Health Insurance Glossary

On occasion, there are questions about what a specific word or term means in the context of health
insurance. This glossary is intended to serve as a tool to assist you in understanding some of the
most common terms.


ACA Penalties by Company Size

The following is ageneral overview of the penalties that may apply if employers do not complywith key provisions of the Affordable Care Act. The information is subject to change based onnew government requirements or amendments to the law.Additionally, your company or group health plan may be exempt from certain requirements and/or subject to more stringent requirements under your state's laws.


HSA FSA HRA Comparison

Health Savings Accounts (HSA)Health Flexible Spending Arrangements (FSA)Health Reimbursement Arrangements (HRA)


Group Health Plan Notices

Basic Notice and Filing Requirements (SPD • SMM • Form 5500)


Nondiscrimination & Classing Rules for Health Plans

Group health plans and tax-favored accounts—including health savings accounts (HSAs), health
flexible spending arrangements (health FSAs), and health reimbursement arrangements (HRAs)—
are subject to numerous nondiscrimination provisions under federal law. As a result, employers
that wish to adopt arrangements that exclude certain classes of employees from group health plan
coverage or offer different benefits or contributions to different classes of employees (e.g.,
managerial vs. non-managerial) must analyze these arrangements under several laws to determine
whether such treatment is permissible. The following provides a summary of key nondiscrimination
requirements that may apply to group health plans and tax-favored accounts under federal law.


Pay or Play Calculators and Guidance

This tool provides step-by-step guidance to help applicable large employers (ALEs) understand
key areas of the Affordable Care Act's "pay or play" provisions, including:
 Calculators to help determine ALE status, coverage affordability, and penalty amounts;
 How to identify full-time employees;
 How to determine whether coverage is affordable and provides minimum value; and
 How to determine if a penalty applies.


2020 Benefits Notices for Open Enrollment Chart

The following list provides an overview of the key required health benefits notices that can be
included in an employer's open enrollment materials for the 2020 plan year in order to satisfy its
distribution obligations under federal law. While some of the notices must be provided annually
(and/or at certain other times outside of the open enrollment period), many employers choose to
include these notices in their open enrollment materials for administrative convenience.


Federal & State COBRA Requirements Chart

The federal Consolidated Omnibus Budget Reconciliation Act (COBRA) generally requires employers with 20 or more employees with group health


Benefits Notices Electronic Distribution Guidelines

Employers are increasingly using electronic media in connection with their
employee benefit plans, including their group health plans. In general,
federal law allows employers to provide most health plan notices
electronically, provided they comply with certain rules regarding
electronic delivery.

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