(Also known as a Primary Care Physician) A health care professional, usually a primary care physician, who coordinates, manages and authorizes all health care services provided to a covered beneficiary in a traditional HMO plan. This physician is chosen from a network of providers by a member of a health maintenance organization to direct and approve the individual’s medical treatment and referrals to specialists. Unless an emergency exists, the gatekeeper usually must pre-authorize referrals to specialists, hospitalizations, and lab and radiology tests.
See guaranteed investment/guaranteed interestcontract.
Employee benefits and incentives linked to an individual’s continued employment with an organization. Leaving the organization would result in forfeiting the value of these benefits.
An employment contract that provides executives with significant compensation payments if the company is sold, dissolved, or restructured; if there is a change of control; or if the position is changed or terminated.
See group permanent insurancecontract.
A specified period after a premium payment is due during which the policyholder may make such payment and the protection of the policy continues.
Individuals that accrued benefits at least $562,500 on August 1, 1986 could have elected to use a the grandfather rule which exempts from the excise tax those benefits accrued as of August 1, 1986.
This is a process that allows you to complain about services provided or not provided to you by your managed care organization.
Group annuity contract
A contract obtained from a life insurance company that guarantees payment of pension benefits to a group of employees; commonly used to meet funding requirements for terminating plans.
Any incentive that focuses on work teams or a group of workers operating as a unit.
Group life insurance
Life insurance, usually without medical examination, on a group of people under a master policy. It is typically issued to an employer for the benefit of employees or to members of an association (e.g., a professional membership group). The individual members of the group hold certificates as evidence of their insurance.
Group permanent insurance
A benefits plan that usually combines life insurance with retirement benefits and uses the level premium method under a group contract between the employer and the insurance company.
Group permanent insurance contract (GPI contract)
An investment method used by insured pension plans whereby annuities or ordinary life insurance contracts are purchased as benefits accrue under the plan. Plan participants receive certificates that indicate the benefits they have accrued and the conditions of coverage that result from a master contract between the plan sponsor and the insurance company.
Group term life insurance
Annual renewable term life insurance covering a class or classes of employees, in accordance with a stipulated schedule of benefits.
Group universal life plan (GULP)
A form of group life insurance that combines term protection for designated beneficiaries with an investment element for the policyholder, which can be used to create nontaxable permanent insurance or to accumulate tax- deferred capital. Participation is voluntary, and premiums are paid by employees.
contract (GIC) An investment vehicle that entails a fixed investment for a specific period at a guaranteed interest rate. GICs are commonly offered by insurance companies.
Guaranteed renewable contract
A contract that the insured person or entity has the right to continue in force by the timely payment of premiums for a substantial period. During this period, the insurer has no right to make unilaterally any change in any provision of the contract while the contract is in force, other than a change in the premium rate for classes of policyholders.
See group universal life plan.
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