apply when you have assigned your insurance or when a valid court order is on file.

Original Medicare

The traditional fee-for-service arrangement that includes Part A and Part B coverage. Please visit www.medicare.gov for more information.

Out-of-Network (FEHB and FEDVIP)

You pay more when you receive treatment from doctors, hospitals, and medical practitioners other than those with whom the plan has an agreement. If you are in a PPO-only option and receive services outside the PPO network, you will generally pay all charges.

Out-of-Pocket Costs (FEHB and FEDVIP)

Health care costs that you must pay because they are not paid for by insurance, such as deductibles, your share of coinsurance, copayments, and all noncovered expenses.

Outpatient Care (FEHB)

All types of health services that do not require an overnight hospital stay.

OWCP

The Office of Workers' Compensation Programs, U.S. Department of Labor, which administers subchapter I of chapter 81 of title 5, United States Code.

Pay and Duty Status (General)

Time when you are actually at work; it does not include time on annual or sick leave, leave without pay, excused absence or other absence from duty.

Point of Service (POS) (FEHB)

A product offered by an HMO (see definition) or FFS (see definition) plan that has features of both. In an HMO, the POS product lets you use providers who are not part of the HMO network. However, there is a greater cost associated with choosing these non-network providers. You usually pay deductibles and coinsurances that are substantially higher than the payments when you use a plan provider. You will also need to file a claim for reimbursement, like in an FFS plan. The HMO plan wants you to use its network of providers, but recognizes that sometimes enrollees want to choose their own provider.

FFS plans generally have deductibles and coinsurance. But in some locations, plans have a POS network of providers similar to what you would find in an HMO. The FFS plan encourages you to use POS network providers, usually by waiving the deductibles and applying a copayment that is smaller than the normal coinsurance. Generally, there is no paperwork when you use a POS network provider.

Post-65 Reduction in Insurance (FEGLI)

The amount by which your insurance coverage reduces after your 65th birthday (or retirement, if later). For Basic insurance, the choices are 75% Reduction, 50% Reduction, and No Reduction. For Option B and Option C, the choices are Full Reduction and No Reduction. There is no choice for Option A; it reduces by 75%.

Preauthorization/Prior Approval (FEHB)

Assurance from the plan that benefits will be provided. Most plans require preauthorization/prior approval for certain services and supplies. See your plan brochure for details.

Precertification (FEDVIP)

Also called predetermination. This is the procedure used by dental offices to determine what services a plan will cover and how much will be paid before the service is rendered. See Section 3 (How You Obtain Care) of your FEDVIP brochure for more information.

Pre-existing Condition (FEHB, FEDVIP and FLTCIP)

A health condition that exists prior to enrolling in an insurance program. The FEHB Program and FEDVIP may not deny your enrollment based on you or your family member having a preexisting condition. FLTCIP may not deny approval of benefits for someone already enrolled based on a pre-existing condition.

Preferred Provider Organization (PPO) (FEHB)

Under the FEHB Program, PPOs are only available through enrollment in a Fee-For-Service plan. The PPO is similar to FFS insurance except it uses a network of providers. PPO's give you the choice of using doctors and other providers within the plan's network (the PPO benefit), or using ones outside the plan's network. You don't have to use the PPO, but you pay less money out-of-pocket for medical services when you use an in-network provider. (Be aware, however, that some of the services provided in a PPO hospital may not be covered by PPO arrangements. Room and board will be covered, but anesthesia and radiology, for instance, may be covered under non-PPO benefits.)

Premium (General)

The amount you pay for insurance.

Premium Conversion (FEHB and FEDVIP)

program that allows Federal employees to use pre-tax dollars to pay insurance premiums for the FEHB Program and FEDVIP. Based on Federal tax rules, employees can deduct their share of health insurance, dental insurance and vision insurance premiums from their taxable income, which reduces their taxes.

Preventive Care (FEHB)

Care to keep you healthy or to prevent illness, such as routine checkups and flu shots, and some tests like colorectal cancer screening and mammograms.

Primary Payer (FEHB and FEDVIP)

When coordinating benefits, the health plan that pays benefits first on a claim for medical care or dental care.

Provider Network (FEHB and FEDVIP)

A group of providers who have a contract with a specific FEHB or FEDVIP plan to provide services at an agreed upon cost.

Qualifying Life Event (QLE)

An event that may allow individuals eligible for the FEHB Program, FEDVIP, FEGLI or FSAFEDS to enroll, or if already enrolled, to cancel or change their enrollment outside of an Open Season. Qualifying Life Events are not the same for all the Programs. There are no specific QLEs for the FLTCIP. You may apply for coverage or make changes to your coverage at any time, although some changes may require you to answer additional questions related to your health (underwriting). Your answers to these additional questions may prevent you from making the change to your coverage.

