Benefits Glossary


A PREMIUM is the amount you pay for insurance, using pre-tax or post-tax dollars.


A COPAYMENT (COPAY) is a fixed amount you pay for health care services or prescription drugs.


A DEDUCTIBLE is the amount you pay before your insurance begins covering certain services such as hospitalization or outpatient surgery.


COINSURANCE is the amount you pay, as a percentage of the cost of your allowed services, after you reach the deductible until you reach the plan’s out-ofpocket maximum.

Allowable Charge

An ALLOWABLE CHARGE is the dollar amount typically considered payment in full by an insurance company and an associated network of health care providers.

Out of Pocket Maximum

An OUT-OF-POCKET MAXIMUM is the most you pay per Plan Year for health care expenses, including prescription drugs. Once this limit is met, the plan pays 100% for the remainder of the Plan Year.