Consumer Tools - Glossary of Terms

Terms beginning with the letter F:

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.

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 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.

First Dollar coverage - Insurance coverage with no front-end deductible where coverage begins with the first dollar of expense incurred by the insured for any covered benefit.

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.

Flexible Spending Account (FSA) - A plan that provides employees a choice between taxable cash and non-taxable benefits for unreimbursed health care expenses or dependent care expenses. This plan qualifies under Section 125 of the IRS Code. See also Medical Spending Account.

Formulary
See Drug Formulary.

Free-Standing Outpatient Surgical Center
A facility which only provides outpatient surgical services. Also called surgi-center.

Fringe Benefits
See Employee Benefit Program.

Fully Insured
An Employer purchases insurance coverage from a licensed insurance company and the insurance company assumes all of the risk.

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. (H) 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.