Quality

Quality is how well insurance plans keep their members healthy or treat them when they need care. Good quality health care means doing the right thing at the right time, in the right way, for the right person - and getting the best possible results.

Reconsideration (FEHB)

The final level of administrative review of an agency's initial decision to determine if the employing office followed the law and regulations correctly in making the initial decision.

Referral (FEHB)

Your primary care doctor's written approval for you to see a certain specialist or to receive certain services. Most FEHB HMOs and some Medicare health plans may require referrals. Important: If you either see a different doctor from the one on the referral, or if you see a doctor without a referral and the service isn't for an emergency or urgently needed care, you may have to pay the entire bill.

Regional Plan (FEDVIP)

A FEDVIP plan which provides services only in specified geographic regions.

Secondary Payer (FEHB)

When coordinating benefits, the health plan that pays benefits only after the primary payer has paid its full benefits. When an FEHB fee-for-service plan is the secondary payer, it will pay the lesser of a) its benefits in full, or b) an amount that when added to the benefits payable by the primary payer, equals 100% of covered charges.

Self Only (FEHB and FEDVIP)

Under the FEHB Program and FEDVIP, this is an enrollment type that covers only the enrolled employee or annuitant. You may choose a Self Only enrollment even though you have a family; however, your family members will not be covered. Note: If you die while in a Self Only enrollment your family members will not be able to enroll in the FHEB Program even if they are entitled to a survivor annuity.

Self Plus One (FEHB and FEDVIP)

an enrollment type that covers you as the enrolled employee or annuitant plus one eligible family member whom you specify. You may choose a Self Plus One enrollment even though you have additional eligible family members, but the additional family members will not be covered.

Self and Family (FEHB and FEDVIP)

Under the FEHB Program and FEDVIP, an enrollment type that covers you as an employed enrollee or annuitant and all of your eligible family members.

Service Area (FEHB)

For plans that make you use their doctors and hospitals, it is the geographic area where the plan provides services - you must live (or sometimes work) in the service area in order to enroll in the plan. Some plans accept enrollment from potential members who live or work in a larger geographic area beyond the service area call the plan enrollment area. See your FEHB plan brochure for service area information.

Suspension of FEHB Enrollment (FEHB)

An annuitant, survivor annuitant, or former spouse covered under the Spouse Equity provision of FEHB law may suspend their FEHB enrollment in order to enroll in a Medicare Advantage plan (Medicare Part C), TRICARE, CHAMPVA, Medicaid or a similar state-sponsored program of medical assistance for the needy, or use Peace Corps health insurance coverage, but still retain the right to reenroll in FEHB. Please visit www.medicare.gov for more information.

If you cancel your FEHB coverage as an annuitant, you probably may never reenroll.

Term Life Insurance (FEGLI)

Life insurance available through an employer or association that covers participating employees and members under one master insurance policy. Most group life insurance policies are term insurance policies that terminate when the member or employee reaches a certain age or leaves the organization and do not accumulate any cash surrender value.

Terminal Leave (FEGLI)

Leave taken immediately prior to separation. Terminal leave is generally prohibited except with specific authority.

Terminally Ill (FEGLI)

For purposes of qualifying for a living benefit, this is a medical prognosis of a life expectancy of 9 months or less.

Testamentary Trust (FEGLI)

A trust that is created by your will at your death.

TRICARE (General)

the US military members, family and retirees health insurance plan.

Underdeduction (FEGLI)

A failure to withhold the required amount of life insurance deductions from your pay, annuity, or compensation. This includes non deductions (when none of the required amount is withheld) and partial deductions (when only part of the required amount is withheld). If there is no pay during a pay period, there is no under deduction.

Underwriting (FEGLI)

Applying for FEGLI coverage by providing medical evidence of insurability to OFEGLI.

Usual, Customary and Reasonable (UCR) (FEDVIP)

A widely used method, which may vary from company to company, to determine benefit reimbursement levels. The initials simply mean:

• Usual. The fee that an individual dentist most frequently charges for a given dental service.
• Customary. A fee determined by the insurance company based on the range of usual fees charged by dentists in the same geographic area.
• Reasonable. A fee which is justifiable considering special circumstances of the particular care rendered.

Viatical Settlement Firm (FEGLI)

A private company that exchanges cash for assignment of life insurance to a terminally or chronically ill person.

Waiting Period (FEHB and FEDVIP)

The length of time a person must be covered under an insurance plan before they are eligible for certain benefits. There are no waiting periods under the FEHB Program. Under FEDVIP, most plans have a 24 month waiting period for orthodontic benefits. This means that you must be covered continuously by the same FEDVIP plan for 24 months before you are eligible for orthodontic coverage.

Waiver of Insurance (FEGLI)

Your written decision upon your employment or reemployment that you do not want any life insurance coverage.

Withholdings (FEGLI)

Amounts deducted from your pay, annuity, or compensation for the full cost of Optional life insurance and your share of the cost of Basic insurance.

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